Wis JI-Children 280

The petition in this case alleges that the unborn child of (expectant mother) is in need

of protection or services. Your role as jurors will be to answer the following questions in the

special verdict:

1. Does (expectant mother) habitually lack self-control in the use of (alcohol

beverages) (controlled substances) (controlled substance analogs) exhibited to a

severe degree?

If the answer to question 1 is "yes," answer question 2:

2. Does (expectant mother)'s habitual lack of self-control in using (e.g., alcohol

beverages) present a substantial risk that the physical health of the unborn child, and

of the child when born, will be seriously affected or endangered unless (expectant

mother) receives prompt and adequate treatment for the habitual lack of self-control?

In answering question 1, the term "habitually" means conduct established by or

repeated by force of habit. "Self-control" means control of oneself as shown by restraint

exercised over one's own impulses, emotions, or desires. In determining whether a lack of

self-control is exhibited to a severe degree, you may consider the frequency of use, the

duration of the use, and the amount used. In answering question 1, you must consider the

facts and circumstances as they existed on (_________________), which was the date on

which this petition was filed. Your answer must reflect your finding as of that date.

If you are to answer question 2, the term "substantial risk" means that a significant and

appreciable threat exists. The physical health of an unborn child and the child when born is

seriously affected or endangered if the expectant mother's failure to receive prompt and

adequate treatment for the lack of self-control in using (alcohol beverages) (controlled

substances) (controlled substance analogs) creates a significant risk that the unborn child and

the child when born will be seriously harmed. However, actual harm or injury need not have

occurred. In determining whether the physical health of the unborn child and the child when

born is seriously affected or endangered, you may consider the natural and probable

consequences of the failure to promptly receive adequate treatment. In answering question 2,

you may consider all evidence bearing on that question, including evidence of events and

conduct occurring since the filing of the petition on (________________). Your answer must

reflect your finding as of today's date.

Before you may answer either question in the special verdict "yes," you must be

convinced by evidence that is clear, satisfactory, and convincing, to a reasonable certainty,

that the question should be answered "yes." If you are not so convinced, you must answer the

question "no."

SPECIAL VERDICT

1. Does (expectant mother) habitually lack self-control in the use of (alcohol

beverages) (controlled substances) (controlled substance analogs) exhibited to a

severe degree?

Answer:__________________

Yes or No

If the answer to question 1 is "yes," answer question 2:

2. Does (expectant mother)'s habitual lack of self-control in using (e.g., alcohol

beverages) present a substantial risk that the physical health of the unborn child, and

of the child when born, will be seriously affected or endangered unless (expectant

mother) receives prompt and adequate treatment for the habitual lack of self-control?

Answer:__________________

Yes or No