Health Law

The appellant appealed a not criminally responsible on account of mental disorder (NCRMD) verdict entered on February 24, 2017, following a psychiatric assessment that concluded the appellant did not know his actions were wrong due to untreated schizophrenia.

The appeal was based on serious procedural defects at the hearing, including failure to arraign the appellant, failure to take a plea, failure to make elections on four of five charges, failure to read facts into the record, absence of viva voce evidence, and failure to address the appellant or allow him to speak.

The Crown conceded the procedural flaws warranted setting aside the verdict.

The court allowed the appeal, set aside the NCRMD verdict, and ordered a new trial.

B.B. appealed decisions of the Consent and Capacity Board that confirmed her incapacity regarding treatment with antipsychotic medications and a community treatment plan, and upheld a community treatment order.

The Superior Court of Justice dismissed the appeal, finding no palpable and overriding error in the Board's conclusions regarding B.B.'s lack of capacity, the likelihood of substantial mental deterioration without continuing care, Dr. Pittman's consultations with health practitioners, or the substitute decision-maker's proper consent to the treatment plan.

The defendant brought a motion for summary judgment to dismiss the plaintiff's medical malpractice and informed consent action.

The plaintiff, who was self-represented for most of the litigation, failed to serve any expert medical report to support her claims, despite repeated requests from the defendant's counsel and court orders.

The court found that expert evidence was required for both the negligence and informed consent claims, and that the case did not fall within the "clearest of cases" exception.

Consequently, the court granted summary judgment, dismissing the action.

The accused, Rodney Nichols, charged with murder, sought a further extension of his fitness assessment beyond the statutory 60-day limit under the Criminal Code.

The defence argued for a liberal interpretation of the provisions to ensure a full answer and defence, citing the complexity of the psychiatric issues and the need for specialized testing.

The Crown did not oppose the request.

The court, adopting the reasoning from R. v. Reimer, held that it had jurisdiction to grant a new assessment order even after the 60-day period, interpreting the statutory time limits as directory rather than mandatory to prevent injustice and achieve the objectives of the mental disorder scheme.

The court granted a new 30-day fitness assessment order.

The appellant, A.B., appealed a disposition order from the Ontario Review Board that did not permit him to work unsupervised in the community.

The Court of Appeal found no error in the Board's decision, noting that the Board's conclusion was justified by the psychiatric evidence and the appellant's changed circumstances, including a subsequent criminal conviction while under a Board order.

The appeal was dismissed.

The Crown brought a motion for a mental health assessment of the accused, who had pleaded guilty to assault causing bodily harm.

The assessment was sought under sections 672.11(b) and 672.12(3)(b) of the Criminal Code to determine if the accused was exempt from criminal responsibility due to a mental disorder under section 16(1).

The accused opposed the application, arguing his psychotic episodes were drug-induced.

The court, reviewing a psychiatric assessment, found reasonable grounds to doubt the accused's criminal responsibility on account of a mental disorder, noting that a diagnosis of "Psychosis Not Otherwise Specified" suggested a potential underlying mental health issue beyond drug-induced psychosis.

The court granted the Crown's application, ordering the assessment.

The appellant, found not criminally responsible on account of mental disorder (NCRMD), appealed the Ontario Review Board's decision to continue his detention at a high secure unit.

He sought a transfer to a less restrictive medium secure facility.

The Court of Appeal upheld the Board's decision, finding it reasonable given the appellant's continued threat to public safety, the unsuitability of other facilities due to risk management concerns and long waitlists, and recent aggressive incidents.

The court affirmed that reweighing evidence is not its role in reviewing Board decisions.

The appellant, JS, appealed two decisions of the Consent and Capacity Board: one declining jurisdiction over his appeal regarding capacity to manage property, and another upholding a finding of incapacity to consent to antipsychotic medication.

The Superior Court of Justice allowed the appeal on property management capacity, finding the Board erred in declining jurisdiction due to an administrative glitch that denied JS his statutory right to prompt rights advice.

This issue was remitted back to the Board for a hearing on the merits.

The court dismissed the appeal on capacity to consent to treatment, finding the Board applied the correct test and had ample evidence to support its findings, without conflating mental illness with lack of capacity or failing to consider up-to-date evidence.

The appellant appealed a Consent and Capacity Board decision that confirmed his incapacity to consent to antipsychotic medication and a community treatment plan, and the validity of a community treatment order.

The court dismissed the appeal, finding that the Board correctly applied the legal standard for capacity and had ample evidence to determine the appellant's incapacity to appreciate the reasonably foreseeable consequences of treatment or lack thereof.

The court also found that the Board had a sufficient basis to confirm that all statutory criteria for issuing the community treatment order were met.

The court addressed a dispute in a medical malpractice jury trial regarding the wording of causation questions and whether the jury should provide reasons for their findings.

The plaintiffs proposed "caused or contributed to" language, while the defendants advocated for "but for" and requested reasons.

The court accepted the plaintiffs' "caused or contributed to" language, finding no compelling reason not to translate the "but for" test into everyday language, and rejected the request for the jury to provide reasons, citing the risk of confusion and violation of jury secrecy.

The applicants challenged the constitutionality of the Canadian prison needle exchange program (PNEP), specifically its "threat risk assessment" (TRA) feature, arguing it violated sections 7 and 15(1) of the Canadian Charter of Rights and Freedoms by denying effective access to essential health care.

The court dismissed the application, finding it premature due to the ongoing PNEP rollout and evolving design.

Furthermore, the applicants failed to establish that professionally accepted standards required a health services-centered model without security staff involvement, or that the PNEP/TRA model breached Charter rights by being arbitrary, overbroad, or grossly disproportionate, or by discriminating on enumerated grounds.

J.G. appealed a Consent and Capacity Board decision confirming his incapacity to consent to mental disorder treatment.

Despite J.G.'s non-attendance and failure to advance the appeal, the Superior Court of Justice proceeded, admitting fresh evidence regarding J.G.'s post-discharge condition and the respondent's efforts to contact him.

Applying appellate standards of review, the court found no palpable and overriding error in the Board's factual findings regarding J.G.'s mania and grandiosity preventing him from appreciating his condition or treatment consequences.

The appeal was denied.

A dual status offender appealed a decision of the Ontario Review Board refusing to schedule a placement hearing to determine whether his current place of custody (a penitentiary) was inappropriate to meet his mental health needs.

The appellant argued that the Review Board was obligated to review placement as part of every disposition review, or alternatively, that the Review Board should have exercised its discretion to order a placement hearing on its own motion.

The Court of Appeal upheld the Review Board's interpretation that a significant change in circumstances is a prerequisite to scheduling a placement hearing on an offender's application, and found no error in the Review Board's refusal to schedule a hearing on its own motion.

An appeal from an Ontario Review Board detention order with privileges up to the possibility of community accommodation.

The appellant challenged the Board's decision on three grounds: insufficient reasons, procedural error due to gaps in the record, and failure to adequately address why a conditional discharge was not the least restrictive disposition.

The Court of Appeal dismissed the appeal, finding no error in the Board's reasoning, no procedural defect, and that the detention order fell within a range of reasonable outcomes based on evidence of ongoing mental illness, delusional thinking, substance abuse, medication non-compliance, and lack of insight into symptoms.

The defendants brought a mid-trial motion to determine the admissibility of two reply expert reports (Prof. Shane O’Mara and Dr. Stephen Xenakis) served by the plaintiffs just before trial.

The defendants argued the reports were late and constituted impermissible case splitting.

The plaintiffs contended the lateness was due to unforeseen circumstances and that the evidence would assist the court.

The court found that the issues addressed by the reply reports were foreseeable and had already been covered by the plaintiffs' initial experts, thus constituting new evidence rather than proper reply.

The court dismissed the motion, ruling the reports inadmissible to avoid prejudice to the defendants and further trial delays, emphasizing the importance of adhering to trial schedules in a long-standing action.

The accused was charged with aggravated assault for stabbing the victim in the neck on August 14, 2017.

The accused pleaded not guilty and raised the defence of not criminally responsible on account of mental disorder under section 16 of the Criminal Code.

The Crown and defence agreed on the facts of the assault.

The defence called psychiatric evidence from two experts: Dr. Beth Eayrs and Dr. Maxym Choptiany.

At the initial hearing, the court found the evidence insufficient to establish the defence.

The hearing was reopened to allow for additional evidence.

At the reopened hearing, the court found that although the accused suffered from schizophrenia and likely experienced psychotic symptoms at the time of the offence, the evidence demonstrated that the accused had the capacity to know his actions were morally wrong and proceeded to commit the act anyway.

The court found the accused criminally responsible and convicted him of aggravated assault.

Olga Chubarev appealed a decision of the Consent and Capacity Board which found her incapable of consenting to treatment with anti-psychotic medications and confirmed the renewal of a Community Treatment Order.

The Superior Court of Justice dismissed the appeal, finding that the Board's decision was reasonable, not infected by factual error, and that the Board reasonably applied the law to the facts.

The court affirmed the Board's conclusion that the appellant was unable to appreciate the benefits of treatment and thus could not weigh them against the risks.

The appellant appealed a Consent and Capacity Board decision confirming her involuntary psychiatric admission.

She sought a declaration that a forced injection of anti-psychotic medication violated her Charter rights and requested rescission of her detention certificate as a remedy.

The central issue was whether the Board has jurisdiction to grant remedies under s. 24(1) of the Canadian Charter of Rights and Freedoms.

The Court of Appeal held that the Board does not have s. 24(1) Charter jurisdiction, despite having authority to decide questions of law.

The court found that the legislature clearly intended to exclude Charter remedies from the Board's jurisdiction based on the removal of s. 52(1) jurisdiction, strict statutory timelines, limited remedial powers, composition of the Board, and the availability of Superior Court appeals.

Application by Syl Apps Youth Centre and Dr. Rod Evans for a 180-day extension of secure treatment commitment for a 17-year-old with complex mental health diagnoses and severe self-harming behaviors.

The respondent opposed the extension, arguing that no appropriate plan for care upon release had been established.

The court granted the extension, finding that while the plan lacked specificity and detail, it was reasonable given the circumstances, including the child's complex needs, limited community resources, and the strong planning process and contingency plans in place.

The Crown sought an adjournment of a scheduled Not Criminally Responsible (NCR) hearing on the grounds that its key psychiatric witness, Dr. McDonald, was unavailable.

The court denied the adjournment, finding that the Crown had failed to exercise due diligence in securing the witness's attendance despite having known the hearing date for eight months.

The court noted that the accused had made significant progress in treatment and rehabilitation since his release on bail, and that the Crown had failed to meet the established test for adjournment under R. v. Darville.

The court proceeded to sentencing based on the accused's guilty pleas.