Consent and Capacity Board

The appellant, George Bennett, appealed a Superior Court decision that upheld a finding of incapacity by the Consent and Capacity Board regarding his ability to make treatment decisions about antipsychotic medication.

The appellant argued the Board erroneously preferred historical evidence over current evidence and erred in its assessment of his ability to appreciate the benefits of the medication.

The Court of Appeal, stepping into the shoes of the Superior Court, dismissed the appeal, finding no palpable and overriding error in the Board's decision.

The court affirmed that historical medical evidence can properly support an assessment of current capacity and that the Board was entitled to make credibility findings and prefer expert evidence.

The appellant, G.H., appealed a decision of the Consent and Capacity Board that upheld a physician's finding of her incapacity to consent to antipsychotic medication and a Community Treatment Plan (CTP), and confirmed the renewal of a Community Treatment Order (CTO).

The Superior Court of Justice dismissed the appeal, finding no palpable and overriding error in the Board's determination that G.H. was unable to appreciate the reasonably foreseeable consequences of her treatment decisions due to her mental disorder, and that the CTO criteria were met.

The court also upheld the Board's dismissal of preliminary objections.

This is an appeal from a Consent and Capacity Board decision finding the appellant, SBJ, incapable of consenting to psychiatric treatment.

The appeal raised two main issues: whether gaps in the hearing transcript prevented effective appellate review and whether the Board applied the correct test for capacity.

The court found that despite transcript gaps, no prejudice to appeal rights occurred as the core issue on appeal was a legal error in applying the capacity test, not a misapprehension of facts.

The court also found that while the Board's language regarding "gamesmanship" and "red herring" for side effects might suggest a "best interests" approach, the Board ultimately applied the correct legal test by focusing on SBJ's inability to appreciate the depth of his disorder and its manifestations.

The appeal was dismissed.

The appellant, JJ, appealed two decisions of the Consent and Capacity Board (the "Board") that confirmed his involuntary status and incapacity to consent to antipsychotic medication.

JJ argued that the Board erred in its capacity finding and in confirming his involuntary status, and that the repeated certification process constituted an abuse of process and res judicata.

The court applied an appellate standard of review (correctness for law, palpable and overriding error for fact/mixed fact and law).

The court found no palpable and overriding error in the Board's findings regarding JJ's incapacity to appreciate the consequences of his treatment decisions or in confirming his involuntary status under the Mental Health Act's "Box B" criteria.

The court also found no error in the Board's decision not to exercise its discretion to find an abuse of process, noting that the merits of the Box B criteria had not been previously tested and there were intervening events of deterioration.

The appeal was dismissed.

The appellant, MLD, appealed a community treatment order approved by the Consent and Capacity Board.

The appeal raised two main grounds: whether MLD received prompt rights advice as required by the Mental Health Act, and whether the Board erred in finding MLD unable to appreciate the foreseeable consequences of a lack of treatment.

The court dismissed the appeal, finding that the 15-day delay in rights advice was not unreasonable given diligent efforts by the rights advisor and lack of prejudice.

On the capacity issue, the court upheld the Board's majority finding that MLD lacked the ability to appreciate the foreseeable consequences of not adhering to treatment, emphasizing that the Board's weighing of conflicting evidence was not a palpable and overriding error.

The applicant appealed a Consent and Capacity Board decision finding him incapable of managing his property under the Mental Health Act.

The applicant failed to comply with the timetable for perfecting the appeal, leading the respondent to request that the appeal hearing be vacated and amicus curiae appointed.

The court granted the respondent's requests, vacating the scheduled hearing and directing the appointment of amicus curiae to assist the court in the interests of justice, pending an investigation into the applicant's legal aid status.

The appellant appealed a Consent and Capacity Board decision revoking a Community Treatment Order (CTO).

A new CTO was subsequently issued for the respondent.

The court found the appeal moot as the original dispute was no longer live and declined to exercise its discretion to hear the academic issue, dismissing the appeal.

The appellant appealed two decisions of the Consent and Capacity Board confirming a Community Treatment Order (CTO) and a finding of incapacity regarding antipsychotic medications and a Community Treatment Plan (CTP).

The appellant argued the Board erred in fact and law by misapprehending evidence and misapplying statutory tests under the Health Care Consent Act and Mental Health Act.

The court, applying a reasonableness standard of review, found the Board's decisions were reasonable, as it properly weighed the evidence of physicians and family, and correctly applied the legal tests for capacity and CTO issuance.

The appeal was dismissed.

The appellant appealed a decision of the Consent and Capacity Board that upheld a finding of his incapacity to make decisions regarding treatment with anti-psychotic medication.

The appellant argued the Board misinterpreted the capacity test under s. 4 of the Health Care Consent Act, failed to consider a breakdown in the patient-physician relationship, and misapprehended evidence.

The court dismissed the appeal, finding the Board's decision was reasonable, based on ample evidence, and correctly applied the legal test for capacity, including the requirement for corroboration of the physician's evidence.

The appellant, W.C., appealed a decision of the Consent and Capacity Board (the "Board") that confirmed his incapacity to consent to or refuse antipsychotic medication.

W.C. argued that the Board erred by accepting evidence obtained during an unlawful detention and by misinterpreting the test for capacity under the Health Care Consent Act, 1996 (HCCA).

The court dismissed the appeal, affirming that the invalidity of the appellant's admission under the Mental Health Act did not void the capacity assessment under the HCCA, and that the "fruit of the poisonous tree" doctrine does not apply in this administrative context.

The court also found that the Board's application of the HCCA capacity test was reasonable, as the Board's conclusion that W.C. was unable to weigh the foreseeable outcomes of treatment was rooted in the evidentiary record.

This application concerned the legal definition of death and the withdrawal of life support for Shalom Ouanounou, a devout Orthodox Jew, who was declared brain dead but whose family believed he was alive under Jewish law.

The applicant sought an injunction to prevent the withdrawal of life support, rescission of the initial death certificate, and a declaration that the Consent and Capacity Board had jurisdiction over such disputes.

Following Ouanounou's natural death, the court considered whether the application was moot.

Citing a recent decision in *McKitty v. Hayani*, which addressed similar issues, the court found the application moot as there was no longer a live controversy and declined to exercise its discretion to hear the academic issues.

The appellant, Timothy Keizer, appealed a decision by the Consent and Capacity Board (CCB) that found him incapable of consenting to psychiatric treatment.

The CCB had upheld Dr. Nagari's finding that Mr. Keizer suffered from delusional disorder and was incapable of applying treatment information to his circumstances due to his failure to recognize his illness.

The Superior Court of Justice allowed the appeal, finding that the Board's conclusion that Mr. Keizer suffered from a delusional disorder at the time of the hearing was unreasonable and unsupported by evidence.

The court emphasized that a patient's disagreement with a diagnosis does not automatically equate to incapacity, especially when the patient recognizes the manifestations of their condition and their refusal of treatment is based on past experience and a differing medical opinion, rather than a delusion.

The court also determined the appeal was not moot, given the potential impact on future substitute decision-maker decisions.

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.

This is a supplementary endorsement addressing Rocco Capano's appeal from two decisions of the Consent and Capacity Board.

The Board had confirmed Dr. Geagea's finding that Capano was incapable with respect to antipsychotic medication and confirmed Capano's involuntary status.

The court dismissed the appeal regarding involuntary status as moot, given Capano's discharge from CAMH.

The appeal concerning incapacity for antipsychotic medication was also dismissed, as the Board's decision was found to be reasonable and fully supported by the evidence.

The appellant, Brian Alta, appealed a decision of the Consent and Capacity Board that confirmed his involuntary status at the Centre for Addiction and Mental Health under section 20(5) of the Mental Health Act.

The Board found that Alta suffered from a mental disorder likely to result in serious physical impairment unless he remained in custody, and that he was not suitable for voluntary admission.

The Superior Court reviewed the Board's decision on a standard of reasonableness for questions of fact and mixed law and fact.

The court upheld the Board's findings, concluding that the Board reasonably considered Alta's difficulties with daily living, risk of retaliation due to aggressive behaviours, and medication mismanagement as factors contributing to serious physical impairment.

The court also found no error in the Board's assessment of Alta's unsuitability for voluntary admission, dismissing the appeal.

M.B. appealed a decision of the Consent and Capacity Board that confirmed his incapacity to manage property.

The appellant argued that the Board erred in law by misconstruing the purpose of cross-examination of an expert witness and by failing to properly evaluate the evidence against the presumption of capacity.

The court found that the Board considered all evidence holistically, including the extensive cross-examination, and did not err in its assessment.

The Board's finding of incapacity was upheld, based on M.B.'s history of poor financial decisions and persistent delusional beliefs that prevented him from understanding relevant financial information or appreciating the foreseeable consequences of his decisions.

Gayle Whalen appealed a decision of the Consent and Capacity Board, which found her incapable of consenting to treatment with anti-psychotic medications and mood stabilizers.

The appeal focused on the Board's finding that Whalen lacked the ability to appreciate the reasonably foreseeable consequences of her treatment decisions, as per section 4(1) of the Health Care Consent Act, 1996.

The Superior Court of Justice upheld the Board's decision, finding that the Board applied the correct legal test and that its conclusion was reasonable, given the evidence of Whalen's persistent denial of her mental disorder and need for treatment.

The appeal was dismissed without costs.

This is an appeal from a Consent and Capacity Board (CCB) decision ordering the substitute decision-maker (SDM) to consent to the withdrawal of life support for her husband.

The appellant, the husband's wife, challenged the CCB's jurisdiction to make a decision binding on her and its finding that cessation of life support was in the patient's best interests.

The court affirmed the CCB's decision, finding its procedural approach reasonable and its determination of the patient's best interests supported by the evidence, including the adequacy of accommodations for the appellant's communication disabilities.

The court heard urgent applications and a cross-application for the appointment of a guardian for personal care and property for an incapacitated individual.

The primary applicant sought guardianship to challenge a doctor's life support plan at the Consent and Capacity Board, while the cross-applicant (spouse) intended to consent to the plan if appointed.

The court dismissed both applications for guardianship of personal care, finding that the need for decisions could be met by a less restrictive alternative, specifically by allowing the Consent and Capacity Board to determine the appropriate substitute decision-maker.

The court emphasized that the Board is the expert body for such life-and-death decisions.

Applications for guardianship of property were adjourned.

The primary applicant was ordered to pay partial indemnity costs to the spouse and a statutory fee to the Public Guardian and Trustee, partly due to the inappropriate conduct of counsel and the lack of admissible evidence.

The applicant sought leave to appeal an order dated January 27, 2017, which authorized the interim administration of clozapine under the Health Care Consent Act, pending an appeal from a decision of the Consent and Capacity Board.

The applicant also sought a stay of the interim treatment order if leave was granted.

The court dismissed the motion for leave to appeal, finding that the applicant failed to meet the two-part test under Rule 62.02(4) of the Rules of Civil Procedure.

Specifically, there was no conflicting decision on a matter of principle, nor was there sufficient reason to doubt the correctness of the original order.

The court also noted that the proposed appeal did not involve matters of such importance to warrant leave, particularly given the applicant's strategic decision not to accelerate the main appeal involving constitutional issues.