M.S.G. Peeris

The Crown sought to admit expert evidence from Dr. Neil Lazar in a criminal trial for manslaughter and criminal negligence causing death against Joanna Flynn, a registered nurse.

The proposed evidence concerned medical ethics and accepted practices in ICUs regarding end-of-life decision-making, including determination of death, discontinuing life support, and obtaining informed consent from substitute decision-makers.

The defence opposed, arguing irrelevance, lack of qualification, and prejudicial effect.

The court applied the two-stage Mohan/White Burgess test for expert evidence admissibility.

It found Dr. Lazar qualified as an expert in medical ethics and ICU decision-making.

The court ruled that evidence regarding the 24-hour wait period before terminating life support and the process of obtaining informed consent from a substitute decision-maker was admissible, as it was relevant and necessary for the jury.

However, evidence related to the technical declaration of "brain death" and the specific GBGH Discontinuation of Life Support policy was deemed irrelevant or outside Dr. Lazar's expertise for interpretation and thus inadmissible.

Joanna Flynn, a registered nurse, was charged with manslaughter and criminal negligence causing death after discontinuing a patient's life support.

The Crown sought to examine hospital physicians and nurses regarding their awareness and understanding of hospital policies and practices concerning life support discontinuation, informed consent, and pronouncing death.

The defence argued this evidence was not logically relevant to the standard of care, which requires expert testimony, and that its probative value was outweighed by its prejudicial effect.

The court dismissed the Crown's application, ruling that the understanding and experience of other hospital staff could not establish the standard of care for a "reasonable" or "reasonably prudent" person, which must be determined by expert evidence.