Court File and Parties

Ontario Court of Justice

Date: July 21, 2017

Court File No.: Halton 0300/10

Between:

Julie Anne Bilodeau Applicant (Mother)

— AND —

Martin Gegus Respondent (Father)

Before: Justice Marvin Kurz

Heard on: July 14, 2017

Reasons for Judgment released on: July 21, 2017

Counsel:

• Jennifer Treloar, counsel for the applicant
• Martin Gegus, on his own behalf

Judgment

KURZ J.:

Overview

[1] There is good news and bad news for thirteen-and-a-half year old Luke Patrick Bilodeau Gegus, born November 20, 2003 ("Luke" or "the child"). The good news is that his parents have been able to discover one of the roots of his behavioural and academic problems at school. He suffers from Attention Deficit Hyperactivity Disorder ("ADHD"). While that diagnosis alone is not a cure-all that will make Luke an A+ student, it is an important step in improving his academic success.

[2] The bad news for Luke is that his parents cannot agree on the manner of his ADHD treatment. More to the point, they cannot agree whether he should be treated with ADHD medication. This motion asks me to decide whether ADHD medication should be one of the tools available to treat Luke's disorder.

[3] Luke's mother, Julie Anne Bilodeau ("the mother" or "Ms. Bilodeau"), wants to allow him the opportunity to be treated with ADHD medication under the supervision of his pediatrician as appropriate. She asks me to order that she be solely able to consent to the administration of such medication as prescribed by Luke's pediatrician. She also asks me to prohibit Luke's father, Martin Gegus ("the father" and "Mr. Gegus"), from discussing ADHD medication with Luke or attempting to dissuade him from its use.

[4] Mr. Gegus opposes this motion. He feels that he is like Luke and turned out just fine without medication. He has done his own research on the internet and turned up articles that oppose the use of ADHD medication. He asks me to dismiss the mother's motion and instead order both parents to meet with Luke's pediatrician in a collaborative manner to determine the course of Luke's ADHD treatment.

[5] Mr. Gegus claims to speak for Luke. He states that Luke does not want to be prescribed ADHD medication. In his oral argument he admitted that he spoke to Luke and even took the child to his pediatrician to discuss the issues in this motion, all without the mother being present.

[6] The psychologist who diagnosed Luke has stated that medical treatment, that is medication, is usually necessary to enable students with ADHD to succeed in high school and university. Luke's pediatrician has stated that both the recommendations of the American Academy of Pediatrics and the science point to medication as the single most effective form of intervention for children with ADHD.

[7] This motion raises the following issues:

1. What treatment modality for ADHD is in Luke's best interests?
2. When Luke's parents cannot agree on a treatment modality, how should decisions about treatment for his disorder be made?
3. Should the father be forbidden from trying to influence Luke against ADHD medication?

[8] The key issue here is whether Luke will be dragged as an ally into a parental conflict between science and opinion.

[9] For the reasons that follow, I grant elements of both parties' motions. I agree with the mother, Luke's psychologist, and his pediatrician that medication is the most effective modality of treatment for ADHD. The mother will be exclusively entitled to consent to the administration of ADHD medication to Luke as it is prescribed by his treating physician. She may choose the identity of the physician for ADHD treatment.

[10] The father may participate in meeting with Luke's treating physician and the mother to discuss a treatment plan for the child, but the father may not do so with Luke present. Further, he may not directly or through others attempt to either discuss the use of medication with Luke or attempt to dissuade the child from using it.

Background

[11] The mother and father lived together for only a few months between 2003 and 2004. They started cohabiting in or about October, 2003, a month before Luke was born. They separated in or about May, 2004, when Luke was about six months old.

[12] The parties have more or less equally shared residence and custody of Luke since their separation. Originally there was no custodial order. The mother first commenced an application to deal with the issues of custody, access and support on July 9, 2010. She did so because the parents were unable to agree on Luke's schooling. This set the pattern of the two equal parents being unable to agree on major issues regarding Luke; one that continues into this proceeding.

[13] After over a year of litigation, the parties settled the parenting issues with an order of Justice Sheilagh O'Connell of this court. Her order of September 29, 2011 granted the parties joint and shared custody of Luke.

[14] Despite the fact that the parties agreed to continue as 50/50 parents, their consent order called for their communication to be by email only. The only exception allowed was in the event of urgency requiring a response time of 24 hours or less.

[15] The parties settled their financial issues with another order of O'Connell J. on October 7, 2011. Neither of O'Connell J.'s orders appears to have been taken out.

[16] This matter returned to court on November 29, 2016. At that time the father brought an "urgent" motion to change Luke's school. He claimed that the child was doing poorly in his French immersion school. But while the mother agreed to remove Luke from that public school program, she did not agree to his request that the child be placed in MacLachlan College. She wanted him placed in another private school, Blythe Academy.

[17] I did not allow this matter to proceed as an urgent motion. Instead, I adjourned it to a case conference. I recommended that in the interim the parties seek the advice of a psychologist to assist in their decision. The parties engaged Dr. Elizabeth Saunders, a registered clinical and school psychologist. Dr. Saunders has expertise in the psychoeducational assessment of children. She was well situated to offer an opinion regarding the schooling path that best met Luke's educational needs.

[18] Dr. Saunders supported Luke's enrollment in MacLachlan College, which he currently attends.

[19] More crucially for this motion, after meeting with the parents and Luke, and testing the child, Dr. Saunders found that Luke suffers from ADHD – Predominantly Inattentive Presentation. She recommended that the parents discuss Luke's ADHD diagnosis with him and his physician.

[20] On December 29, 2016 the parents attended at a case conference before me. The mother agreed to allow Luke to enroll in MacLachlan College for the winter/spring, 2017 term. The father was to pay the MacLachlan College school fees, subject to reapportionment. The issue of his attendance for 2017-18 was adjourned to June 12, 2017.

[21] The parents also agreed to select a pediatrician for Luke and to follow the pediatrician's recommendations.

[22] Although it has been uneven, Luke has made progress in his six months at MacLachlan College. Although he joined MacLachlan College halfway through the school year, he managed to pass all of his courses. His final marks spanned a range from 53% in science & technology and 56% in mathematics, to 83% in music. His marks in his other subjects were in the 60's and 70's. These marks were not substantially different than his final marks in the French immersion program at Pine Grove Public School in June, 2016.

[23] Luke's June, 2017 MacLachlan College report card shows that he did make some gains in independent work and self-regulation at that school. However, it is hard to compare his skills growth in the two schools because of the smaller class size that Luke enjoyed at MacLachlan College. He also received a level of one-on-one tutorial help at MacLachlan College that would not have been available in the public school system. Nonetheless the parties agree to accept that Luke has made progress in his new school.

[24] The father claims a great deal of the credit for any progress that Luke has made at MacLachlan College. He claims that he is far more willing and able than the mother to assist Luke with his homework and organization. He claims that the mother does little to help Luke in those areas, although he offers little proof and few details of that alleged failure.

[25] The father does point to Luke being absent for 6 days and late on 11 other days on the mother's watch, while the child was absent only one day and late twice on his watch.

[26] The father's argument is that the mother fails to take responsibility for Luke. Rather than put in the necessary work to help the child, he claims that the mother:

…would rather resort to potent psychoactive drugs and risk the child's health rather than look into equally effective and far less risky treatment options for Luke's ADHD.

[27] The mother denies any paucity of assistance for Luke. She offers him a tutor a number of times per week. She states (and the father does not deny) that Luke has failed to complete assignments in the father's home as well. She claims that the two parents are equal in this.

[28] I have no independent evidence to confirm either parent's perspective. I note that nothing in Luke's report card points to a lack of parenting assistance to Luke. His attendance record is not sufficient, in the absence of other evidence, for me to make an adverse finding against the mother.

[29] The mother states that the father prefers naturopathy to traditional medicine and that he wishes to concentrate on dietary matters. The father does not deny this either.

Issue No. 1: What Treatment Modality for ADHD is in Luke's Best Interests?

The Law

[30] The jurisdiction to make the order requested by the mother is found in s. 28 of the Children's Law Reform Act (the "CLRA"). Under s. 28(1)(b) of the CLRA, a court may determine any aspect of the incidents of the right to custody and access. Under s. 28(1)(c)(ii) of the CLRA, the court may prohibit "… a party or other person from engaging in specified conduct in the presence of the child or at any time when the person is responsible for the care of the child".

[31] Under CLRA s. 24(1) the merits of an application under that part of the statute regarding custody of or access to a child shall be determined on the basis of the best interests of the child. CLRA s. 24(2) sets out a broad menu of factors relevant to a determination of a child's best interests, including a child's views and preferences (s. 24(2)(b)), and the following:

(d) the ability and willingness of each person applying for custody of the child to provide the child with guidance and education, the necessaries of life and any special needs of the child;

(e) the plan proposed by each person applying for custody of or access to the child for the child's care and upbringing;

[32] In making my decision I have considered all of the best interests factors set out in CLRA s. 24.

Medication the Best Form of ADHD Treatment

[33] On the evidence, the first question regarding Luke's best interests has a clear answer: medication is the best form of treatment for Luke. This finding is based on the evidence of the two participating experts who have worked with Luke in regard to his ADHD: psychologist, Dr. Elizabeth Saunders, and pediatrician, Dr. Cynthia M. Fiorini. The mother's position about the utility of medication to treat ADHD is in accord with that of those two experts.

[34] Dr. Saunders put it as follows:

[u]sually medical treatment is necessary to enable students who have ADHD symptoms to succeed in high school and university.

[35] Dr. Saunders also called for Luke to receive extra support from his parents in regard to improving his organizational skills, completing his homework and preparing for his tests.

[36] Dr. Fiorini met with both parents and Luke this spring, after they received the child's diagnosis from Dr. Saunders. Dr. Fiorini's opinion was rather definitive. In her report of May 2, 2017, Dr. Fiorini offered a taxonomy of effective forms of treatment for ADHD, with medication as the most effective. She reported that behavioral interventions are only effective as an adjunct to medication. She stated that:

Current recommendations for the treatment of ADHD, as outlined in the AAP (American Academy of Pediatrics), includes medications and behavior modification therapy. Studies indicate that medical management alone is a stronger intervention than behavioural treatment alone and combination therapy with both medication and behavior therapy does not demonstrate significantly greater benefits than medication alone. Finally, behavioral interventions alone are often insufficient for effective treatment of core ADHD behaviours.

[37] Dr. Fiorini was also clear in recommending that Luke try medication along with supports at home and at school. She stated:

With this, recommendations for Luke include a trial of medication in an effort to increase his attention, on-task behavior, ability to learn and academic success. In addition, Luke will benefit from continued support at home with a consistent and structured environment. Teachers at school are encouraged to be aware of Luke's academic challenges and offer support and accommodations when necessary as well as maintaining a clear line of communication and feedback with Luke's parents. [emphasis included in original]

Dr. Fiorini Did Not Change Her Views Re ADHD Medication

[38] The father was not convinced by this report. When the parties attended before me at a case conference, he stated that he had spoken to Dr. Fiorini after the release of her May 2, 2017 report. He claimed that she had changed her mind from the position set out above. He did not tell me that he and Luke had actually met together with Dr. Fiorini behind the mother's back.

[39] On June 12, 2017 the parties agreed that counsel (Mr. Gegus was represented at the time) would jointly write to Dr. Fiorini to determine whether she had changed the position she had articulated in her May 2, 2017 letter. Ms. Treloar wrote the joint letter to Dr. Fiorini after counsel sorted out the contents of her letter in a conference call with me. Dr. Fiorini responded with an equivocal and manifestly guarded letter, dated July 8, 2017.

[40] In that letter, Dr. Fiorini did not indicate any change of her views regarding the primary efficacy of drug treatment for ADHD. Nonetheless, she described that second letter as offering a clarification of her position regarding Luke. In doing so she ostensibly came out firmly on both sides of the fence. However, a closer look shows no change in her opinion.

[41] Dr. Fiorini stated that she did not offer an "opinion" in her first letter. Rather she "…pointed out the current recommendations for ADHD therapy based on scientific studies." She added her view that her "position as Luke's paediatrician" is to provide him and his parents with "up-to-date information and current recommendations for treatment of ADHD." But the decision on what modality of treatment to take is a collaborative one for Luke and his parents.

[42] Mr. Gegus took this abstruse explanation as confirmation of his views. In doing so, he highlighted the fact that Dr. Fiorini, like Dr. Saunders, spoke of Luke being involved in the process of selecting his treatment. Mr. Gegus ignores the fact that Dr. Fiorini has not changed her view of the effectiveness of ADHD medication one bit.

[43] The use of medication to treat ADHD is not an "opinion" according to Dr. Fiorini. Rather it is "…the current recommendations [sic] [of the American Academy of Pediatrics] for ADHD therapy based on scientific studies." [emphasis added].

[44] In other words she was not quoting her views, she was quoting the science.

[45] With regard to Dr. Fiorini's comments about a collaborative process to choose Luke's treatment modality, nothing here is new. Neither Dr. Fiorini nor Dr. Saunders ever attempted to arrogate the right to foist medication on Luke against the wishes of the parents and child. Rather they were setting out the state of the science.

[46] Attached to his affidavit, the father has included a number of articles and excerpts from the internet that speak to side effects of ADHD medication. But he is not an expert in any of the areas in which he opines and is not in a position to weigh the gains of ADHD medication against the slim chances of side effects. On the other hand, Dr. Fiorini has cited an organization able to do just that: the American Academy of Pediatrics. Based on scientific studies that Dr. Fiorini obviously feels that it has the expertise to opine on, that group supports the use of medication.

[47] In conclusion, the science, as Luke's psychologist and pediatrician have described it, supports the use of medication as the primary method of treating ADHD in children such as Luke. The evidence produced at this motion shows that such medication is in Luke's best interests.

Issue No. 2: When Luke's Parents Cannot Agree on a Treatment Modality, How Should Decisions About Treatment for His ADHD Be Made?

[48] Luke's parents are joint and shared caregivers of the child. Normally this arrangement is predicated on the ability to effectively communicate and make decisions together. As the Ontario Court of Appeal stated in Giri v. Wentges, 2009 ONCA 606:

[10] Second, as this court has repeatedly held, joint custody requires a mutual commitment between parents to cooperate on matters pertaining to the raising of their child, and an ability for the parents to put their own interests behind those of the child.

[49] Such mutual commitment appears to be absent here. That fact is more than unfortunate and costly to the parents. It is almost certainly harmful because it puts Luke square in the middle of his parents' conflict.

[50] Here it is obvious that each parent has a great deal to offer to Luke, even if they have little to offer each other. I am not called upon to make a judgment about the mode of their parental decision making generally. Rather I am required to look to one specific issue: ADHD treatment.

[51] I find that the mother is best able to make decisions regarding Luke's ADHD treatment. Accordingly, it is in the child's best interests that she have sole decision-making authority with regard to Luke's ADHD treatment, including the use of medication and choice of professionals to deal with this disorder. I make that finding for the three following reasons:

1. The father does not show himself to be open to any form of drug therapy for Luke's ADHD.
2. The father has not shown himself to be open to working with the mother in jointly arriving at a treatment strategy.
3. The father has already attempted to unilaterally influence Dr. Fiorini to change her mind.

1. The Father Does Not Show Himself to Be Open to Any Form of Drug Therapy for Luke's ADHD

[52] The father has made clear in his materials that he is not open to drug therapy for ADHD. His attack on this treatment modality comes in three ways.

[53] First, he offers his lay opinion on the dangers of ADHD medication. He neglects to mention that the child's pediatrician makes no reference to sharing any of his concerns for those purported dangers. That absence is telling in light of the fact that Dr. Fiorini met privately with the father and Luke without the mother. The court can infer that the father raised all of his medication concerns with her.

[54] Second, the father does not even profess to adopt the stance of critically considering the efficacy of non-drug therapy. Instead, he speaks broadly of "…an array of effective, non-drug based treatment programs for ADHD …" that the mother refuses to consider. In contrast to his internet research regarding medication, he offers no evidence on the efficacy, let alone superiority of non-drug therapy. He simply assumes its efficacy.

[55] Further, while purporting to rely on Dr. Fiorini's comments (where he misinterprets them to support his position), the father ignores one key fact. The pediatrician was clear that the science shows that non-drug modalities are inferior to drug therapy. Her second letter did not retract that view.

[56] Third, the father's argument discloses one key weakness in his position. He feels so strongly about drug therapy because of the extent to which he identifies with his son. Mr. Gegus attaches his own grade 6 and 9 report cards as an exhibit to his July 13, 2017 affidavit. While he makes no reference to this exhibit in the body of the affidavit, he placed great emphasis on it in his oral argument.

[57] Mr. Gegus argued (without evidence) for the alignment of his son's needs with those of his own teenaged self. Like Luke, he had problems at school and poor time management skills. But his parents worked hard with him without the benefit of drugs to improve his marks. So if non-drug therapy was fine for him, it was fine for his son. He asked me to consider his three-decades-old report cards as proof that non-drug therapy can be effective. That argument is specious for a number of reasons.

[58] Many children have problems with academics and organization in school. But I have no evidence of any diagnosis that Mr. Gegus may have received in his childhood or any treatment available to him some 30 years ago. I cannot compare his situation to that of his son. I am not in a position to contrast Luke, who has been diagnosed with ADHD by a present day clinical psychologist, informed by modern science, with a father who offers no evidence of any neurological reason for his three-decade-old academic problems.

[59] Mr. Gegus also neglects to consider the fact that the state of medical science, particularly neuroscience, is quite different now than it was three decades ago. Even if he had ADHD (which I cannot find), his argument is akin to saying that the cancer treatment that suited his parents three decades ago is good enough for him now.

[60] All of this shows a major weakness of the father's position. He is fixed in his views, but not simply because of his own investigations. Quite the opposite; his investigations, such as they are, are informed by his pre-existing views and his self-identification with his son. So what was good for him in 1987 is good for his son in 2017. That would only be true if I had expert evidence about his treatment, and if neuroscience and pharmacology failed to advance over the past thirty years. I have no proof of either proposition.

2. The Father Has Not Shown Himself to Be Open to Working with the Mother in Jointly Arriving at a Treatment Strategy

[61] The father criticizes the mother for a failure to work cooperatively with him, Luke and Dr. Fiorini. He offers such cooperation as a panacea for Luke's ills. But a look at his approach shows both that his kettle is calling the pot black and that his solution is not realistic.

[62] First, the father's approach to the mother is anything but cooperative. His affidavit is riddled with stark personal attacks on the mother, which are not reciprocated in her materials. Without a trace of self-consciousness, he blames her for most of Luke's problems.

[63] Mr. Gegus condemns the mother for her purported indolence and inadequate parenting. He goes further by criticizing her for her failure to take "personal responsibility" for offering Luke inadequate assistance in his schooling.

[64] He then goes further to assert that the mother is "…completely dismissing the possibility that her own behavior, as well as the parent's continued fighting could be contributing factors to the child's scholastic difficulties."

[65] It may seem salutary that the father appears to allow that he has even a smidgen of responsibility for Luke's condition. He is, after all, a party to the parental conflict. But much of the previous portion of his affidavit, blaming the mother for any parental conflict, undermines any hope that Mr. Gegus accepts any responsibility for the present state of Luke's affairs.

[66] Mr. Gegus also blames the mother's previous schooling choices for much of Luke's problems. He takes her to task for not originally agreeing to his choice of MacLachlan College, even though she agreed once the parents heard from Dr. Saunders.

[67] The father then contrasts the blame he heaps on the mother with the credit he takes for the choice of MacLachlan College and the excellent parenting and homework assistance that he claims to offer Luke.

[68] With so uncooperative and non-self-aware an attitude, it would be foolhardy to think that Mr. Gegus would be able to cooperate with the mother on a form of ADHD treatment that he did not choose.

3. The Father Has Already Attempted to Unilaterally Influence Dr. Fiorini to Change Her Mind

[69] Put bluntly, the father has not been an honest broker when it comes to his dealings with Dr. Fiorini. He operated behind the mother's back and then misled her and the court in regard to his attempts to convince her to change her opinion.

[70] During his oral argument, the father took the mother strongly to task for having sent an email to one of Luke's teachers without copying him. He asserted that such contact was improper and that he would never do so. But it turns out that he did far worse.

[71] At the June 12, 2017 case conference, the father asserted through counsel that he had spoken to Dr. Fiorini after she released her letter of May 2, 2017. He claimed that she had changed her mind about offering Luke a trial of medication. That is why counsel jointly wrote to Dr. Fiorini for a confirmation on whether she had indeed changed her mind.

[72] The fact that Mr. Gegus violated his own principle, one which apparently only applied to Ms. Bilodeau, was not in issue at the time. But during his argument of this motion, Mr. Gegus admitted that he had done far worse than send an email to a teacher or even speak to Dr. Fiorini without the mother. He had met with Dr. Fiorini to try to persuade her to change her mind. Even worse, he brought Luke along. This explains the diffidence of Dr. Fiorini's July 8, 2017 letter.

[73] In discussing this, Mr. Gegus expressed no self-awareness of the impropriety of taking Luke to Dr. Fiorini behind the mother's back, let alone the hypocrisy of his position. He added that he had his own conversation with Luke about medication and showed Luke his research from the internet. In other words, he arrogated the right to convince Luke to join him against his mother in a parental dispute. In doing so he violated the essence of the parents' joint and shared custody regime. This kind of behavior is classic alienation conduct.

[74] No wonder Mr. Gegus assumes the right to speak for Luke, as if he were his son's advocate against his mother. His affidavit is replete with alleged comments from Luke that are critical of his mother, without stating how he steered Luke to the subject. For example he swears:

• Luke tells me regularly that he cannot get the help he needs when he is at his mother's home…

• Luke has repeatedly stated and continues to assert that he does not want to be medicated.

• …the Applicant told Luke that she intends to put him on medication "as soon as she wins in Court." This causes Luke much stress and unnecessary worry.

[75] For a parent who wants to cooperate with the mother there is no evidence that the father has attempted to re-assure the boy about the bone fides of the mother's position. He seems instead to be fueling the fire; turning the child against the mother.

[76] Knowing all of this, it comes as no surprise that the father is so intent on Luke having a big say in this matter. He is convinced that Luke is onside with him. Having so often spoken to the child behind his mother's back about the issues in this motion, he is confident that he has recruited a like-minded ally. If so, it is likely because Luke has only heard one, biased side of the argument.

[77] I note that Luke is not the only person for whom the father claims to speak. As set out above, the father claims to speak for Dr. Fiorini herself; filling in the pesky gaps between his position and her two letters.

[78] I have already described the father's claim that Dr. Fiorini had changed her mind about a trial of ADHD medication; an assertion that turns out to be a great exaggeration, if not a falsehood. He also claims that in his private conversations with Dr. Fiorini, the pediatrician has offered him a view not articulated in her letters. In doing so he has likely decontextualized if not misstated her views. He claims in his affidavit that Dr. Fiorini:

…voiced her objections to the manner in which these proceedings were unfolding. She reiterated, [sic] that "it is the collaborative decision of Luke and his parents to choose which treatment modalities will be effective for Luke. And the course of the child's medical treatment is a joint decision between the parties (Luke and his parents) and that she hopes the Court will support her position.

[79] If Dr. Fiorini felt so strongly about the court's work in this matter she could have said so herself in her letter to counsel. Instead she offered a diffident account that was likely influenced by the pressure that the father attempted to place on her.

[80] Clearly the father is not well placed to work cooperatively with the mother to objectively determine the course of Luke's treatment. On the other hand, the mother is open to the prospect of medication for Luke's ADHD, but only if so prescribed. She wishes to follow Dr. Fiorini's original lead with regard to only a trial of medication, not a lifetime of drug therapy. She is far more open than the father to the evidence and advice of others (she followed the advice of Dr. Saunders regarding Luke's schooling even when it contradicted her own views). That is why she will have the exclusive right to consent to the prescribing of ADHD medication for Luke.

[81] The father shall not interfere with either the prescribing or administering of ADHD medication. In other words he will cooperate with the administration of any medication prescribed to Luke for ADHD in accord with this decision.

[82] One thing that concerns me about the father's involvement with Dr. Fiorini is that she could decide that she does not need his interference. She could either buckle under to his views to treat Luke in a sub-optimal manner, or just ask the child and his parents to find another doctor. That would be unfortunate.

[83] This explains why I grant the mother the right to choose Luke's ADHD treatment provider(s). Accordingly, the mother is the sole parent who can make decisions about the course of Luke's ADHD treatment.

Issue No. 3: Should the Father Be Forbidden from Trying to Influence Luke Against ADHD Medication?

[84] I have set out above the concerns I have with the father's attempts to manipulate Luke to follow his position regarding ADHD drug therapy. He is skating close to the line of parental alienation.

[85] It would be very rare that a parent would be ordered to desist in discussing a health issue with a child. But this is one of those rare events. The father is not open to ADHD drug therapy, despite the evidence in its favour. He is not a fair broker when it comes to this issue. He is willing to go behind the mother's back to convince Luke to ally himself with his anti-medication stance. I am very concerned that the father will sabotage any attempt to offer Luke the best form of therapy for his disorder.

[86] For that reason, I will require the father to not discuss this issue with Luke or attempt to dissuade him from taking ADHD medication. He should instead inform his son that the decision has been made and that he supports it. Any breach of this term may also be a breach of the joint custody arrangement between the parties.

[87] The father will have the right to consult with both the mother and Dr. Fiorini about drug therapy for ADHD, even though he will not have a right to make decisions about it.

Conclusion

[88] For the reasons set out above, I order:

1. The mother will have the exclusive right to consent to the prescribing of ADHD medication to Luke, which shall occur in consultation with his treating physician;

2. The mother will have the exclusive right to choose Luke's ADHD treatment provider(s);

3. The father will have the right to consult with the mother and Luke's treatment provider(s) about ADHD treatment, but he shall not do so in the presence of the child.

4. The father shall neither discuss ADHD medication with Luke, nor shall he attempt to dissuade Luke from its use. He shall also ensure that any partner, friend or relative of his abide by this term as well.

5. The father will not interfere with the prescribing of ADHD medication for Luke. He shall fully cooperate with its administration when Luke is in his care.

[89] I may be spoken to regarding costs.

Released: July 21, 2017

Signed: Justice Marvin Kurz