Peter Scott Knighton (Re), 2025 CanLII 122697

Ontario Review Board

Re: Peter Scott Knighton

ORB File No: 0964

Hearing held on: Monday, October 6, 2025

Place of hearing: St. Joseph's Healthcare Hamilton West 5th Campus, 100 West 5th Street

Pursuant to: Section 672.81(1) of the Criminal Code

Before:

Alternate Chairperson: Ms. S. Clapp

Members: Dr. H. Bloom

Dr. A. Kerry

Mr. P. Capelle

Mr. B. Apted

Parties Appearing:

Accused: Peter S. Knighton

Counsel: Mr. M. Schloss

The Person in charge of Hospital: Counsel: Ms. L. Barney

Attorney General of Ontario: Counsel: Ms. K. Malkovich

REASONS FOR DISPOSITION

(Dated November 28, 2025)

Introduction

On April 29, 1987, Peter Knighton was found not guilty by reason of insanity (“NGRI”) on a charge of second-degree murder, contrary to the Criminal Code of Canada (the "Criminal Code"). Mr. Knighton is currently subject to a Disposition of the Ontario Review Board (the "Board") dated October 21, 2024, detaining him at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton, West 5^th Campus (“St. Joseph's”), with privileges up to living in the community within the catchment area of St. Joseph's in supervised accommodation approved by the person in charge.

On October 6, 2025, a panel of the Ontario Review Board (the "ORB" or the "Board") convened a hearing pursuant to s. 672.81(1) of the Criminal Code. Mr. Knighton was in attendance and was represented by his counsel, Mr. Schloss.

The Hospital Report dated September 26, 2025 was marked as Exhibit 1. Dr. S. Nagari, Mr. Knighton’s attending psychiatrist, gave oral evidence.

Without Prejudice Position of the Parties

The hospital seeks a renewal of the Detention Disposition but for the following amendments to subparagraphs 2(f) and 2(g) which would increase the geographical area for indirectly supervised passes and community living from the catchment area of St. Joseph’s to Southern Ontario:

2(f) to read: “passes for up to 7 days to enter the community of Southern Ontario, indirectly supervised”.

2(g) to read: “to live in the community within Southern Ontario in supervised accommodation approved by the person in charge.”

Ms. Malkovich, on behalf of the Attorney General, joined the hospital’s recommendation as did Mr. Schloss, on behalf of Mr. Knighton. The hearing therefore proceeded by way of a joint position. Mr. Schloss added that he may ask for an assessment of appropriate housing as per Shortt (Re), 2020 ONCA 651.

Background and Index Offences

Mr. Knighton is a 63-year-old male with schizophrenia. His parents reported behavioral changes at approximately age 13, which worsened by age 19. He has experienced psychiatric difficulties, high school attendance issues, and employment challenges. His mental condition has significantly impaired social and occupational functioning, including difficulty maintaining full-time employment and sustaining friendships. He has never held a full-time job. When not in hospital, he has lived with his family or stayed with friends or at hostels.

Mr. Knighton reported drinking three to four beers on the night prior to his arrest and smoking marijuana two days before the index offence.

Following an NGRI finding in May 1987, Mr. Knighton was admitted to Oak Ridge Division (now known as Waypoint Centre for Mental Health Care) and subsequently transferred to Ontario Shores Centre for Mental Health Sciences in August 2010, then to St. Joseph's on January 23, 2020.Mr. Knighton has no prior criminal convictions.

Mr. Knighton has had multiple psychiatric admissions beginning with his first admission in July 1980 at age 16. These have included Hamilton Psychiatric Hospital, St. Joseph's Hospital, McMaster University Psychiatric Hospital, and the Clarke Institute of Psychiatry (as it then was), among others. His hospitalizations have frequently been precipitated by poor medication compliance, resulting in angry outbursts and unmanageable behaviors. There is also documented history of suicide attempts. Additionally, he has assaulted his parents on multiple occasions.

The circumstances of the index offence are taken from last year’s Reasons for Disposition as follows:

“On August 10, 1986, he met an older man who befriended him and took him home for the night. While the man was sleeping, Mr. Knighton bludgeoned him to death with a shovel. He reported the incident to police and he was arrested for first-degree murder. Mr. Knighton subsequently reported that his victim frightened him by talking angrily about his wartime experiences, and he feared the man would kill him unless he killed the man first.”

Current Diagnoses

• Schizophrenia,

• Cannabis Use Disorder (in sustained remission, in a controlled setting).

Evidence at Hearing

Dr. Nagari confirmed having read and adopted the contents of the Hospital Report. Mr. Knighton’s reporting year was similar to the previous one. Mr. Knighton is now diagnosed as suffering from a Treatment Resistant Schizophrenia and Cannabis Use Disorder. Dr. Nagari has ruled out Antisocial Personality Disorder and Alcohol Abuse as diagnoses. Mr. Knighton is incapable of consenting to treatment and the Public Guardian and Trustee is his substitute decision-maker. Clozapine and Amisulpride have settled him behaviourally but residual symptoms persist including grandiose, paranoid, and somatic delusions. He requires significant oversight to ensure medication compliance. No aggression or cannabis use has been seen for several years. Mr. Knighton’s main community support is his father who is over 90 years of age.

Mr. Knighton responds well to supervision in hospital. As referenced at page 94 of the Hospital Report, nursing staff have noted a decline in Mr. Knighton’s functioning. Dr. Nagari opined this is due to aging in combination with schizophrenia. Responding to questions from a panelist, Dr. Nagari confirmed that his patient remains able to adapt to the hospital environment notwithstanding that his higher mental functions have declined. A Montreal Cognitive Assessment and/or Mini-Mental Exam will be considered to ascertain the extent of the decline. Long-term care for Mr. Knighton has not yet been considered.

Mr. Knighton remains on a waitlist for community placement. He requires a supervised setting as he is otherwise likely to wander off, fall away from medications and resume the use of cannabis leading to an elevated degree of significant threat. Mr. Knighton continues to advocate the benefits of cannabis use.

Dr. Nagari referenced page 93 of the Hospital Report which speaks to a housing waitlist Mr. Knighton is on for supervised and subsidized community housing. One of the reasons his housing must be supervised is his history of elopement. Further, when accompanied in the community, Mr. Knighton will sometimes become disoriented and wander off to walk with individuals that are not his co-patients or staff.

Mr. Knighton is highly obsessive about smoking which impacts his clozapine levels. He currently smokes 11 to 12 cigarettes per day. Each morning some degree of persistence is required to ensure he ingests his clozapine.

At present, no movement has been seen regarding potential community residences that could accommodate his needs. Mr. Knighton was offered a community residence in 2023 but it was determined to be inappropriate due to insufficient oversight of medication compliance. Earlier this year the Good Shepherd residence was identified but it was again determined that this residence would not support his needs. A description of the hospital’s placement efforts is contained at page 93 of the Hospital Report as referenced by Dr. Nagari and reproduced below for ease of reference:

“The Social Worker spoke with Good Shepherd about this and advocated that Mr. Knighton is an appropriate candidate for CHO. Good Shepherd explained that it is up to the individual service provider and agreed to keep him on the CHO wait list for other housing opportunities in the future. We discussed his needs and writer asked for him to be placed on the wait list for Mathias Place at that time (December 5, 2024). Writer also referred Mr. Knighton to First Place Supportive Housing but discovered that his needs exceed their services as well, so the referral was withdrawn.”

Dr. Nagari testified that Mr. Knighton’s verbal escalation is currently regulated in a controlled hospital setting, adding that his patient cannot deal with conflict. In the community, where people may not know him, this could escalate to a level of psychological or physical harm. Dr. Nagari noted that his patient had used cannabis a couple of years ago. Mr. Knighton was then disappointed that the use was detected by a urine drug screen. Responding to questions from Mr. Schloss, Dr. Nagari agreed that prior to 2018 there had been no aggressive incidents noted since 1999, although this was in the context of being contained in a controlled hospital environment.

Dr. Nagari noted that Mr. Knighton has not lived in the community since being found NGRI in 1987. He acknowledged that Mr. Knighton has suffered a degree of institutionalization which further complicates identifying a possible community placement. Therefore, a relatively small fraction of available community housing in and around Hamilton would be appropriate for Mr. Knighton as he needs a level of care that almost mimics what he receives in hospital.

Dr. Nagari is unsure if a Board-ordered assessment of housing would be helpful. It is not a matter of lack of funds with Mr., Knighton, rather finding the appropriate place for his complex needs. The hospital grasps that there is a gridlock of available housing in the Hamilton area and elsewhere in the province. The hospital is already making its best efforts and will expand the search radius to Southern Ontario if permitted in the upcoming Disposition.

Closing Submissions

Ms. Barney submitted that the goal is to discharge Mr. Knighton to the community. He is now institutionalized having been maintained in hospital since 1987. Mr. Knighton has attained indirect privileges on hospital grounds. A Detention Disposition remains necessary and appropriate. His social worker is working hard to identify and place him on waitlists for appropriate housing.

Ms. Malkovich submitted that housing referrals have been ongoing since 2021. Cognitive decline will further restrict potential community housing option as Mr. Knighton's needs are increasing.

Mr. Schloss reiterated that notwithstanding the joint position, he is requesting an independent housing assessment to ascertain the housing options that may be available for Mr. Knighton in Southern Ontario. He referred the panel to the previously cited Shortt decision which speaks to a residential impasse, in particular paragraphs 53 to 59, noting that the court ultimately ordered the Ministry to fund further housing.

Mr. Schloss submitted that after an independent assessment of Mr. Knighton’s circumstances, the hospital would benefit from a fresh perspective to identify what resources may have been overlooked. Paragraphs 53-59 are reproduced below for ease of reference:

53Section 7 allows for restrictions on liberty that are in accordance with the principles of fundamental justice. Mr. Shortt submits that the restriction on his liberty is arbitrary.

54Arbitrariness is "the absence of any link between the objective of the law and its negative impact on security of the person": Canada (Attorney General) v. Bedford, [2013] 3 S.C.R. 1101, [2013] S.C.J. No. 72, 2013 SCC 72, at para. 35. A deprivation of a s. 7 right will be arbitrary where the law or government action contravenes or undermines the objective of the law: Bedford, at paras. 98, 100.

55The only reason advanced for Mr. Shortt's continued detention in forensic custody is a lack of funding. In 2019, this court held that the barrier to community living was "a lack of public funding; long waiting lists; or inadequate attendant care to respond to Mr. Shortt's admittedly complex physical and psychiatric requirements": Shortt, at para. 3. Lack of funding, as a potential justification for the deprivation of Mr. Shortt's liberty, does not properly fall within the scope of the s. 7 analysis. Rather, any costs or benefits to the public in relation to funding fall within the scope of the s. 1 analysis: Bedford, at para. 121.

56All parties agree that while Mr. Shortt continues to pose a significant threat to public safety, such that he cannot be discharged, this risk can be managed by the means identified in the Board's disposition, which includes the availability of community living. [page 463]

57Section 672.54 sets out the factors that the Board must consider when making a disposition. The factors include public safety, the mental condition of the accused, the reintegration of the accused into society and the other needs of the accused.

58There is no rational connection between the Mr. Shortt's continued detention and the purposes of Part XX.1. There would be no threat to public safety if the disposition order were implemented under the direction of the Hospital, and the goal of reintegration identified in s. 672.54 is being undermined by Mr. Shortt's continued detention in forensic custody. Mr. Shortt's frustration at waiting five years for appropriate residential arrangements, with no end in sight, has "led to a deterioration in his progress, including angry outbursts, damage to property, and elopements on his part": Shortt, at para. 3.

59Mr. Shortt's continued detention in forensic custody undermines the purposes of the Part XX.1 regime set out in s. 672.54 and is therefore arbitrary. Mr. Shortt has been deprived of his liberty in a way that is not in accordance with the principles of fundamental justice.

Ms. Barney in addressing the Shortt (Re), decision noted that it involved a patient that was entitled to Developmental Services of Ontario (DSO) Residential Placement funding because of a developmental disability, which is not the case with Mr. Knighton. Ms. Malkovich added that the Shortt (Re), decision is further distinguishable over and above any developmental/psychiatric issues, because Mr. Shortt was wheelchair bound. Therefore, accommodating his physical disabilities was at issue whereas Mr. Knighton ambulates well.

Ms. Schloss argued that a treatment impasse is analogous to a residential impasse and as referenced in Shortt (Re), at paragraph 72, the Board should exercise its inquisitorial powers to break the impasse. That paragraph is reproduced below for ease of reference

72Against this backdrop about what treating doctors, social workers, the Hospital, and the Board have said about Mr. Shortt's placement and treatment over the last five years, it bears repeating what this court said in its 2019 decision [2019 ONCA 232, [2019] O.J. No. 1488] allowing the appeal from the Board's 2018 annual review decision, at paras. 8-9:

In the present case, more than four years have passed since the hospital determined that Mr. Shortt could live in a community residential setting with appropriate and significant support. The hospital has made meaningful inquiries. They have contemplated creative solutions, such as long-term care. Mr. Shortt is fortunately surrounded by caregivers devoted to his wellbeing. The difficulty for the hospital and Mr. Shortt is that their efforts are impeded by factors beyond their control. Without assistance, this situation is not going to improve.

Given the clear impasse, it was an error on the Board's part to repeatedly reach its dispositions based on the material introduced only by the hospital. The Board has the obligation and the power to try to break the clear impasse concerning Mr. Shortt's residential community placement by exercising its inquisitorial powers and gathering significant evidence, including expert evidence.

Analysis and Decision

The Board unanimously finds that Mr. Knighton continues to pose a significant threat to the safety of the public. In arriving at this determination, the Board considered the joint position of the parties and accepted the uncontroverted evidence of Dr. Nagari that Mr. Knighton’s propensity for verbal escalation is well managed within the confines of a medium secure forensic hospital by an inpatient team that know him well. However, in a community setting, absent that familiarity, Mr. Knighton’s verbal outbursts could escalate to the threshold of physical or psychological harm as related in the Supreme Court of Canada decision in Winko, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625. The doctor’s evidence at the hearing is consistent with a risk scenario summation found at page 94 of the Hospital Report and reproduced below for ease of reference:

Without the oversight of the Review Board and the support of the forensic psychiatry program, Mr. Knighton would likely refuse to take his medications and return to substance use. Based on a significant prior history of violence in the context of untreated psychosis, it can be inferred that Mr. Knighton will act out violently in similar circumstances. His own personal safety will also be jeopardized in the context of worsened psychosis. The likely scenario would involve Mr. Knighton taking offense at somebody’s remarks, misinterpreting their intentions or feeling that they are mocking his religious beliefs. The potential victim could be a random individual, and magnitude of harm perpetrated may range from verbal aggression to serious physical violence.

The Board therefore accepts that absent an ORB Disposition, Mr. Knighton would likely become non-compliant with prescribed medications which would lead to decompensation, use of substances and the re-emergence of behaviours similar to those seen at the time of the index offence. We are satisfied that absent an ORB Disposition, it is likely that Mr. Knighton will cause serious physical or psychological harm to members of the public and such conduct will likely be criminal in nature.

(b) Disposition

Flowing from the Board’s finding that Mr. Knighton continues to pose a significant threat to the safety of the public it must shape a Disposition for the year ahead. Its paramount consideration in doing so must be the safety of the public while also considering Mr. Knighton’s needs pursuant to s. 672.54 of the Criminal Code.

The necessary and appropriate disposition for Mr. Knighton provides him as much freedom as possible without subjecting the community to a real risk of dangerous behaviour.

In considering Mr. Knighton’s needs, the Board accepted the joint position of the parties that his Detention Disposition be renewed absent any changes but for the proposed amendments to subparagraphs 2(f) and 2(g).

This panel was also attentive to Mr. Schloss’s request for an independent housing assessment to ascertain available options for Mr. Knighton. We have however determined that this request is currently unwarranted. This is because of the identified and ongoing efforts of the hospital to find community housing for Mr. Knighton coupled with the Board’s agreement to expand the geographic scope of supervised community accommodation to Southern Ontario from a catchment area that was limited to St. Joseph’s Healthcare Hamilton. The panel also considered the further complications associated with finding a suitable placement for this patient as he has only known institutional settings for the past 38 years and will require a level of care that virtually mirrors what he currently receives in hospital.

As noted by Ms. Barney and Ms. Malkovich in their closing submissions the Shortt (Re) decision is distinguishable from Mr. Knighton’s circumstances because:

• it involved a patient that was entitled to DSO funding due to developmental issues, which is not the case with Mr. Knighton,
• over and above any psychiatric issues, Mr. Shortt was wheelchair bound. Therefore, accommodating his physical disabilities was at issue, whereas Mr. Knighton ambulates well.

Further, Mr. Knighton’s circumstances do not equate to the sort of treatment/residential impasse which resulted in the Ontario Court of Appeal ordering the Ministry to allocate additional DSO funds required to enable Mr. Shortt’s community placement.

Without question Mr. Knighton is entitled to the least onerous and least restrictive community housing consistent with public safety. However, it cannot be said that a treatment/residential impasse has stalled his community reintegration. As described in these Reasons for Disposition the hospital has continued to search for suitable supervised accommodation for Mr. Knighton. Following release of the Board’s October 2025 disposition the hospital is now able to expand the radius of available, albeit limited, supervised accommodation options for Mr. Knighton to all of Southern Ontario. Again, the challenge is that any supervised accommodation potentially identified as suitable for this patient must essentially mirror the level of care he currently receives in hospital while concurrently managing his risk to public safety. Nevertheless, if the steps set out in this paragraph prove fruitless, it may be appropriate to revisit the merits of an order of assessment of appropriate housing (although it is suggested that the Board’s jurisdiction and ability to make such an order should be explored more thoroughly).

Conclusion

The Board unanimously determines that the necessary and appropriate Disposition required to manage the threat Mr. Knighton poses to the safety of the public while still meeting his needs remains a Detention Order.

In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Nagari and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Knighton’s mental condition, his reintegration into society and other needs.