Re: Joseph Mark Edwards
ORB File No: 7411
Hearing held on: Thursday, August 21, 2025
Place of hearing: North Bay Regional Health Centre – North Bay Site
Pursuant to: Sections 672.48(1), 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. C. Flanagan
Members: Dr. W.J. Komer Dr. M. Green Ms. C. Murray Ms. B. Naegele
Parties Appearing:
Accused: Joseph Mark Edwards Counsel: Mr. J. Saftic
The person in charge of hospital: Counsel: Mr. P. Trenker
The person on behalf of hospital: Ms. J. Doyon
Attorney General of Ontario: Counsel: Ms. D. McCaig
REASONS FOR DISPOSITION
(Dated September 5, 2025)
Introduction
On August 28, 2018, Mr. Joseph Mark Edwards was found unfit to stand trial on account of mental disorder (“unfit to stand trial”) on charges of assault and second-degree murder, contrary to the Criminal Code of Canada (“Criminal Code”).
Mr. Edwards is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”), dated September 11, 2024, finding him permanently unfit to stand trial and detaining him at the Forensic Programs of the North Bay Regional Health Centre – North Bay Site (“NBRHC” or “the hospital”) with privileges up to and including living in the community in a 24 hour a day supervised accommodation approved by the person in charge that provides for a private room.
On August 21, 2025, the Board convened a hearing at the hospital to conduct the annual review of the current Disposition.
Mr. Edwards was not present at the hearing. His counsel, Mr. John Saftic, requested that Mr. Edwards be permitted to be absent from the hearing because he experiences extreme anxiety and distress when attending hearings. The Board granted an order pursuant to s.672.5(10)(a) of the Criminal Code permitting Mr. Edwards to be absent.
Evidence at the hearing included a Hospital Report, dated July 16, 2025 (the "Hospital Report"), which was entered as Exhibit 1, and the viva voce evidence of Dr. Gagnon.
In accordance with s.672.48(1) of the Criminal Code, the Board must determine if Mr. Edwards remains unfit as of the date of the hearing within the meaning of s. 2 of the Criminal Code. If he remains unfit, the Board must determine whether he continues to represent a significant threat to the safety of the public. If so, the necessary and appropriate disposition to manage that risk must be determined, bearing in mind the criteria set out in s. 672.54 of the Criminal Code.
For the reasons set out below and based on the evidence before us, the Board concludes that Mr. Edwards remains permanently unfit and continues to represent a significant threat to the safety of the public. A continuation of the existing Detention Order is the necessary and appropriate disposition in the circumstances.
Current Psychiatric Diagnoses
- At Korsakoff Syndrome; and
Substance Use Disorder (alcohol, cannabis) in sustained remission in a controlled environment
Position of the Parties
- At the commencement of the hearing, the parties were canvassed for their positions. Counsel for the hospital, Mr. Trenker, took the position that Mr. Edwards remains permanently unfit to stand trial as of the date of this hearing and he continues to pose a significant threat of harm to the public. He submitted that the necessary and appropriate disposition is a continuation of the existing Detention Order. Counsel for the Attorney General of Ontario, Ms. McCaig, supported the hospital’s position. Counsel for Mr. Edwards, Mr. Saftic, did not oppose the hospital position and conceded the issue of significant risk. Therefore, a joint submission was put before the panel.
Outstanding Charges
- The Hospital Report provides the details of the offences alleged against Mr. Edwards. Briefly, On August 22, 2017, Mr. Edwards was admitted into the Wikwemikong Nursing Home from the Moosonee, Ontario area. He shared a room with the 85-year-old victim. On August 25, 2017, the victim was asleep in an upright seated position on his recliner chair in their shared room. Mr. Edwards assaulted the victim by punching him with both fists, predominantly on the right side of the head and facial area. The victim sustained significant injuries and was transported to hospital by ambulance where he ultimately succumbed to his injuries and died.
Background and History
The Hospital Report contains detailed information regarding Mr. Edwards’ background and psychiatric history, the entirety of which need not be repeated here in detail. In brief, Mr. Edwards is a 71-year-old indigenous man born in Moosonee, Ontario. He reported that both of his parents were alcoholics, and he started drinking at age 15.
Mr. Edwards attended a residential school in northern Quebec until he quit in grade nine.
Mr. Edwards is incapable of consenting to treatment. Mr. Edwards’ daughter, Sophia, is currently his substitute decision maker (“SDM”). Mr. Edwards adheres to his pharmacological treatments and is cooperative with staff when receiving his prescribed medications.
Mr. Edwards has a criminal record, which is set out in the Hospital Report for the period from 1972 to 2008. His convictions include crimes of violence and failing to comply with court orders. Mr. Edwards has no recollection of the index offences.
Mr. Edwards has a history of substance use, including alcohol and cannabis. Urine drug screens are completed twice per year as per his disposition and have returned negative.
Mr. Edwards has multiple medical conditions including a seizure disorder. He experiences balance difficulties, leg weakness and shortness of breath, which place him at an elevated risk for falls. He uses a rollator walker to ambulate.
Mr. Edwards’ cognitive and memory functioning was assessed in August 2018. He was found to suffer from profound cognitive difficulties and memory problems. The results were consistent with the diagnosis of major neurocognitive disorder due to substance use. As such, he is unable to form and retain new memories.
Mr. Edwards lacks insight and fails to recognize his cognitive challenges. He requires daily support to help orient himself to his environment and requires assistance with activities of daily living.
The treatment team must continuously observe and assess Mr. Edwards to identify stressors to minimize the risk to others and manage his triggers for physical aggression. The treatment team provides one-on-one supervision to mitigate the escalation of anger and ensure the safety of others. For group outings in the community, he requires one-on-one supervision. For individual activities such as attending appointments, Mr. Edwards requires two staff members to provide oversight.
Clinical Course Since Last Disposition
On February 24, 2025, Mr. Edwards participated in the Canadian Indigenous Cognitive Assessment (“CICA”). His score suggests cognitive impairments, particularly in the area of memory recall.
There have been no incidents of physical aggression in the reporting year. During this reporting period, Mr. Edwards displayed signs of emotional dysregulation, irritability, and reactivity.
Mr. Edwards received regular phone calls and virtual visits from his family. He is encouraged to speak with his family when they call.
The treatment team continues to provide evidence that Mr. Edwards is permanently unfit to stand trial. Mr. Edwards’ cognitive limitations make it extremely unlikely that he will become fit for trial.
Mr. Edwards’ neurological issues and background of impulsive and aggressive conduct present a considerable danger to public safety.
Oral Evidence
In his oral evidence, Dr. Gagnon, Mr. Edward’s treating psychiatrist, testified that, in his opinion, Mr. Edwards remains permanently unfit to stand trial.
Dr. Gagnon testified that Mr. Edwards suffers from Korsakoff Syndrome and is significantly cognitively impaired. He has no recollection of the index offences. In fact, one of the reasons that he is not brought to the annual hearings is because he has no recollection of the alleged offences and becomes extremely agitated hearing about the alleged offences. Mr. Edwards is quite impaired with respect to forming new memories. He is unable to remember Dr. Gagnon or anyone in his care team with the exception of the caregiver who provides full day care daily. Due to his memory issues, it is like he is meeting new people every day because he can’t remember or recognize people from prior interactions. Mr. Edwards would not be able to participate in his defence in any shape or form.
Mr. Edwards is reactive and aggressive when his routine is disrupted. The hospital has created a ‘bubble’ around him to minimize aggression. It doesn’t take much disruption in his surroundings for him to become aggressive. For instance, he has attacked people walking to close to him while eating. He also assaulted a blind patient for ‘looking at him’. The treatment team maintains a very low stimulation environment for him so that his aggressiveness is minimized.
Mr. Edwards has one-to-one care from 7:00 a.m. to 9:00 p.m. daily to manage him. There are no nursing homes able to accommodate his high care needs.
Mr. Edwards enjoys activities such as playing cards and cribbage.
Mr. Edwards would not be able to live in a communal setting outside of the bubble the treatment team has created for him. The only way that Mr. Edwards will be able to be accepted into a nursing home in the future would be if he physically declined enough that he wouldn’t be able to attack someone.
Dr. Gagnon would like to leave clause 2(e) in the disposition because Mr. Edwards would be appropriate to live in 24-hour supervised accommodation in the community in the future if he physically declined sufficiently that he became unable to attack people.
Fitness and Conclusions
Fitness
- Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board finds that Mr. Edwards remains permanently unfit to stand trial. Mr. Edwards would not be able to be meaningfully present nor meaningfully participate in a trial at this time due to his cognitive and memory challenges. He has no recollection of the index offence and has a history of emotional dysregulation, confusion, and agitation when attempts have been made to discuss his legal situation. There is no reasonable prospect that his condition will improve in the future.
Significant Risk / Necessary and Appropriate Disposition
The Board accepts the joint submission of the parties that Mr. Edwards remains a significant risk to public safety.
Having found Mr. Edwards permanently unfit to stand trial, the Board must make a Disposition that is necessary and appropriate, considering the criteria delineated in s.672.54 of the Criminal Code.
During this reporting period, Mr. Edwards displayed signs of emotional dysregulation, irritability, and reactivity. He may act aggressively if startled or provoked in social interactions and often does not understand how his behaviour impacts those around him. Therefore, he requires close monitoring to prevent aggressive behaviour. Mr. Edwards requires one-to-one supervision from 7:00 a.m. to 9:00 p.m. daily. Door and bed alarms are in place for prompt intervention.
Although episodes of agitation are generally brief, Mr. Edwards occasionally requires psychopharmacological interventions to address his aggressive behaviours when other de-escalation methods are ineffective. When he engages in negative behaviours, he does not recall the incidents and displays confusion.
Mr. Edwards relies heavily on his treatment team for support and guidance in managing his environment and emotions. Without the high degree of supports in place, Mr. Edwards may become confused, anxious, and fearful, which historically triggers aggressive behaviours. He would be unable to manage his medication. He must continue to receive the support in place to mitigate the risk he poses to others.
The current disposition manages his challenges well and provides an effective strategy to mitigate his risk to public safety. There are currently no suitable housing placements for Mr. Edwards due to his unpredictability and his risk to the public.
In consideration of the criteria set out in s.672.54 of the Criminal Code and based on the documentary and viva voce evidence, and in particular the safety of the public, the mental condition of Mr. Edwards, his other needs, the Board unanimously agrees that the least onerous and least restrictive disposition is Detention at the Forensic Programs of NBRHC with no change to the terms, as set out in our formal Disposition.
DATED this 5th day of September 2025, at the City of Toronto, in the Toronto Region.
Ms. Christine Murray
Legal Member
Office of the Registrar
Ontario Review Board