Re: Ainar Gancthev
ORB File No: 7842
Hearing held on: February 20, 2026
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. K.A Connidis Members: Dr. J. Cheston Dr. A. Prakash Mr. D. D’Intino Ms. B. Little
Parties Appearing:
Accused: Ainar Gancthev Counsel: Mr. M. Moon
The Person in Charge of Hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Mr. I. Shaikh
REASONS FOR DISPOSITION
(Dated May 8, 2026)
Introduction
On January 21, 2021, Ainar Gancthev was found not criminally responsible on account of mental disorder on a charge of manslaughter, contrary to the Criminal Code. Mr. Gancthev is currently subject to a Disposition of the Ontario Review Board (the “Board” or “ORB”) dated December 11, 2024, detaining him at St. Joseph’s Healthcare Hamilton (“SJHCH” or the “hospital”) with privileges up to and including entering the community of Hamilton for up to 12 hours, indirectly supervised.
On February 20, 2026, a panel of the Ontario Review Board (ORB) convened in person and a hearing was held at St. Joseph’s Healthcare Hamilton (SJHH). The purpose of the hearing was to determine if Mr. Gancthev continues to represent a significant threat to the safety of the public as defined in the Criminal Code of Canada, and if so, to decide on the necessary and appropriate Disposition.
For the reasons set out below, the Board unanimously finds that Mr. Gancthev does meet the threshold for significant threat to the safety of the public and that the necessary and appropriate Disposition is a continuation of the existing Detention Order with no changes to its terms and conditions.
Current Psychiatric Diagnosis:
Schizophrenia
Cannabis Use Disorder; and
Narcissistic / Antisocial traits
Index Offences:
- The facts arising from the index offence are extracted from the Hospital Report and are as follows:
“Flor Marvel resides with her son, the accused, Ainar Gancthev and husband, the victim, Yura [sic] Gancthev at [address] in the City of Mississauga.
There have been no previous domestic occurrences with the family. Drugs or alcohol were not involved in this occurrence. There are no firearms or licenses registered to the address or any of the involved parties.
Victim services was offered and accepted.
Charge: Arson Causing Damage to Property
On Sunday, June 24, 2018 at 6:51 p.m. emergency services responded to a vehicle fire located near 1352 Lakeshore Road East, Mississauga. Upon arrival, the vehicle was fully engulfed by fire, involved vehicle was Ontario bearing marker BMVN853.
Once the fire was extinguished, a burnt body was located inside the vehicle.
Investigation revealed Ainar Gancthev fled the scene and was arrested for arson and was held at 12 Division pending a bail hearing. The scene was held pending attendance by the Ontario Fire Marshal.
The Homicide and Missing Person’s Bureau is continuing the investigation.
Count 2: Second Degree Murder
On June 25, 2018, the accused was arrested for an additional charge of Second Degree Murder at 5:28 a.m.."
Without Prejudice Positions of the Parties:
At the commencement of the hearing, the parties were canvassed for their initial positions.
The Hospital took the position that Mr. Gancthev continues to meet the threshold for significant threat to the safety of the public and that the necessary and appropriate Disposition was a Detention Order Disposition with no changes to its terms and conditions.
Counsel for the Attorney General supported the Hospital’s position.
Counsel for the accused agreed with the position of the Hospital and conceded the presence of significant threat but wanted a term that would permit him access to a cannabis vape no more than twice per month, on request.
Evidence at the Hearing:
The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. S. Nagari, who is Mr. Gancthev’s attending psychiatrist.
Dr. Nagari testified that he has been Mr. Gancthev’s most responsible physician since 2023. Over the past reporting year, Mr. Gancthev’s progress has plateaued because of his use of cannabis and resultant “low intensity” oppositional behaviour toward staff members. The latter behaviour is discussed in the Hospital report as resulting from Mr. Gancthev’s antisocial personality traits.
While the doctor testified that Mr. Gancthev has some insight into his problematic cannabis use, he struggles with recalling how his cannabis use affected him historically. Mr. Gancthev has told Dr. Nagari that he has smoked cannabis in the past with no change to his mental status.
Dr. Nagari explained that there is ample literature supporting the conclusion that cannabis use increases psychotic symptoms. and that Mr. Gancthev did in fact use cannabis at the time of the index offence, which was both horrific and violent.
The doctor felt that Mr. Gancthev is too “cannabis focused” – that this is his main goal. The treatment team has tried to encourage him to pursue more vocational tasks, but he has great difficulty in doing so.
For those reasons, among others, the Doctor did not support Mr. Gancthev having access to cannabis.
Dr. Nagari further explained that Mr. Gancthev does not have abstinence from cannabis as one his goals, and that as it concerns therapeutic programming, his motivation is largely extrinsic, because he was to be seen in a favourable light by the Board. As a result, he was described by Dr. Nagari as “set in his ways” and therefore has not made much progress in the past reporting year.
Dr. Nagari also testified that Mr. Gancthev has a history of medication noncompliance, especially at the time of the index offence, and has remained highly resistant to a trial of clozapine.
When asked to explain Mr. Gancthev’s most likely reoffending scenario, Dr. Nagari pointed to page 61 of the Hospital Report. In summary, if not for the oversight of the ORB, Mr. Gancthev would increase his cannabis use, discontinue his medication and become floridly psychotic. Any person could become a part of his delusional belief system and would be at risk of serious violence or worse.
In response to questions from Counsel for the Attorney General, Dr. Nagari testified that one of Mr. Gancthev’s personality traits includes difficulty accepting limitations and accepting accountability. While these behaviours are usually seen in terms of pushing back against staff in the context of rules around smoking for instance, Mr. Gancthev does then back down, reflect and apologize for them.
It was noted through questions from a panel member that Mr. Gancthev’s immediate risk is described in the Hospital Report as arguably driven by personality factors and that his narcissistic and antisocial personality traits are “main barriers to him reliably engaging with his environment in a prosocial manner”. Dr. Nagari responded to these concerns by saying that he felt the influence of Mr. Gancthev’s personality traits will resolve spontaneously over time.
In the questioning by Mr. Moon, Counsel for Mr. Gancthev, the Panel did not find the examination of Dr. Nagari to be very helpful. Almost the entire time for this examination was spent arguing with Dr. Nagari about whether the requirements for Mr. Gancthev to pursue employment, as stipulated by the vocational counsellor, were “redundant” or “unnecessary” in the opinion of Mr. Moon.
In summary, it seems the vocational counsellor, in accordance with either hospital policy or basic requirements of arranging for employment for Mr. Gancthev, or both, has requested that Mr. Gancthev provide a resume and complete a food handler’s certification, and Mr. Gancthev is not agreeable to this. Mr. Moon was interrupted by the Alternate Chairperson on more than one occasion in his questioning of the doctor, out of concern that his restating of the hospital’s evidence was not accurate or fair.
The evidence from Dr. Nagari on this point was simply that the vocational counsellor is trying to help Mr. Gancthev obtain employment outside the hospital in an area of his interest and has explained what Mr. Gancthev needs to provide in order for this process to move forward and be successful. It appears that Mr. Gancthev does not wish to comply with those requirements for whatever reasons.
On the cannabis use issue, Mr. Moon queried the doctor as to how cannabis use was any more deleterious to the mental health of Mr. Gancthev than his tobacco use. The doctor’s reply is summarized as follows:
Cannabis and nicotine are not equivalent in their effect on psychotic symptoms;
There is clear evidence linking the consumption of cannabis with the unmasking or exacerbation of psychotic symptoms;
There is no logic to the suggestion that because Mr. Gancthev may have used cannabis on an isolated occasion and not developed psychotic symptoms, that he can use cannabis without ever having a psychotic episode;
That there is a history of cannabis use in Mr. Gancthev’s past that was proximate to both the index offence and other occasions where he has been psychotic, and;
Psychiatric medication alone cannot fully attenuate his risk to the safety of the public if he is consuming cannabis or other psychoactive substances, as the protective effect of the medication has its limits.
Dr. Nagari did not believe that Mr. Moon’s proposal – that Mr. Gancthev be allowed to purchase his own vape and cannabis and have it stored in a locker with nursing staff and be allowed to use it twice monthly – was workable. The doctor explained that not only would it present safety concerns for the hospital, but it would run against hospital policy and against medical advice because cannabis use by this patient is contraindicated.
In response to questions by the Panel, Dr. Nagari testified that when a random urine drug screen comes back positive for cannabis, Mr. Gancthev will deny usage. Then, only when additional confirmatory testing is done also confirming cannabis usage, will he admit to its use.
In the opinion of the doctor, the lack of progress in Mr. Gancthev’s treatment stems largely from his unwillingness to accept that any use of cannabis, however infrequent, can destabilize his mental status. As noted above, Mr. Gancthev’s personality traits have also been identified as many obstacles to his treatment progress.
Dr. Nagari was not confident that Mr. Gancthev could moderate or control his consumption of cannabis if allowed to consume it in accordance with Mr. Moon’s proposal. When Mr. Gancthev has broken hospital rules, he appears to be content to simply wait for his privileges to be reinstated rather than change his behaviour or decision making.
Among the concerns of the Hospital with Mr. Moon’s proposal, Dr. Nagari testified that it would be impossible to monitor Mr. Gancthev’s consumption of cannabis because the tool to do that is a urine drug screen. THC metabolites tend to linger in urine sometimes for weeks at a time in seasoned users, making such a tool useless to determine recency of cannabis use and the amount of use. Furthermore, the Hospital could not guarantee that any cannabis brought to the facility by Mr. Gancthev would not be diverted to other patients, thereby causing them harm.
On the issue of Mr. Ganchev’s frustration with the vocational counsellor, Dr. Nagari agreed with the hypothetical that, if Mr. Gancthev were to obtain employment on his own, should there be an incident in the workplace and he had not disclosed his forensic status, that there could be consequences for the Hospital.
Beyond that concern though, Dr. Nagari explained all of the logistics of having a forensic patient under a detention order working in the community and opined that the procedures and requirements cannot be navigated by the patient alone without the assistance of the vocational counsellor.
At the conclusion of the evidence, all parties maintained their initial positions.
Analysis and Conclusions
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board finds that Mr. Gancthev continues to meet the threshold for significant threat to the safety of the public and concludes that a Detention Order Disposition with no changes to its terms and conditions is the least onerous and least restrictive, necessary and appropriate Disposition in the circumstances.
The Panel has come to this decision after a careful review of the Ontario Court of Appeal decision in Ramos (Re), 2025 ONCA 820. While the facts in Ramos differ significantly from that of the present case, the ratio decidendi is relevant to all cases that the Board hears.
In summary, the case of Ramos requires the Board to:
Remain attentive to constitutional protections and avoid the influence of stereotypes or prejudice;
Give thoughtful weight to the reasonable wishes and preferences of NCR individuals, while still prioritizing community safety;
Undertake a careful, individualized assessment that avoids assuming permanent or inherent dangerousness and instead evaluates the person’s present clinical and social circumstances;
Keep the legal thresholds distinct from hospital preferences or institutional rule compliance, recognizing that clinical convenience cannot substitute for the legal test and conducting a holistic assessment which acknowledges strengths and improvements;
Exercise its own independent judgment when reviewing professional opinions; and
Approach hearsay evidence with care, ensuring that any reliance on such information is fair, balanced, and consistent with the Board’s dual role of protecting both individual rights and public safety.
A significant threat to the safety of the public cannot be speculative. It must entail a real risk of serious physical or psychological harm arising from conduct that is both serious and criminal in nature.
In determining whether Mr. Gancthev represents a significant threat to the safety of the public, the Board has carefully analyzed the evidence as it relates to the Supreme Court of Canada decision in Winko, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625 and the definition of the term in s. 672.5401 of the Criminal Code. By definition, the term “safety of the public” has been held to include psychological harm.
Mr. Gancthev suffers from schizoaffective disorder which is largely controlled by his psychotropic medication. His personality factors have made further progress in his treatment quite difficult, however.
When he was previously unwell, and in the context of his cannabis use and medication noncompliance, Mr. Gancthev committed a shockingly violent and horrific offence against his father which caused his death. He has a prior criminal history with findings of guilt for violent offences and, while previously incarcerated, he assaulted not only correctional staff but his own lawyer.
Mr. Gancthev’s insight remains underdeveloped, and he refuses to believe that cannabis had any contribution to his previous delusions and psychosis, or that it could in any way destabilize his mental status.
According to the Hospital Report, in the hospital setting, Mr. Gancthev is described as generally compliant with rules, but he frequently pushes the boundaries of acceptable behaviour. He is quick to deny any rule violations and takes no responsibility for his actions. He struggles with underlying irritability and a sense of entitlement.
He had several notable incidents in the past reporting year, many involving cannabis use. Losing his privileges does not seem to motivate him to change his ways to increasingly prosocial and safe behaviour, which would be counter to the influence of his personality traits.
The Panel accepts the Hospital’s evidence that absent the stringent oversight of the Board, and the forensic structure and support provided by the Hospital under the Detention Order, Mr. Gancthev would engage in unmitigated cannabis and substance abuse which would destabilize his mental state, cause a reemergence of his delusional beliefs and other psychotic symptoms, and significantly increase the risk of violence against members of the public.
The Panel also accepts the evidence of the Hospital that Mr. Moon’s proposal for limited access to cannabis is neither practical nor consistent with criteria set out in s. 672.54 of the Criminal Code. The evidence is clear that cannabis has been a contributing factor to Mr. Gancthev’s previous periods of psychosis, including the index offence and his violent behaviour while he was incarcerated. This persuasive value of that evidence is not at all diminished by Mr. Gancthev’s subjective belief that cannabis does not affect his mental state. Clearly it has and it will in the future.
The Panel acknowledges the concerns of Mr. Moon, to the extent that Mr. Gancthev’s unwillingness to cease using cannabis is affecting his progress through the forensic system. The Panel does not agree with Mr. Moon on what the solution to this issue would be.
Many forensic patients struggle with achieving abstinence from substances, and this in turn, often slows or frustrates their progression through the forensic system. Forensic Hospitals have to consider not only the safety of their own patients but also the public at large, and they have to, and do, enact processes and procedures to achieve those goals.
In the case of Mr. Gancthev, the slowing of his progress through the forensic system seems to be tied not only to his inability to cease using cannabis, but his personality traits which manifest in his unwillingness to abide by the Hospital rules and to fully engage in his therapeutic programming.
If Mr. Gancthev were to develop some internal motivation to engage in therapy, this in turn would certainly help him in using that therapy to better develop his insight, his coping strategies and his ability to abstain from using cannabis.
Mr. Moon suggests that the Hospital should simply abandon its evidence-informed position on Mr. Gancthev’s use of cannabis and allow him to bring cannabis onto the Hospital Grounds. To do so would cause numerous problems and endanger the safety of the public, which includes Hospital staff and its many other patients. It would also set a dangerous precedent for other patients: if you protest enough, the Hospital and the Board will back down and give you what you ask for.
Mr. Gancthev is not in a position similar to the patient in Davies (Re) 2022 ONCA 716 – in fact the two cases could hardly be more dissimilar. Therefore, the Panel rejects Mr. Moon’s request to have some sort of carve-out to Mr. Gancthev’s Detention Order term that he not possess or consume intoxicating substances. The prohibition clause is clearly and unambiguously in accordance with the criteria set forth in in 672.54 of the Criminal Code.
In consideration of all the evidence, the submissions of the parties, the wishes of Mr. Gancthev and the criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Gancthev, his reintegration into society and his other needs, the Panel finds that a Detention Order Disposition with no changes to its terms and conditions is the necessary and appropriate Disposition.
DATED this 8th day of May 2026, at the City of Toronto, in the Toronto Region.
Mr. D. D’Intino Legal Member
Office of the Registrar Ontario Review Board