Re: Terrence Shorter
ORB File No: 7256
Hearing held on: Tuesday, April 7, 2026
Place of hearing: Centre for Addiction and Mental Health
Pursuant to: Sections 672.48(1) and 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Fromstein
Members: Hon. N. Kozloff
Dr. J. Kis
Dr. A. Kerry
Mr. S. Doherty
Parties Appearing:
Accused: Terrence Shorter
Counsel: Ms. M. Murphy
The person in charge of hospital: Counsel: Mr. J. McIntyre
Attorney General of Ontario: Counsel: Mr. D. Brandes
REASONS FOR DISPOSITION
(Dated May 21, 2026)
Introduction
On November 16, 2017, Mr. Terrence Shorter was found unfit to stand trial on account of a mental disorder (“unfit”) on one count of manslaughter, contrary to the Criminal Code of Canada (“Code”).
Mr. Shorter has remained under the jurisdiction of the Ontario Review Board (“ORB” and “the Board”) since that date. He is currently subject to a Disposition of the Ontario Review Board (“ORB” and “the Board”) dated February 12, 2025, finding that he is “at present unfit to stand trial” and ordering that he be detained at the Forensic Service of the Centre for Addiction and Mental Health (“CAMH” and “the hospital”), Toronto, with privileges up to and including living in the community of the Greater Toronto Area in accommodation approved by the person in charge.
On Tuesday, April 7, 2026, this panel of the Board was convened to conduct Mr. Shorter’s annual review. Mr. Shorter was present at the hearing and represented by Counsel, Ms. M. Murphy.
The issues to be determined at the hearing were whether Mr. Shorter remains unfit and if he is unfit, whether he continues to represent a significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code; if so, we must make the necessary and appropriate disposition which is also the least onerous and least restrictive, taking into account the factors set out in section 672.54 of the Criminal Code.
Position of the Parties
At the outset of the hearing, the parties were invited to provide without prejudice positions.
Counsel for the hospital submitted that Mr. Shorter continues to be unfit to stand trial and is not likely ever to become fit to stand trial, that he continues to pose a significant threat to the safety of the public, and, that a continuation of the current detention order on the same terms and conditions as the current disposition is the necessary and appropriate, least onerous and least restrictive disposition to protect the public in the circumstances.
Counsel for the Attorney General joined the hospital.
Counsel for Mr. Shorter advised that she was not seeking any change to the current disposition; in effect, this is the joint submission of all parties.
The Evidence
- A Hospital Report, dated March 19, 2026 (the "Hospital Report"), was entered as Exhibit 1 in the hearing. Dr. M. Choptiany, one of the authors of the Hospital Report and Mr. Shorter’s responsible psychiatrist, testified viva voce at the hearing.
Conclusions of the Board
- For the reasons that follow, the panel accepted the joint submission and concluded that Mr. Shorter remained unfit, was not likely to ever become fit, and was a significant threat to the safety of the public; and, that the current detention order at the Forensic Service of CAMH upon the same terms and conditions as the current disposition remains the necessary and appropriate, least onerous and least restrictive disposition.
The Outstanding Offence
- The details of the outstanding charge against Mr. Shorter are extracted from the Hospital Report (and have been edited for accuracy) as follows:
“CHARGE: MANSLAUGHTER CC 236
DATE: FEBRUARY 26TH, 2017
LOCATION: BRIDGEPOINT HEALTH CENTRE, 7TH FLOOR
1BRIDGEPOINT ROAD, TORONTO
VICTIM: Catherine MCNAMEE, 90 years
On February 26th, 2017, at approximately 6:00 AM the victim in this matter, Catherine MCNAMEE was walking in the hallway of the 7th floor of the Bridgepoint Health Centre, near room #125.
The accused shouted at the victim to "get away from me". The accused is a resident of the Bridgepoint Health Centre, room #125. This interaction was observed by a security officer employed by the Health Centre. Soon after this interaction the accused exited his room and pushed the victim. The victim fell to the floor and struck her head.
The security officer took photographs of the victim and the accused as he walked away.
Emergency Services were contacted and the victim was transported to St. Michael's Hospital by Ambulance. The victim was diagnosed with an inter-cranial bleed. Treatment was limited due to the victim's age, and she was eventually released back to Bridgepoint Health Centre on March 1st, 2017, and was to be monitored by hospital staff. The victim's health deteriorated and on March 4th, 2017, at approximately 10 PM the victim died. The coroner attended Bridgepoint Health Centre on March 5th, 2017, and commenced an investigation. An autopsy was ordered and the deceased was followed by police officers to the morgue.
Officers arrested the accused, Terry SHORTER for the assault that occurred on February 26th, 2017. The accused was given his rights to counsel and transported to 55 Division where he was held pending a bail hearing.
Ms. McNamee was a 90 year old, frail, elderly woman with clinically severe dementia. Although overall she was clinically stable in the months prior to her head injury, this is relative to her fragile baseline that was largely a consequence of her advanced age and chronic medical issues.
A postmortem was conducted by Dr. Kris Cunningham, Forensic Pathologist. Dr Cunningham determined the cause of death to be:
ACUTE ASPIRATION PNEUMONIA FOLLOWING BLUNT INJURIES OF THE HEAD AND BUTTOCK IN A FRAIL ELDERLY WOMAN WITH DEMENTIA
The blunt impact injuries to her head and left buttock in themselves would not have been independently lethal in an otherwise healthy individual. However, given her relatively delicate medical state, the blunt injuries likely started a chain of events that she was unable to manage physiologically. This would not be unexpected in a woman of this age and medical status. The physical and psychological stress of the trauma (although not directly lethal) on a background of severe dementia and frail constitution likely triggered the subsequent aspiration pneumonia, which represented the immediate cause for her death.
As a result on April 21, 2017, the charged were upgraded to manslaughter. The accused was advised of his new charges.”
Background History
- Mr. Shorter's background history is set out in detail in the Hospital Report. For the purposes of this Disposition, the following summary will suffice:
Mr. Shorter was born in England and moved to Canada at the age of six. He lived in Toronto for most of his life. He completed some grade 11 or 12 credits but did not obtain a high school diploma.
Mr. Shorter was diagnosed with schizophrenia in his early 20s and was hospitalized at various hospitals in the Toronto region. He has a history of medication non-adherence and refusal. In addition to his lengthy psychiatric history, Mr. Shorter also has a lengthy
criminal record commencing in 1978 and including multiple convictions for assault and assault causing bodily harm.
In June 2007, when he was approximately 58 years old, Mr. Shorter suffered a traumatic brain injury, likely from a physical assault. He suffers from vascular dementia secondary to the traumatic brain injury and has a poor memory and difficulty recalling events that have occurred since the 1970s. In a psychological report prepared in June 2018, Dr. Percy Wright found that Mr. Shorter's ability to consolidate memory into longer term storage is "grossly impaired", and that while fitness coaching may be of some benefit, this will likely not assist Mr. Shorter in incorporating information into his longer-term memory.
Sometime in the spring of 2015, Mr. Shorter suffered an ankle fracture. As a result, in May 2015, he was admitted to a long-term care bed at Bridgepoint Health (Bridgepoint) in Toronto, where he resided until his arrest in respect of the index offence in late February 2017.
Mr. Shorter was found unfit to stand trial on November 16, 2017. He was then admitted to the Forensic Assessment Treatment Unit at CAMH on November 23, 2017. Mr. Shorter was transferred to a forensic secure unit of the hospital on July 13, 2018, where he remains to date. He is being treated with paliperidone, a long-acting injectable antipsychotic, as well as valproic acid by substitute consent provided by his sisters.
Course since the Last Disposition
- The details of Mr. Shorter’s course in hospital since he was found unfit in 2017 are set out in the Hospital Report and need not be repeated here. The following is extracted from the portion of the report sub-titled CAMH. LSUB: January 2025 to March 2026:
“Mental Health
Mr. Shorter’s mental state remained relatively stable, except for intermittent unprovoked verbal outbursts towards male staff and co-patients. He continued to suffer from residual psychotic symptoms and cognitive impairment due to dementia. His thought process was tangential and circumstantial.
Concerning Behaviours
Mr. Shorter frequently exhibited verbal aggression, typically shouting profanities such as "shut up" or "fuck off" at co-patients or male staff, often triggered by environmental overstimulation, loud noises, or perceived boundary violations. A primary management strategy was modifying his mealtimes so that he could eat in the dining room before or after co-patients had eaten to avoid noise triggers. He agreed to a trial of noise-cancelling headphones to reduce stress from unit noise. When verbal de-escalation failed, PRN medications such as Olanzapine or Quetiapine were effectively used to settle his agitation.
Mr. Shorter was scored daily on the Dynamic Appraisal of Situational Aggression (DASA), a 7-item, evidence-based tool used in mental health settings to assess the risk of imminent patient aggression within the next 24 hours. It focuses on 7 dynamic behaviors rated 0-1, with total scores of 0–1 (low), 2–3 (moderate), and 4–7 (high) to guide immediate preventative interventions. While many shifts DASA scores of 0, several high DASA scores were noted:
DASA 5 (May 23, 2025): Mr. Shorter used verbal slurs and then yelled at and pushed a co-patient after exiting the treatment room.
DASA 7 (June 10, 2025): This was the highest recorded score, resulting from an unprovoked physical altercation. He refused redirection, pushed two co-patients, and engaged in a fight that required a Code White response and PRN medication.
DASA 6 (July 17, 2025): Mr. Shorter displayed physical aggression toward security staff during both day and night shifts, following an earlier outburst that led to a period of emergency locked seclusion.
DASA 4 (Multiple dates including September 1, October 30, and December 1, 2025): These scores were typically for impulsivity and sensitivity to provocation. For instance, on December 1, Mr. Shorter threw his walker to the ground and chased a co-patient and staff after becoming explosively angry in the dining room.”
Diagnoses
Mr. Shorter’s psychiatric diagnoses are set out in the Hospital Report:
Schizophrenia
Mild Neurocognitive Disorder, Multiple Etiologies (Vascular Disease, Traumatic Brain Injury)
Fitness to Stand Trial
- The following is extracted from the Hospital Report:
“Mr. Shorter has been unable to recall the nature of charges or the circumstances that resulted in his detention under the auspices of the ORB. His ability to process and retain information and to consolidate information into memory is limited due to his cognitive impairment. As a result, he is unable to understand and comprehend legal proceedings. Furthermore, his selective aggression towards males and unfamiliar people would likely interfere with his ability to engage meaningfully in judicial processes.
As such, Mr. Shorter presents as unfit to stand trial from a psychiatric perspective and is likely permanently unfit.”
Risk
- The following is extracted from the Hospital Report:
“Based on Mr. Shorter’s active symptoms of major mental illness, problems with treatment and supervision response, and violence risk assessment scores, the clinical team opines that he continues to represent a significant threat to the safety of the public as defined in Section 672.54 of the Criminal Code. He would remain a moderate risk for violence under the recommended disposition with the current supports in place.”
- Given the risk factors outlined in the Hospital Report, and given that Mr. Shorter represents a significant threat to the safety of the public, the clinical team does not recommend a Stay of Proceedings.
Recommendation of the Clinical Team
- The following is extracted from the Hospital Report:
“The following recommendations are based on the unanimous opinion of the treatment team. It constitutes a necessary and appropriate disposition in the circumstances, having considered the liberty of the accused, the safety of the public, which is the paramount consideration, the mental condition of the accused, the reintegration of the accused into society and other needs of the accused.
Mr. Shorter will continue to require treatment with antipsychotic medications for his schizophrenia. There has been a partial response to these medications, with residual symptoms such as delusions and irritability. Mr. Shorter’ diagnosis of a neurocognitive disorder further exacerbates any irritability and behavioural disinhibition. Due to the chronic and progressive nature of dementias, and the lack of available treatments to target these aspects, risk management is more limited. While some behavioural disturbances associated with dementia can be addressed, the cognitive decline will continue to have destabilizing and disinhibited effect. Appropriate environmental settings with intensive staff supervision will be required to manage this risk factor.
Presently Mr. Shorter requires inpatient hospitalization until such time that an appropriate long-term care facility in the community is available. A medium secure forensic unit provides the level of care and supervision that he requires. Mr. Shorter has both psychiatric and medical needs that require monitoring by professional services for any signs and symptoms of decompensation. A suitable community living would need to provide 24-hour high supports. In considering his violence risk profile and ongoing dynamic risk factors, he continues to meet the threshold for significant threat and is best managed under a Detention Order disposition.
The clinical team recommends the continuation of a detention at the Forensic Service at CAMH with community living.”
Evidence at the Hearing
Dr. Choptiany has been a psychiatrist on the Forensic inpatient unit at CAMH since 2018. He began by adopting the contents of the Hospital Report of which he is a co-author.
By way of update, the doctor advised that he had met with Mr. Shorter “today” and conducted a further fitness assessment. In his opinion, Mr. Shorter remains unfit for the reasons set out in the Hospital Report. He has no recollection, awareness or understanding of the index offence. He has no ability to instruct counsel and/or to participate meaningfully in his trial. This is due to his psychosis and his traumatic brain injury.
Mr. Shorter continues to meet the significant threat threshold.
A conditional discharge disposition would be inadequate to manage his risk because there is no suitable housing available or anticipated, and because swift intervention by the hospital would be required in the event of decompensation and the Mental Health Act is inadequate.
There are no suitable long term care facilities available to manage Mr. Shorter’s care or his risk.
When counsel for the Crown noted Mr. Shorter’s (rare) attendance at the hearing and asked if that was a sign of improvement, Dr. Choptiany replied, “Not in his case… Mr. Shorter did not recognize me today and I’ve been treating him for 8 years.”
The doctor noted that Mr. Shorter’s sisters, who live in Pembroke, visit him and call him. He observed that this helps with his care and management, adding that the clinical team is fortunate to have them involved.
Dr. Choptiany opined that Mr. Shorter “does not know why he is here today:”
Regarding management strategies, the doctor listed inter alia “eating alone” and “reducing his exposure to stimuli and disruption” while noting the recent violent acting out by Mr. Shorter in hospital. (See above in Course since the Last Disposition under Concerning Behaviours) He opined that Mr. Shorter seems to be easily upset without provocation.
Regarding term 2(h) in the current Disposition - “to live in the community of the Greater Toronto Area in accommodation approved by the person in charge” – Dr. Choptiany explained that “we ask to have it included in case appropriate accommodation becomes available.”
Final Submissions
- Counsel for the hospital, the Attorney General and Mr. Shorter maintained the positions they had taken at the outset of the hearing.
Analysis and Conclusions
Fitness
As summarized by the Court of Appeal in R. v. Bharwani. 2023 ONCA 205 at para. 167, the following principles inform all fitness assessments:
"1. There is one fitness test for all accused, whether represented by counsel or not. This test is applied contextually.
The test for fitness is set out in the statutory definition of “unfit to stand trial” in s. 2 of the Criminal Code.
A person is unfit to stand trial if, on account of mental disorder, the person is unable to conduct a defence or to instruct counsel to do so.
The purpose of the s. 2 fitness test is to ensure that the accused can be meaningfully present and meaningfully participate at their trial. These touchstones inform a purposive interpretation and application of the s. 2 fitness test and do not themselves constitute a stand-alone test.
The Taylor test questions are not a sufficient surrogate for assessing fitness but are helpful in providing insights into an accused's abilities in relation to the s. 2 criteria. Applying the fitness test is more nuanced than the questions recognize.
The accused must have a reality-based understanding of the nature and object and possible consequences of the proceedings.
The accused must have the ability to make decisions. This involves the ability to understand available options, the ability to select from those options, the ability to understand the basic consequences arising from those options, and the ability to intelligibly communicate to either counsel or the court the decision arrived upon.
The accused need not have the capacity to engage in analytic thinking in the sense that the accused need not be capable of making decisions in their own best interests."
As set out in the Hospital Report and the testimony of Dr. Choptiany, Mr. Shorter’s fitness to stand trial was assessed on multiple occasions over the reporting year, including on the morning of the hearing.
“Mr. Shorter has been unable to recall the nature of charges or the circumstances that resulted in his detention under the auspices of the ORB. His ability to process and retain information and to consolidate information into memory is limited due to his cognitive impairment. As a result, he is unable to understand and comprehend legal proceedings. Furthermore, his selective aggression towards males and unfamiliar people would likely interfere with his ability to engage meaningfully in judicial processes.
As such, Mr. Shorter presents as unfit to stand trial from a psychiatric perspective and is likely permanently unfit.”
Based upon the clear, convincing, and uncontradicted evidence in the Hospital Report and the oral testimony of Dr. Choptiany, and having heard and considered the submissions of counsel, the Board is in unanimous agreement that Mr. Shorter continues to be unfit to stand trial and that he is likely permanently unfit. Mr. Shorter is diagnosed with schizophrenia and with neurocognitive disorders. He is unable to recall the nature and of and circumstances underlying the charge against him. His ability to process and retain information is limited due to his cognitive impairment. Mr. Shorter would be unable to instruct counsel and to meaningfully participate in a trial.
Significant Threat to the Safety of the Public
Given our finding that Mr. Shorter is not likely to ever become fit to stand trial, s. 672.851 of the Criminal Code obliges us to go on to consider whether we are of the opinion that he poses a significant threat to the safety of the public.
A significant threat to the safety of the public is one that involves a real risk of serious physical or psychological harm to members of the public that goes beyond the merely trivial or annoying. If he does not, then we are obliged to make a recommendation to the court that has jurisdiction in respect of the offences charged against Mr. Finkler to hold an inquiry to determine whether a stay of proceedings should be ordered.
Based upon the clear, convincing, and uncontradicted evidence in the Hospital Report and the oral testimony of Dr. Choptiany - the salient portions of which are set out in these reasons - and having heard and considered the submissions of counsel, the Board is in unanimous agreement that Mr. Shorter is a significant threat to the safety of the public as defined in Section 672.5401 of the Code, in that there is a significant risk that he will engage in criminal conduct that would cause serious physical or psychological harm to others.
The Necessary and Appropriate Disposition
The parties are all agreed, and we unanimously so find on the totality of the evidence, that a detention order with the same terms and conditions as the current Disposition continues to be required to manage Mr. Shorter’s risk. In coming to our decision, we have taken into consideration the factors at s. 672.54 of the Criminal Code of Canada, namely the protection of the public, which is the paramount consideration, the mental condition of the accused, his reintegration into society and his other needs.
DATED this 21st day of May, 2026, at the City of Toronto, in the Region of Toronto.
Hon. N. Kozloff
Legal Member
__________________
Office of the Registrar
Ontario Review Board

