CITATION: Taylor v. Ogbonna, 2026 ONSC 3143
ONTARIO
SUPERIOR COURT OF JUSTICE
BETWEEN:
JENNIFER TAYLOR
Appellant
– and –
DR. CHINEDU OGBONNA
Respondent
IKENNA ANIEKWE
Self Represented
S. Morris, for the Respondent
DAVID W. SHANNON
Amicus Curiae
HEARD: April 02, 2026
Rasaiah J.
REASONS ON APPEALS
INTRODUCTION
1This case involves two appeals from decisions of the Consent and Capacity Board (“Board”) made pursuant to the Health Care Consent Act, 1996, S.O. 1996, C. 2, Sched. A (“HCCA”).
2The appellant is challenging the Board decision made June 25, 2025, finding that she is incapable under the HCCA of consenting to treatment with antipsychotic medications; Court File No. 29921/25.
3The appellant is also challenging the Board decision made October 10, 2025, finding that she lacked capacity to manage property; Court File No. 30001/25.
4Mr. Shannon was appointed as Amicus Curiae on the first appeal, for the appellant who represents herself; Ms. Morris appeared for the respondent.
5Mr. Aniekwe was appointed as Amicus Curiae on the second appeal, for the appellant who represents herself; Ms. Morris appeared for the respondent.
ANALYSIS
Legal Principles/Authorities
6Section 80 of the HCCA is the applicable authority for both appeals.
7There is a statutory right of a party to a proceeding before the Board to appeal on a question of law, fact, or both to this court.
8The appellate standards of review apply to appeals from decisions of the Board: Canada (Minister of Citizenship and Immigration) v. Vavilov, 2019 SCC 65 at para. 37. As set out in Housen v. Nikolaisen, 2002 SCC 33, the standard of correctness applies to questions of law (including questions of statutory interpretation and those concerning the scope of a decision-maker’s authority) and the standard of palpable and overriding error applies to questions of fact, and questions of mixed fact and law, unless an error of law can be extricated from the mixed question of fact and law, in which case the standard of correctness applies: R.J. v. Liu, 2022 ONSC 3386, para 36.
9Section 80 of the HCCA provides that this court may exercise all powers of the Board; substitute its opinion for that of a health practitioner, an evaluator, a substitute decision-maker, or the Board; or refer the matter back to the Board, with directions, for rehearing in whole or in part.
10The correctness standard means that a reviewing court need not show deference to the reasoning process of the lower court or tribunal and must undertake its own analysis of whether the decision was legally correct.
11The issues in these appeals I find pertain to the application of the law to the facts and are questions of mixed fact and law. As a result, with one exception discussed below, the standard of review is palpable and overriding error.
12The standard of palpable and overriding error was described as follows by the Court of Appeal in Farsi v. Da Rocha, 2020 ONCA 92 at para. 35:
[35] A palpable and overriding error is one that is clearly wrong, unreasonable, or not reasonably supported on the evidence: H.L. v. Canada (Attorney General), 2005 SCC 25, [2005] 1 S.C.R. 401, at para. 110. The Supreme Court recently explained in Salomon v. Matte‑Thompson, 2019 SCC 14, 432 D.L.R. (4th) 1, at para. 33, “[w]here the deferential standard of palpable and overriding error applies, an appellate court can intervene only if there is an obvious error in the trial decision that is determinative of the outcome of the case.”
13In Liu, at para. 38, the court writes: The fact that an alternative factual finding could be reached based on a different ascription of weight does not mean that a palpable and overriding error has been made: see Nelson (City) v. Mowatt, 2017 SCC 8 at para. 38 and Salomon v. Matte‑Thompson, 2019 SCC 14 at para. 33.
14The question of the weight to ascribe to different and potentially conflicting evidence is a question of fact to which the standard of palpable and overriding error applies. Weighing evidence is a fundamental function of the trier of fact. The court must remain mindful that it would not be appropriate to interfere when there was ample evidence on which the administrative tribunal could come to the decision it did: MLD v. Liu, 2023 ONSC 2756, para. 19.
15For questions of procedural fairness, the standard of review is correctness; in determining whether the Board met the standard in its application of procedural fairness, the Board is entitled to some deference in determining the scope of procedural fairness in a particular proceeding and is dependent on the administrative tribunal, and its enabling legislation: L.L. v. Rohani, 2023 ONSC 4349, para. 19.
16The test for capacity to manage property under s. 6 of the Substitute Decisions Act is to be analyzed as the similar test for capacity for treatment under the HCCA, s. 4(1); a person is incapable of managing property if the person is not able to understand information that is relevant to making a decision in the management of his or her property, or is not able to appreciate the reasonably foreseeable consequences of a decision or lack of decision. A person will be incapable if he or she fails one or the other.
17Section 4(1) of the HCCA describes the elements as follows:
4(1) A person is capable with respect to a treatment, admission to a care facility or a personal assistance service if the person is able to understand the information that is relevant to making a decision about the treatment, admission or personal assistance service, as the case may be, and able to appreciate the reasonably foreseeable consequences of a decision or lack of decision.
18The Supreme Court of Canada in Starson v. Swayze, [2003] 1 S.C.R. 722, 2003 SCC 32, para. 77, wrote regarding applicable presumptions, onus and standard of proof:
77 The law presumes a person is capable to decide to accept or reject medical treatment: s. 4(2) of the Act. At a capacity hearing, the onus is on the attending physician to prove that the patient is incapable. I agree with the Court of Appeal that proof is the civil standard of a balance of probabilities. As a result, patients with mental disorders are presumptively entitled to make their own treatment decisions. Professor D. N. Weisstub, in his Enquiry on Mental Competency: Final Report (1990), at p. 116 (“Weisstub Report”), notes the historical failure to respect this presumption:
The tendency to conflate mental illness with lack of capacity, which occurs to an even greater extent when involuntary commitment is involved, has deep historical roots, and even though changes have occurred in the law over the past twenty years, attitudes and beliefs have been slow to change. For this reason, it is particularly important that autonomy and self determination be given priority when assessing individuals in this group.
The Board must avoid the error of equating the presence of a mental disorder with incapacity. Here, the respondent did not forfeit his right to self-determination upon admission to the psychiatric facility: see Fleming v. Reid, supra, at p. 86. The presumption of capacity can be displaced only by evidence that a patient lacks the requisite elements of capacity provided by the Act.
19The Supreme Court of Canada in Starson at para. 78, wrote:
78 Capacity involves two criteria. First, a person must be able to understand the information that is relevant to making a treatment decision. This requires the cognitive ability to process, retain and understand the relevant information. There is no doubt that the respondent satisfied this criterion. Second, a person must be able to appreciate the reasonably foreseeable consequences of the decision or lack of one. This requires the patient to be able to apply the relevant information to his or her circumstances, and to be able to weigh the foreseeable risks and benefits of a decision or lack thereof ...
20The Supreme Court of Canada in Starson at para. 79, wrote:
79 … a patient need not agree with the diagnosis of the attending physician in order to be able to apply the relevant information to his own circumstances. Psychiatry is not an exact science, and “capable but dissident interpretations of information” are to be expected: see Weisstub Report, supra, at p. 229. While a patient need not agree with a particular diagnosis, if it is demonstrated that he has a mental “condition”, the patient must be able to recognize the possibility that he is affected by that condition. Professor Weisstub comments on this requirement as follows (at p. 250, note 443):
Condition refers to the broader manifestations of the illness rather than the existence of a discrete diagnosable pathology. The word condition allows the requirement for understanding to focus on the objectively discernible manifestations of the illness rather than the interpretation that is made of these manifestations.
As a result, a patient is not required to describe his mental condition as an “illness”, or to otherwise characterize the condition in negative terms. Nor is a patient required to agree with the attending physician’s opinion regarding the cause of that condition. Nonetheless, if the patient’s condition results in him being unable to recognize that he is affected by its manifestations, he will be unable to apply the relevant information to his circumstances, and unable to appreciate the consequences of his decision.
21The Supreme Court of Canada in Starson at paras. 80, and 81, wrote:
80 Secondly, the Act requires a patient to have the ability to appreciate the consequences of a decision. It does not require actual appreciation of those consequences. The distinction is subtle but important: see L. H. Roth, A. Meisel and C. W. Lidz, “Tests of Competency to Consent to Treatment” (1977), 134 Am. J. Psychiatry 279, at pp. 281-82, and Weisstub Report, supra, at p. 249. In practice, the determination of capacity should begin with an inquiry into the patient’s actual appreciation of the parameters of the decision being made: the nature and purpose of the proposed treatment; the foreseeable benefits and risks of treatment; the alternative courses of action available; and the expected consequences of not having the treatment. If the patient shows an appreciation of these parameters — regardless of whether he weighs or values the information differently than the attending physician and disagrees with the treatment recommendation — he has the ability to appreciate the decision he makes: see Roth, Meisel and Lidz, supra, at p. 281.
81 However, a patient’s failure to demonstrate actual appreciation does not inexorably lead to a conclusion of incapacity. The patient’s lack of appreciation may derive from causes that do not undermine his ability to appreciate consequences. For instance, a lack of appreciation may reflect the attending physician’s failure to adequately inform the patient of the decision’s consequences: see the Weisstub Report, supra, at p. 249. Accordingly, it is imperative that the Board inquire into the reasons for the patient’s failure to appreciate consequences. A finding of incapacity is justified only if those reasons demonstrate that the patient’s mental disorder prevents him from having the ability to appreciate the foreseeable consequences of the decision.
22On ability to understand the matters relevant to competence, the Ontario Court of Appeal referred with approval to a comment made by a Board, stating that there are situations where a person may understand in an intellectual sense the subject-matter in respect of which consent is requested and further understand the nature of the illness for which treatment is proposed and understand the treatment proposed, but his or her ability to appreciate the same as it relates to themselves may be impaired by the mental disorder: Khan v. St. Thomas Psychiatric Hospital, 1992 7464 (ONCA)
23The Supreme Court of Canada in Starson at paras. 18, and 19, wrote:
18 Commentators have identified three “common clinical indicators” of a person’s ability to appreciate the consequences of accepting or declining treatment: “whether the person is able to acknowledge the fact that the condition for which treatment is recommended may affect him or her; whether the person is able to assess how the proposed treatment and alternatives, including no treatment, could affect his or her life or quality of life; [whether] the person’s choice is not substantially based on a delusional belief”: B. F. Hoffman, The Law of Consent to Treatment in Ontario (2nd ed. 1997), at p. 18. These indicators provide a useful framework for identifying what “ability to appreciate” means in concrete terms.
19 Like understanding, appreciation does not require agreement with a particular conclusion, professional or otherwise. A patient may look at the pros and cons of treatment and arrive at a different conclusion than the medical experts. Nor does it amount to a “best interests” standard. A patient who is capable has the right to refuse treatment, even if that treatment is, from a medical perspective, in his or her best interest. It is crucial to guard against interpreting disagreement with a particular diagnosis or proposed treatment plan as itself evidence of incapacity. But just as it is important to protect patients’ capable wishes to refuse treatment, so is it important to ensure that patients who are not capable of making treatment decisions receive appropriate treatment.
The June 25, 2025-Decision: CV-25-00029921-000
Introduction
24The appellant appeals the June 25, 2025 decision of the Consent and Capacity Board (“Board”) finding that she lacked capacity, as defined in the HCCA to consent to treatment with anti-psychotic medication and mood stabilizers.
25On this appeal, the appellant seeks extension to appeal be granted under s. 80(1) of the HCCA and a publication ban. The appellant’s position is that the appeal should be allowed; the Board’s finding of incapacity set aside; and that the court declare that the appellant is capable or in the alternative remit the matter to a different constituted panel of the Board for rehearing of the issue of capacity.
26As for the extension of time to bring the within appeal and publication ban, same was not opposed; the respondent takes no position on the request for extension under s. 80 of the HCCA or the requested publication ban. Accordingly, the respondent takes no position against the appellants submissions of no prejudice, that it promotes procedural fairness in adjudicating a matter involving personal autonomy and fundamental rights, and considering the delay was minimal and explained. As to interests of justice favouring a hearing of the merits, that was not opposed either; the respondent taking no position. As such, I see no reason not to grant the foregoing. These findings also apply to the October 10, 2025 decision, and I will not repeat them under that section. Accordingly leave and the publication ban are hereby granted.
27The appellant submits that this appeal presents an important question concerning the proper interpretation of “appreciation” under s. 4(1) of the HCCA and the protection of the presumption of capacity. The appellant submits: that the Board wrongly accepted and relied on extensive collateral evidence, namely photographs and a letter from the individual, C.M.; that the Board wrongly found that the appellant was guarded and disengaged with the physician; that the Board wrongly and heavily relied on demeanour observations (specified as tangentiality, agitation and guardedness), on prior hospital admissions, collateral correspondence, third-party letters, and photographs provided mid-hearing; that the Board wrongly concluded that her guarded and oppositional stance showed a lack of insight and therefore concluding an inability to appreciate the consequences of refusing treatment, failing to consider how she was taking in the information, believing it and/or weighing it; and that the Board wrongly conflated their assessment with “best interests”. The appellant states the inquiry is not into her choice (only what is best) but into her ability to choose; identifying what specific cognitive step she cannot perform: understand, believe or weigh, not unreasonableness of her decision to refuse treatment.
28The appellant also submits that the Board received hearsay evidence failing to be careful with their assessment of it, placing undue emphasis on uncorroborated evidence that lacked sufficient indicia of reliability; that while medical records may be received, caution is required against undue reliance on uncorroborated or unreliable evidence.
29The appellant takes the position that she did not experience psychosis, that she had PTSD, that she had ADHD, that she had legitimate concerns about side effects (such as tardive dyskinesia) that she communicated to the Board; and that she expressed willingness to receive medical care in a setting where she trusted the clinician (she had a lack of trust of the physician).
30With respect to the June 25, 2025 decision, the respondent is seeking an order dismissing the appeal. The respondent’s position is that the Board considered and weighed the evidence and correctly applied the law to the facts; that there was no palpable and overriding error made. The respondent’s position is that the Board’s decision should be upheld.
31In this appeal, as to capacity findings, it is the findings on the second criterion of capacity that is in issue: ability to appreciate the reasonably foreseeable consequences of taking or not taking the medication that was being recommended, the treatment. In this case, as to the first criterion regarding the test for capacity, the Board identified that this was not in dispute.
32I do not find that the Board ignored the appellant’s autonomy and self-determination, that they equated presence of a mental disorder with incapacity; There was evidence to displace the presumption of capacity, evidence that the appellant was not able to apply the relevant information to her circumstances to be able to weigh the foreseeable risks and benefits of her decision to refuse the treatment. I recognize that the appellant does not agree with her diagnosis, however there was ample evidence before the Board that the appellant had mental health conditions and that she was not able to recognize the possibility that she was affected by that condition. The manifestations of the illness were before the court, and evidence that she was not able to recognize she is affected by the manifestations making her unable to appreciate the consequences of refusing the treatment. The evidence included the purpose of the proposed treatment; the nature, meaning administration of medications, that these medications were the course of action available; and the expected consequences of not having the treatment. The evidence included inquiry into the reasons for the appellant’s failure to appreciate consequences and it did not include any failure on the part of the respondent to adequately inform herself of them. The Board’s decision reflects that their assessment that the appellant’s ability to appreciate the foreseeable consequences of her not taking the medications as being impaired by her mental disorder. They had reviewed the materials. The Board identified a common clinical indicator, namely choice being substantially based on delusional belief and rejected that she had looked at the pros and cons and that she was capable. In my view, the analysis was there and was sufficient. I do not agree that the approach was “medical best interests”. The appellant was represented and testified. The respondent testified and was cross-examined. The panel also asked questions. The appellant had been admitted three times in the last year prior and the respondent had been her physician since first admission. Before Ontario, the appellant had been admitted to hospital in Alberta twice. This was all known by the panel. The consequences of not receiving the treatment were in the materials that were before the panel as pointed out by Ms. Morris at the appeal hearing. The example of comorbid health issues were exemplified in the appellants evidence before the board, as identified by Ms. Morris as well. Deference is owed. I cannot find clear error or unsupported findings. The foregoing was engaged both at the hearing and in the Board’s reasons; I agree with the submissions of Ms. Morris.
33I do not find that the Board wrongly accepted or relied on the collateral evidence tendered before them.
34I do not find that the Board wrongly and heavily relied on demeanour observations (specified as tangentiality, agitation and guardedness). The evidence was not limited to their demeanour observations. The testimony of the respondent and documents formed part of their considerations.
35The appellant states the Board’s reliance on/assessment of her having guarded affect, frustration and distrust of Dr. Ogbonna is relational dynamics, not cognitive incapacity. The appellant presents the Board as wrongly relying on her guardedness, distrust of the physician, disagreement with diagnosis, refusal of treatment, and her concerns about previous adverse side effects. The appellant highlights Fleming v Reid (1991) 1991 2728 (ON CA), 4 O.R. (3d) 74 (C.A.) as underscoring that forced psychotropic treatment is among the most intrusive forms of medical intervention and requires strict adherence to the statutory protections. I do not agree.
36I do not find that the Board wrongly found that the appellant was guarded and disengaged with the physician on the evidence tendered; that the Board wrongly concluded that her guarded and oppositional stance showed a lack of insight and therefore concluding an inability to appreciate the consequences of refusing treatment, failing to consider how she was taking in the information, believing it and/or weighing it. Again, there was direct evidence of the respondent and medical records before them to this effect,
37While the appellant expressed that she did not experience psychosis, that she had PTSD, that she had ADHD, that she had legitimate concerns about side effects (such as tardive dyskinesia) that she communicated to the Board; and that she expressed willingness to receive medical care in a setting where she trusted the clinician (she had a lack of trust of the physician). There was ample evidence of delusional thinking and evidence that she had improved in the past with treatment and observed deterioration when she stopped compared to her baseline. She became essentially homeless; stayed in a cabin with no fresh water; was refusing to take medication; was relying on others; believed she suffered multiple health issues, etc.
38The appellant states she raised drowsiness and movement problems related to the proposed treatment; that she distinguished those experiences from untreated hypothyroidism accurately describing symptoms of myxedema coma and need for titration.
39She states she expressed that she thought her PTSD and ADHD overlapped with bipolar disorder and thyroid disease (and her medication had been withheld since June for that). She states she was entitled to disagree with the diagnosis of her having bipolar disorder, the diagnosis, while also demonstrating that she appreciates the drug would sedate her, alter her perception or have other consequences; stating she may choose to live with the voices.
40The appellant raises states that she explained in June when she arrived there about her thyroid and ADHD; that medication was withheld; that the doctor was not familiar with her history; that she was refused permission to take her medication; that she repeatedly asked the respondent to step away from her care. The appellant states this demonstrates a detailed knowledge of her medical concerns, understanding her conditions, the nature of them, and consequences of under-treatment. She demonstrated ability to process reasoning. They injected “unwiseness” improperly. She was making an informed, reasoned and autonomous choice to refuse medication at this time.
41The appellant states she repeatedly expressed a willingness to engage in care if under a different physician she trusted: page 55-56 of the transcript, lines 19-25 and 1-13 respectively.
42The appellant states that the thyroid medication issues, housing instability and strained family relationships bore on overall wellness but did not prove incapacity; that the Board’s consideration of this pushed them to wrongly use a “best interests’ approach” which is wrong; that they imported non-psychiatric considerations. The appellant states that these facts were/are irrelevant to her treatment decision, which should be confined to discussion regarding the specific drugs proposed, their intended effect, and the magnitude of potential benefits and risks. The appellant repeated the Board did not do this; there is no discussion in the decision of same. By contrast, the appellant states she discussed the medications by name, dosing history, and that she weighed the perceived benefit against side-effects, demonstrating her capacity.
43The appellant states there was extensive evidence of rational and reality-based reasoning citing accurately identifying the nature and risks of her thyroid condition, being able to distinguish between emotional language and literal belief (puked by guts out), recognition of social and legal context of her detention; articulation of a coherent plan to continue treatment voluntarily under another doctor. The appellant asserts the Board made impermissible attitudinal judgments, that she was difficult, distrustful, or angry, none of which she states establishes cognitive inability to appreciate the reasonable foreseeable consequences of taking or not taking the medication. I do not agree.
Details
44The hearing was held June 25, 2025, and the Board released its decisions the same day with requested written reasons that followed, on July 8, 2025.
45The panel was properly constituted per the reasons filed before me.
46The appellant was presented as having a mental disorder of a nature or quality that would likely result in serious physical impairment of herself and substantial mental deterioration.
47The appellant was represented by legal counsel at the hearing.
48The decision outlines that testimony was received from the physician and the appellant and sets out a list of the documents that were filed as evidence.
49The Board summarily outlined the background of the appellant demonstrating an appreciation of her age, history, supports, and how she came to be at and held by the Sault Area Hospital (“SAH”).
50The Board identified the correct onus at the hearing and standard of proof. They also properly identified the need to be satisfied on cogent and compelling evidence, and that there is no onus whatsoever on the appellant.
51The Board identified correctly their responsibility to consider all evidence properly before it and that while hearsay evidence may be accepted, it must be carefully weighed.
52The Board properly identified the test for capacity.
53On page 7 of their written reasons, the Board presents as having accepted the respondent’s evidence that the appellant had an initial diagnosis of bipolar disorder, but that it was revised thereafter to schizoaffective disorder, bipolar type; that she had manic manifestations of paranoia, persecutory delusions, grandiosity, lability, irritability, agitation, intrusiveness, pressured speech, tangential thought processes, bizarre behaviours, guardedness, poor judgment, and lack of insight. The Board considered that there had been two previous psychiatric hospitalizations in Alberta, and that her hospitalization at the time in Ontario was her third since returning to Ontario (in the Spring of 2024); a total of five. They considered that the respondent had known the appellant since her first SAH hospitalization (in Ontario); outlining that the first one was almost three weeks in duration, the second almost 3.5 months (before the third).
54The Board demonstrated consideration of collateral evidence from the appellant’s former partner of mental decline since June of 2023 that had been reported, and it being steep over the two months preceding her first hospitalization in Ontario in July of 2024. They considered his comments that she was paranoid, claiming police were imposters, that she was driving at extremely high speeds between Alberta and Ontario causing her partner to ask to be let out of the car and she being later stopped for speeding 130 to 150 km/h; that he observed her to be pacing, hyper talkative, not sleeping for days and grandiose. Of note, there was no objection to the admissibility of this evidence; and later through the appellant’s own testimony there were corroborative comments of some of the events from the appellant albeit she did not agree with the characterization (for example, the speeding, and she and her former partner travelling to Ontario and her being hospitalized shortly thereafter). This was all evidence properly before them.
55The Board considered the hospital discharge summary for her July 2024’s hospitalization wherein she was noted to have exhibited rapid speech, tangential thought form and agitation; that she had refused treatment with antipsychotics and was discharged. This was a medical record that was admissible, and the Board was entitled to review, medical records.
56The Board considered in the medical records regarding the second hospitalization, noting family member reports of the appellant exhibiting low frustration tolerance, being increasingly irate, confrontational, invading personal spaces, being easily agitated, exhibiting persecutory delusions, that she was found walking on a highway inappropriately dressed for the weather. As to corroboration, and weighing, with respect to this evidence, I noted that the Board noted that the appellant had been observed expressing the same persecutory delusions in hospital as had been reported by the family members, observed to be intrusive with co-patients, irritable, labile, dismissive and suspicious of staff, having pressured speech and her thought form tangential. They noted administration of antipsychotic injection January of 2025 and a CTO that was revoked after.
57The Board considered that the appellant at the time of the hearing had been hospitalized for 1.5 weeks (third admission) and referring to the direct observations of the respondent during that time, and comparisons to previous presentations from the previous hospitalizations directly observed by him. The Board considered records of another physician similarly documenting the same/similar observations. This was proper.
58The foregoing demonstrated to me that the Board was considering the whole of the evidence and weighing it, including corroboration that included direct observation by the respondent and other health care providers.
59The Board considered documented collateral information from family members and friends regarding the appellant’s living conditions and behaviour prior to her third admission which included alleged threats to kill herself. The collateral information included three photographs stated to have been taken by her family after her arrival and were purported to depict level of agitation. The information included a letter from a family friend C.M. who was noted as being stated as a support for the appellant. When referring to C.M.’s letter, the decision reads as the Board considering C.M.’s direct observations recorded/reported and confirming her support role as indicated by family; and not relying on any “double hearsay”.
60The Board considered that the appellant did not repeat her delusions to the respondent directly, but also noted his direct interactions with her and what other staff noted; the appellant asking to see ID badges to confirm identity and her often talking about cameras watching her when there were none, referencing a “hit” out on her, and that others were responsible for her decline. The Board considered that delusions were not communicated every single day during his assessments. The Board considered the respondent’s evidence that many delusions were reported to him by staff members including nurses, a social worker and other physicians. The Board considered the respondent’s evidence that the appellant was not at her baseline.
61As to side effects, it is clear the Board considered that the respondent testified that the appellant had improved with treatment in her last hospitalization, that by January of 2025, she was less intrusive, less irritable, less paranoid, her personal care improved, and her speech returned to normal tone, pitch and rate.
62The Board presents has having considered the respondent’s evidence that the appellant was very dismissive during the respondent’s conversations with her and that she stated that she did not believe that she had any mental health concerns; that she only acknowledged having ADHD; that she disagreed she was experiencing mania, hypomania, or psychosis; that she was adamantly disinterested in medications. The Board considered that the foregoing was similarly noted by another physician, namely that the appellant was conveying that she did not require mental health attention or mental health admission, that she believed she never had bipolar disorder and did not understand how she could have it now; that she believed her previous hospitalizations were unwarranted. The evidence was before them.
63As for foreseeable consequences of not taking the medication, the Board noted the respondent’s evidence that same would include worsening mental deterioration, rehospitalizations, physical impairment, complications of hypothyroidism, functional impairment, financial instability, increased social isolation, impact on ability to parent, and homelessness.
64As to the appellant’s hypothyroidism, the Board considered the respondent’s evidence that the appellant presented as not having been taking her medication prior to hospitalization based on testing, and noting she had been discharged in January of 2025 with a prescription. The Board noted that the appellant was not able to provide a clear reason as to why she did not access same. The Board noted the risks related to non-compliance to include goitre, congestive heart failure, nerve damage, numbness, anemia, weight gain, dyslipidemia, dry skin, hair loss, memory problems leading to dementia, and myxedema coma. On this same topic, the Board noted the testimony of the respondent that the appellant was asking to be placed back on at highest level despite repeated recommendations that the medication needed to be titrated up, and she was refusing; they were not refusing to give her medications.
65The Board considered documents that indicated that the medications and benefits were communicated to the appellant, risks of refusing and side effects.
66The Board considered the appellant’s belief that she previously experienced TDK even though she had received her last injection approximately five months previous in January of 2025 against the evidence of the respondent that same would by completely dissipated by six months and no observation or evidence of the appellant experiencing TDK; no evidence.
67The Board considered the appellant’s suggestion, namely that the respondent was allegedly refusing to give her ADHD and thyroid medications and was “incredibly unfamiliar with her medical history”, and that she explained her behaviour with him as relational; that she was not interested in any kind of relationship with him. The Board also considered at the same time that the appellant expressed no desire to receive medical care in Ontario because she was not a member of the province, in terms of her explanation as to why she never tried to get these medications before on her own in Ontario at an ED.
68As to the considerations of family reports, the Board considered the appellant’s description of her relationship at that time of being tumultuous, that she had gone several months without speaking to them at the time of the hearing, and intentionally kept them at a distance. As to C.M., the Board considered the appellant’s evidence that she had not spoken to him in about a decade however that she also in contradiction, described instances of him giving her money or dropping off groceries at the cabin, explaining it was because she did not have a vehicle or driver’s licence and she lived in a rural area.
69The Board also considered the appellant’s evidence that she stated she had not taken medication in 20 years and that she did not provide her medical history to the respondent, that it came from third parties, that she disagreed with diagnoses. This is clear.
70The Board noted that the panel asked the appellant if she had any mental conditions, and that she explained she had inattentive ADHD and PTSD, that there was no overlap with her ADHD and bipolar disorder; that she felt her reports were being misinterpreted or were being taken out of context.
71The Board noted that the appellant was essentially not cooperatively answering questions and being tangential answering questions, highlighting that they had to ask her four times about broken dishes depicted in one of the photographs filed, calling her evasive, and how her answers developed and veered off, to ultimately her refusing to answer questions about the other photographs. They were entitled to assess her evidence in this way.
72They even state it was not necessary for them to rely on C.M.’s evidence or the photographs but that they did corroborate the respondent’s evidence, along with the appellant’s answers on the photographs and her explanation not being persuasive. This wording demonstrates that the weight was not significant but not irrelevant.
73During the hearing, on the photos, after being given an opportunity to review them, counsel stated that the appellant saw them, and that they would continue with cross-examination. No further objection was made or other relief sought. Accordingly, there was an appropriate level of procedural fairness. The Board has the power to determine its own procedure. The admission of the evidence did not prejudice the appellant, and it was more so the note in the photograph, that the appellant herself wrote that was of consideration. She was provided with opportunity to review them and to explain them and had assistance of counsel.
74In my view, the Board’s written reasons, highlighted inconsistencies in the appellant’s evidence, evasiveness, and demonstrated that they heard and considered her evidence and arguments which are essentially the same on this appeal. They highlighted observing the appellant’s manner as she testified as corroborating the respondent’s reports on her behaviour including paranoia. They are entitled to consider her demeanour and what they see as and when she testified. They highlighted that despite the appellant’s disagreement with her diagnoses, that they accepted the respondent’s diagnoses. They found the respondent to be a credible witness, which they are entitled to do.
75The Board considered the respondent’s evidence that the superficial and hostile manner in which the appellant communicated with him alone was not indicative of substantial mental deterioration, but that she was very upset, screamed at him, and lacked insight.
76The Board accepted on the whole of the evidence that the appellant did not believe there were reasonably foreseeable consequences if she was not treated with the medication, considering also her evidence on her unwillingness to consider the recommendation of titrating her thyroid medications, the blame she placed on others for her situations and decline, her demonstrated anger, her evidence on not considering herself a resident of Ontario, her unwillingness to accept assistance to file for disability. I do not interpret these findings to be applying a “best interests’ approach”, but as the sentence that follows states, essentially, that this was all evidence of the appellant not appreciating or being able to apply information to her own circumstances, a capacity issue. Further, this is followed by the Board stating that in light of all the foregoing, the panel found that the appellant was unable to appreciate the reasonably foreseeable consequences of a decision or lack of decision about the medications being recommended.
77In this case, in their Reasons in the Record of Proceedings, at pages 27 and 28 of Tab 3, the Board found the appellant’s testimony confirmed the respondent’s evidence that she was unable to recognize the possibility that she was affected by a psychotic disorder resulting in manifestations, including delusions; the appellant maintains she has no mental health disorder and does not need to be on antipsychotics; she perceived symptoms to be side-effects of anti-psychotic medication administered 6 months prior, and to cardiac and thyroid issues for which there was no clinical evidence. For these reasons the Board in terms of capacity was of the view that the appellant had an inability to appreciate even the possibility of illness, rooted in cognitive distortion, constituting a functional impairment; very relevant to the test of capacity. They found that she presented as not even cognitively able to accept even the possibility that her symptoms had a psychiatric cause, distinct from mere disagreement, guardedness or volitional refusal.
78While the Board presents as acknowledging the appellant’s guarded effect, frustration and distrust of the respondent, the Board evaluated the second criterion on the totality of the clinical evidence concerning ability to appreciate the reasonably foreseeable consequences of not receiving treatment; the Board found the appellant did not believe there were any. The evidence before the Board included the respondent’s testimony that the appellant was exhibiting psychotic symptoms that mirrored those observed during her prior hospitalization, that the physician grounded his opinion in contemporaneous clinical observations with an assessment of a decline from baseline functioning with respect to the appellant. The respondent had also submitted in evidence that four different physicians, including himself, came to the same conclusion; namely the appellant having a chronic mental condition, and having observed the “clear” manifestations. There was accordingly a “convergence” of clinical opinion before them, in determining that evidence of delusions was cogent, and compelling, based on the respondent providing testimony and with the multiple chart notes from other physicians filed. The documentary evidence included notes authored by the respondent and several other physician-medical records. Medical records made contemporaneously by someone having personal knowledge of the matters being recorded and being under a duty to make the entries permits the records to be received in evidence as prima facie proof of the facts stated in them: Ares v Venner, 1970 5 (SCC), [1970] S.C.R. 608.
79The Board found the evidence on delusions to be cogent and compelling on the totality of the evidence that they were permitted to consider, the evidence of the respondent and the medical records filed.
80The Board asked the respondent about side effects and that there was no evidence supporting the appellant’s belief that the medication caused her brain to be slow caused by the medication.
81From the transcript, the appellant did suggest that her behaviour was related to myxedema coma which was not a complete loss of consciousness and includes as lead up, psychosis, delusions, groggy thinking. She went on to state what she needed to control it, medication-wise and it has happened every single year for 8 years. She also stated there was overlap with ADHD inattentive type and bipolar disorder and then effects of adding thyroid medication on top of that. There was no support for these statements.
82The respondent, testified in chief, the applicant was provided opportunity to canvass all arguments, and cross-examine. Procedural issues were also addressed. The Board is stated to have reviewed all documentary evidence filed, including collateral evidence from the appellant’s family and a family friend, in addition to the oral testimony of the appellant and also heard testimony from Dr. Ogbonna.
83As to hearsay, the Board addressed hearsay arguments. Regarding C.M., the comments were made based on her own experiences regarding the appellant and the Board considered C.M.’s own “observations” in their reasons, record of proceedings, Tab 3, at page 27. The Board further correctly acknowledged the care to be taken in weighing hearsay. The Board demonstrated application of care, by not relying on C.M.’s letter or the photos, expressing use as corroboration of oral and documentary evidence regarding the appellant’s behaviours and medical presentation. It is clear that the Board was alive to hearsay and the arguments being made by the appellant with respect to C.M. and the photographs. The Board’s decision was not focussed on the subject matter of the photographs and more so, the manner in which the appellant addressed questions concerning them, in any event, concerning consideration of them and any weight attached.
84As to the photographs, and procedural fairness, (noting that the physician had indicated that they had been served); copies were provided to the appellant and her then counsel; a recess was taken for the photographs to be provided, and for them to be reviewed by the appellant and her counsel. There is confirmation in closing submissions from the appellants’ then counsel that concerns regarding the disclosure of the photographs had been rectified by the Board.
85Therefore, the Board clearly considered the appellant’s arguments on hearsay in the medical documentation concerning reported delusions. The Board considered this against the respondent’s direct observations and the fact that four different physicians observations reported clear manifestations. They went on to find that the respondent’s evidence was not hearsay and noting notes written by him, himself, along with multiple other physicians.
Conclusion
86I find that it would not be appropriate to interfere when there was ample evidence on which the Board could come to the decision it did.
87Accordingly, for all reasons stated above, I find there was no error in weighing the evidence nor application of the law. There was ample evidence to support the Board’s finding that the appellant was unable to appreciate the reasonably foreseeable consequences of treatment. I do not find that the Board erred. As such, the finding of incapacity is upheld, and the appellant’s appeal of this decision, dismissed.
The October 10, 2025-Decision: CV-25-00030001-000
Introduction
88The appellant submits: In assessing her capacity, the Board erred in law (to be assessed on the standard of correctness), namely that they reached their decision on facts not relating back or applicable to property management; shifted the burden of proof and/or drew adverse inference against the appellant for not filling the gaps in the respondent’s case; made decisions based on conjectures, speculations and in contradiction with facts; and reached its decision without any corroboration in violation of the Evidence Act, ss. 14(1)(i) and 14(2) (standard of correctness). The appellant seeks that her appeal be granted or set back for a new hearing.
89With respect to the October 10, 2025-decision, the respondent is seeking an order dismissing the appeal. The respondent’s position is that the Board’s decision should be upheld.
90I find that none of the appellant’s grounds have been made out.
91I will be addressing the grounds as submitted in the materials filed. There were times where the appellant raised issues of bad faith and/or related to constitution of the panel, orally, during submissions. I do not find that any of those grounds were made out either. I do not propose to go into those issues. In detail based on lack of support in the record.
Ground One
92I do not agree that the Board made its decision on facts that were not related to property management. Of note, property management under the framework of the Substitute Decisions Act, 1992 involves the management of the individual’s finances (including acquiring money/income and managing it) as well as assets, including banking, paying bills, managing investments and handling income, and dealing with their home or other property.
93Although not addressed orally, I do not agree that the evidence regarding an available income stream and the sale proceeds of the matrimonial home are characterizable as “phantom property”, or that the potential income stream and proceeds in this specific case were in fact “phantom property” available to the appellant on the evidence before the Board. I do note that in argument, the focus was on the appellant’s explanation for not pursuing same, however, the decision must be read as a whole and the issue not dealt with in a vacuum.
94A review of the transcript demonstrates, that while ODSP and proceeds from the sale of her home were being considered, that globally, that the focus at the hearing was what if anything, the appellant was doing by way of management of her assets and available finances, and why, to specifically determine her appreciation of the foreseeable consequences of not making decisions available to her to make regarding finances and property.
95The evidentiary record reflects that there are decisions to be made by the appellant related to property and income; available streams and/or sources of property. Of note, the appellant herself was expressing goals for herself. The appellant expressed a goal/desire to leave Ontario and not wanting to be a resident of Ontario, that was very clear. Explanations were sought regarding her decisions or lack of decisions in respect of same, not only including her residency in Ontario (temporary or otherwise) but also her plans to return to Alberta; both were considered in my view; the focus on the record cannot be said to have been assessing the circumstances on the appellant remaining in Ontario. Questions were asked about return to Alberta, and how that would be managed. The appellant’s ability to apply for income is directly related to ability to manage property, if not for her goals, at the very least for maintaining herself and accommodations in Ontario; having money to live or move elsewhere. There was evidence that family members and/or friends/others had been helping or attempting to help her, and her own confirmation that she was at that time estranged from them. This was the scenario on the evidence before the Board.
96There was ample evidence before the Board supporting that the appellant was living well below her available means. It was up to the Board after hearing all the evidence to determine if this was an appreciative choice made with capacity; that was their job. While the appellant was presenting that this was her choice and that in her view it was not based on any delusional belief (meaning, she did not want to be a resident so why would she apply for ODSP, and/or she would or could not deal with the sale proceeds, unless and until she returned to Alberta). At the same time, before the Board was evidence that the appellant’s presentation, was one of disinterest, lack of motivation and delusional-based, related to paranoia, described by the witness before them, the respondent noting them as being manifestations of the diagnosis he made; buttressed by his evidence based on his direct observations that when the appellant was on medication, the appellant was motivated and acting, for example, being agreeable to making an application to ODSP. He provided evidence of direct observations of improvement with the appellant’s speech, manner of personal care etc and ability to act when previously medicated.
97At the same time, the appellant did provide contradictory evidence or evidence that did not align with her explanations, which is what I interpret the Board to be stating, when they stated that her own evidence was in contradiction with her stated goals; not that they were making a value judgment, as submitted.
98Of note, the appellant’s own evidence before the Board was that she did not have access to a driver’s licence or a vehicle or a home of her own for some time (homeless, using a cabin without fresh water, isolated, not having food and groceries at times without family or friend involvement); she was estranged from family and C.M. The photographs filed demonstrated she was staying in the family cabin. The letter of C.M. and other family information recorded, demonstrated the appellant was being brought groceries by others. Even though she had periods of non-admission, she was stating that her bank card, credit card, etc. had been seized from her and she took no steps to return to Alberta during these times. This is and was evidence before the Board. To submit that this evidence does not relate back or is not applicable to “property management”, in my view, would be wrong.
99Of note, the appellant’s own evidence was that she had been trapped in Ontario by others (family members and the respondent included). There were many statements made by the appellant before the Board, interpretable as everyone was or is “out to get or trap her”. Using these types of phrases, explanations, and/or expressions are capable of being found by the Board as being interpreted as delusional belief; it was every family member, every member of staff; no one was capable in Ontario. Amicus’ examples of delusion respectfully were extreme and not recognizing that there are levels of delusion (that are still delusion nonetheless), and combined effect of multiple; Even delusions even “lower-level” delusions, taken together could most certainly demonstrate manifestations of a mental condition. There is a line of judgment that must be applied on whether the beliefs are simply just foolish or unreasonable or if they are in fact an indicator of delusional belief. All her expressed statements on the other aspects of her life, were relevant and material on the issue of evidence of manifestations of delusional belief and to state that this does not constitute evidence, in my view is wrong. The Board had the right to accept the evidence of the respondent that there were many examples of behaviour demonstrating manifestations of his diagnosis, including but not limited to paranoia and lack of motivation evidence.
100The appellant’s decision not to seek her share of the sale of the matrimonial home is directly related to management of her property. The value, in my view, lack of particulars, is of no consequence. The funds, no matter what their value, are hers to manage, and were only a part of the property management issues before the Board. I do not accept that the appellant’s presentation before the Board was one of choice to delay and/or work on her own time frame to obtain them that was just simply different that did not meet with the respondent or the Board’s values. The evidence was that the property was sold in 2024. She testified to many reasons why she was not pursuing this that contradicts intention to pursue them. Her own evidence before the Board included that she does not like the manner in which she would have to go about getting these proceeds namely not wanting to be “on the books” for seeking them, or “in the system” or that doing so may impact custody of her daughter or that, essentially, the sale was all part of a plan with her former spouse and mother-in-law, to while she was in Ontario, have her admitted and to deal with this while she was “trapped” by the respondent. She does not recognize that she lost her licence after being stopped by police for speeding well over the speed limit.
101To submit that the appellant is permitted and may knowingly be acting foolish or unreasonable, based on the appellant’s evidence and explanations that were before the Board, her evidence did not present her as being one who is consciously deciding to be foolish and unreasonable; she in fact provided many explanations for why she has not made decisions for her finances and property, that she believes to be true; many impediments she believes to be true related to state programs, state action, family member-actions, and even the respondent’s actions. There was a repeated cast of blame, not expression of choice or, knowingly making foolish decisions. Those explanations on the evidence were directly related by the respondent in his evidence to be manifestations to her mental state; paranoia, this evidence was before the Board; indicators the Board could consider, delusional belief. The evidence was there.
Shifting of Onus
102On the record (review of transcript and decision combined), I disagree with the characterization of the Board’s statement in question, that the onus was shifted. I read the decision as communicating observed behaviour (during the hearing) and noting that procedural opportunity for participation was provided.
103Further, this statement cannot be considered in a vacuum.
104The appellant chose to testify. The appellant had counsel.
105The decision reflects that the Board was quite aware of the onus and set it out correctly and clearly.
106The Board, in pointing out that the appellant could provide little information in their decision is interpretable as demonstrating that the opportunity that was provided to the appellant to provide information for consideration that may contradict or impact the balance of probability of incapacity burden, not shifting the burden. When reviewing the transcript, it presents as clear to me that the Board was trying to provide this opportunity to the applicant demonstrated by the words they used at the hearing, namely explaining what it was the respondent was saying and what they had to decide; alerting her to the fact that it was her opportunity to challenge with her own evidence, not that she bore the onus.
107Equally, this statement relates to independent observations made during the proceeding which are relevant and permissible for the Board to consider. After choosing to testify, assisted by counsel, the record reflects that the appellant was disruptive and refusing to provide answers to questions that were relevant and material while being examined by the respondent.
108Equally, aside, if a witness is refusing to answer proper questions, their role is to manage same. Procedural fairness applies to all parties to a proceeding.
109On the whole of the evidence, I did not view the Board as shifting the onus or drawing adverse inferences or requiring the appellant to fill in the gaps as submitted.
Conjectures, Speculation, Contradiction with Facts, and Corroboration
110The Board received testimony from the respondent and the appellant. They are entitled to assess that evidence, including make credibility findings. They have the right to accept some, none or all a witness’ evidence. It is clear to me that they engaged in this process carefully including reference to other evidence that was before them, and contradicting evidence/positions being presented.
111The respondent testified as to his assessment of the appellant and her mental state, which was not just based on observations of others; based on his own direct observations. The same can be said regarding the appellant’s explanations for her lack of decision making or choices.
112The appellant herself corroborated by her own testimony that she was not making any decisions; and provided some explanations and background for her choices.
113There was ample evidence on how the appellant was living, not being able to manage the cabin or potentially even being destructive at this cabin, that she was staying at the grace of family, from which she agreed she was estranged at the time of the hearing.
114The way the appellant testified just by the written word on the record before me (acknowledging that I can only read the words, and did not have the benefit of hearing her, like the Board did) confirms for me their conclusions on capacity to appreciate foreseeable consequences (the finding of the Board), including demonstration of paranoia, and tangential expression of thought. The evidence about and/or presentation of the appellant not being able to explain the basis for her decisions or refusing to provide information was not irrelevant in the context of the proceeding either; it is part of the Board’s assessment process, nor does it amount to the Board having no evidence on that, nor constitute engaging in speculation or conjecture.
115On why she did not apply for ODSP, the appellant, on the transcript, tangentially veered off to testifying about or questioning the respondent’s need to know what she was doing, to that she would never work in Ontario, to thoughts of ODSP being an abused program, to why anyone would think she would like to live here or have anything to do with the hospital.
116I disagree that it was “clear” that the appellant was receiving other income benefits or had any intention to address same; the transcript reflects her blaming many others for her various situations, ranging from her former spouse, his family, her family, police, the respondent, to the hospital etc., and it got to the point of her expressing her thoughts that the respondent had successfully “trapped” her in Ontario. This was all before the Board.
117The appellant did not present as appreciating that she could deal with her property issues physically from Ontario, expressing that she had to be in Alberta. This evidence was before the Board. It is not unusual for litigants to be involved in litigation in jurisdictions they do not reside in. Remote participation has increased significantly.
118I disagree with the suggestion that the evidence supports a finding that the appellant had plans to ultimately make inquiries on the home or that the Board decision was an imposition of value judgment. In her evidence related to the topic, more than once she was stated to have expressed that she did not want to be “on the books” or “in the court system” or have anything to do with her former spouse; or that she thought it may impact custody of her daughter; that was all before the Board.
119Records were tendered at the hearing; medical records including records of her assigned social worker (part of the health care team), which included that at one point, the appellant made application for ODSP (when her condition had improved on administered medications) but then refused to follow through (after stopping her medications), being unable to explain why, noted by the Board as Exhibit 1, page 19; a direct reference to other evidence before them.
120The respondent is noted to have filed a 32-page document package for the hearing; the evidence was not merely the testimony of the respondent and the appellant. The Board had clearly identified that they had read these documents and were only seeking the respondent to highlight what he wished at the hearing (in the transcript of the proceeding).
121The evidence of the respondent before the Board on having home sale funds was not only that he had received the information from the social worker, but also the same information from the appellant herself, and her family members from previous admissions.
122The evidence clearly included that there was a period where she was receiving treatment and improved and some steps were taken to cooperate with the social worker, which stopped after medication stopped, and was not contradicted.
123The respondent stated that he knew she was estranged from her family and stated that she blamed her family for her admission (which the appellant presented as doing so in her own testimony at this hearing and also essentially confirmed estrangement [transcript of proceeding]).
124The documents included that the appellant was being vague about the reasons for her delay for moving, and was unable to explain to the social worker how she could move without any identification, income or temporary housing plan, notably, in the face of being told it would impact discharge and release from the hospital; the appellant was exhibiting disinterest and lack of motivation, which was asserted to be directly related to lack of ability to appreciate foreseeable consequences based on her mental state on the record ( the assessment evidence of the respondent that was before the Board, evident in the transcript).
125The social worker, as stated by the respondent, documented that the appellant confirmed there were funds from the sale of the home and that the appellant had not taken steps to obtain these funds after more than one year, despite having no income. The appellant confirmed the home was sold in 2024. The Board noted that the appellant confirmed there were funds at the hearing, which she did (transcript of the proceeding).
126My interpretation of the decision is that the Board clearly assessed and found on the whole of the evidence that the appellant’s lack of action was related to her mental condition; lack of motivation and/or paranoid delusional beliefs that she had expressed to family, friends and her health team (which was in evidence on the record before them); again, the appellant herself was expressing that she did not “want to be on the books” or in the system and/or her belief that any application could be used against her in some way in the custody of her daughter.
127The evidence also included the respondent’s testimony that the appellant refused to speak to him, that she yelled at him, screamed at him, swore at him in every meeting, and it had been like that since her admission; the appellant not really engaging, direct observation of the basis for his assessment of disinterest and paranoia.
128The respondent also testified that the appellant expressed and/or was of the view that people knowing about her information would be detrimental to her if it was made public, his evidence was that these statements were part of her paranoia; this was the reason she cancelled her application for ODSP. Her explanation, according to the respondent’s testimony, related to the home sale proceeds, included not wanting to have anything to do with her former spouse and not wanting to be in the books or the system, again stated by the respondent to be largely paranoia, having a distrust of the system and being worried about her ex-partner using her information in the courts. He also testified that this was also related to lack of motivation, providing observations of her staying in her room, nor coming out or socializing, hiding in the dark all the time, not showering, not changing her clothes, having an odour, all of which were contrary to her baseline, meaning at one point, she was working in health care and not unkempt in terms of appearance. The respondent gave further evidence that lack of motivation is a negative symptom to her condition, and he has known her since 2024. The respondent also testified that her condition improved when she was on medication, but she stopped it, and they had not been able to treat her since because of her appeal (the July 25, 2025-decision). He described the circumstances to the Board as reflective of a deep decline in her function. This was all evidence the Board was entitled to consider and had before them; including hearsay properly filed and assessed, most of it in the form of observations noted on medical records recorded in the exercise of the health care providers’ duties.
129Of note, the Board highlighted the goals that the appellant was stating for moving and/or her plan but that her actions were in direct contrast with same. Based on the evidence, there was no error in stating this; this is supported.
130Just on the written words alone, unequivocally, the appellant while testifying presented as viewing the respondent as constantly harassing or interfering with her. The appellant on the one hand at one point testified that she was not aware about the sale of her house but then testified that it was sold while she was being held under an opinion that she had bipolar disorder that was based on a lie, essentially casting blame on the respondent, but then confirming she knew it was sold in 2024.
131At the hearing, the appellant also testified that the respondent had never assessed her or even met with her since October of 2025 and expressed her view that he was not even capable of actually conducting any sort of actual assessment. The respondent was not moved by the appellant’s counsel on cross-examination that he had in fact assessed the appellant whether she engaged or not. This was all evidence before the Board. Behaviour is a matter, not just words exchanged during conversation.
132During the hearing the appellant herself expressed that she did not need to get money together to move but would also go on to say that everything was being withheld from her (licence, bank card, credit card etc.) and she was trapped in Ontario based on actions of others, including the respondent. The appellant during the hearing placed blame on her being in Ontario on the respondent interfering, yet at the same time, again blaming her former spouse, his mother and/or her parents too.
133The evidence filed supported that there were other doctors who had also made the same diagnoses before the respondent made his, but the appellant expressed a view, that these doctors bounced off the respondent’s previous false, essentially, non-existent or falsified diagnosis from when she was age 23; it was confusing but nonetheless more evidence before the Board of paranoid thinking, namely the other doctors were not doing independent assessments in accordance with their duties and obligations related to their respective licenses and oaths.
134At one point, when asked about when her home sold, the appellant tangentially veered on to her mother-in-law formerly working in the department (I interpreted as the SAH psychiatric department).
135The appellant, as stated, eventually did agree that the home was sold in 2024 explaining she was not able to get back to fight any of the issues, when there were times, she was not hospitalized on the record before the Board. Again, at the hearing, the appellant asserted that her drivers licence, bank card, credit card and debit card were all being withheld from her; that the respondent was “successful enough to trap her” as part of her explanation.
136The appellant was given opportunity to state why she had not made any inquiries as to the sale of the house and her explanation was that it was none of the respondent’s business; that the respondent inserts himself where he is not welcome and there is no reason he needs this information. She refused to provide information as to what it was sold for and continued to state it was none of the respondent’s business.
137As stated, my interpretation of the Board’s questions/questioning, was that they were attempting procedurally to give her an opportunity to respond to the respondent’s position that she was not capable of managing her property not to place the onus on her; and also to procedurally manage refusals to answer questions posed on cross-examination after choosing to testify, all of which is something the Board is permitted and obliged to do. It is part and parcel of responsibility to manage witness testimony whether the witness is one with or without an onus in a proceeding. Just on the written word, it was very clear to me that the appellant was disruptive and interfering during cross-examination. Of note, additionally, the Board is permitted to ask their own questions with the format of these hearings. Moreover, fact finders are not required to sit and be silent when there are issues for them to determine and/or the proceeding requires management. They are charged with proper administration of the proceeding and/or achieving a proper finding, fairness to all parties. Of note, the appellant’s counsel did not object. Additionally, the appellant’s counsel was offered opportunity to ask further questions “arising” which opportunity was declined.
Conclusion
138Overall, reviewing the whole of the decision in conjunction with the transcript, it is clear to me that the Board’s assessment was in accordance with the law and their application was correct on the record that was before them (related to management of property), and with respect to facts or mixed fact/law issues, they made no palpable or overriding errors. I am not persuaded that their decision reflects “an application of wisdom or assessment of reasonableness”; the whole of the evidence before them supports that this was not a case of the appellant simply being foolish knowingly or knowingly making unreasonable choices willing to assume risks voluntarily. There was ample evidence of her prejudgment of programs and people and processes that on the evidence that they accepted was related to her mental state rendering her incapable of understanding the consequences of her decisions and did not understand the consequences of her not making decisions to seek help or to facilitate help when it was offered to her; that she holds many delusional beliefs concerning the state (knowing information about her) or being a target/victim of others and/or their actions. There was ample evidence that she was unable to consider the risks and benefits of making any decision about property, including the risks of making no decisions at all. There was ample evidence of disinterest and paranoid delusional thoughts that were impacting her ability to realistically appraise the risk and likely outcome of a decision or lack of decision.
139I find it would not be appropriate to interfere when there was ample evidence on which the Board could come to the decision it did.
140For all these reasons, I do not find that the Board erred in any way that would impact their decision. As such, the finding of incapacity is upheld, and the appellant’s appeal of this decision, dismissed.
Rasaiah J.
Released: May 29, 2026