Simon N Verdun-Jones & Michelle S. Lawrence, “The Charter Right to Refuse Psychiatric Treatment: A Comparative Analysis of the Laws of Ontario and British Columbia Concerning the Right of Mental Health Patients to Refuse Psychiatric Treatment”

Working Abstract

In many jurisdictions, patients enjoy an absolute right to refuse medical treatment, even if doing so risks death or is otherwise contrary to the advice of treating physicians. This right is premised on a respect for the personal dignity, autonomy and self- determination which extends to all citizens, including those with mental disorders. This paper explores the legal and ethical issues that arise in those circumstances wherein mental health patients, by reason of their mental disorders, are considered to lack the competence required to refuse psychiatric treatment. It compares the statutory regimes in place in two Canadian jurisdictions with radically contrasting positions and procedures. In Ontario, the applicable mental health legislation provides that, apart from emergency situations, medication cannot be administered without either the prior consent of the patient (given while she or he was competent) or the consent of the patient’s substitute decision­maker. In British Columbia, however, consent is “deemed” to have been given, notwithstanding any wishes of the patient to the contrary. It is argued that the administration of antipsychotic medications in the latter circumstances violates inherent and fundamental human rights. In the Canadian context, these rights include the Charter right to liberty and security of the person.

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