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Health Law - HEALTH CARE PROFESSIONALS - Treatment, authorization for - Consent

Thursday, January 12, 2017 @ 7:00 PM  


Appeal by the patient, Coburn, from dismissal of her appeal from a ruling by the Consent and Capacity Board. The respondent, Doctor Wilkie, was a psychiatrist who proposed to treat the appellant’s bipolar schizoaffective disorder with anti-psychotic and mood stabilizing medications. The proposal accorded with the view of the appellant’s treating psychiatrist, Doctor Cyr. The appellant objected to the treatment due to the side effects. She claimed that any manifest symptoms were a result of fibromyalgia and sleep apnea rather than a mental health condition. In 2015, the Board ruled that the appellant was unable to appreciate the consequences of her decision to reject the proposed treatment. The appellant’s appeal of the Board’s decision was dismissed. The Court upheld the Board’s decision. The patient appealed to the Court of Appeal.

HELD: Appeal dismissed. The appellate judge did not err in finding that the Board had applied the proper test for capacity. The Board was clearly alive to the appellant’s right to disagree with the proposed treatment. The appellate judge based his decision on the review of the Board’s reasons as a whole rather than the isolated passages relied upon by the appellant. In spite of isolated misstatements in the Board’s decision, the judge was entitled to conclude it had applied the proper test for capacity. The Board arrived at its decision by following the path outlined in the jurisprudence, examining the evidence by asking whether it established the appellant was unable to appreciate the reasonably foreseeable consequences of a decision regarding the proposed treatment. The finding that the appellant suffered from delusional and mood disorders caused at least in part by a mental condition was available on the evidentiary record. The physicians’ recognition that some of the appellant’s symptoms could flow from her various physical ailments did not preclude the mental health diagnosis, as the physical ailments did not explain all of the appellant’s symptoms. The Board’s decision was not unreasonable and was entitled to deference. There was no indication the appellant failed to receive necessary information due to a breakdown in the physician and patient relationship.