Approaches to capacity and competency: The Canadian view

International Journal of Law and Psychiatry

Volumn 20, Issue 1, 1997, Pages 35-46

  Verma, Sarita ^a   Silberfeld, Michel ^b  

^a QUEEN S UNIVERSITY   (Canada)

^b BAYCREST CENTRE FOR GERIATRIC CARE   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

COMPETENCE; COURT; DECISION MAKING; INFORMED CONSENT; LAW; MENTAL CAPACITY; REVIEW;

EID: 0030989787     PISSN: 01602527     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0160-2527(96)00021-0     Document Type: Article

References (24)

1. Imperial Lunacy Act 1890. 53&54 Vict.c.5. For further comment also see Gordon, Verdun-Jones & MacDougall, 1986. STANDING IN THEIR SHOES: GUARDIANSHIP, TRUSTEESHIP AND THE ELDERLY CANADIAN. A Report to the Social Sciences and Humanities Research Council of Canada.
2. STRATEGIES FOR CHANGE: COMPREHENSIVE REFORM OF ONTARIO'S LONG-TERM CARE SERVICES, 1990. Ministry of Community and Social Services, Ministry of Health, Queen's Printer.
3. See the Appendix. This includes a comprehensive list of relevant Canadian Statutes by province and territory.
4. ENQUIRY ON MENTAL COMPETENCY: FINAL REPORT, 1990. Chairman, D. N. Weisstub, Toronto, p. 439.
5. Madigan, K. V., Checkland, D., Silberfeld, M. 1994. "Presumptions Respecting Mental Competence" 39(3) Canadian Journal of Psychiatry, 147-152.
6. Madigan, K. V., Silberfeld, M. 1993, "Clinical Application of the Least Restrictive Alternative in Competency Assessment." 12(3) Estates and Trusts Journal, 282-292.
7. Silberfeld, M., Corber, W., Madigan, K., Checkland, D. "Capacity Assessment for Requests to Restore Legal Competence" IN PRINT International Journal of Geriatric Psychiatry; Silberfeld, M. 1991. "Competency Assessments" 11(2), Estates and Trusts Journal, 165-175; Silberfeld, M. "Ethical Issues of Competence in the Older Patient" November, 1989. Medicine North America, 86-92.
8. Silberfeld, M., Corber, W., Madigan, K., Checkland, D. "Capacity Assessment for Requests to Restore Legal Competence" IN PRINT International Journal of Geriatric Psychiatry; Silberfeld, M. 1991. "Competency Assessments" 11(2), Estates and Trusts Journal, 165-175; Silberfeld, M. "Ethical Issues of Competence in the Older Patient" November, 1989. Medicine North America, 86-92.
9. Silberfeld, M., Corber, W., Madigan, K., Checkland, D. "Capacity Assessment for Requests to Restore Legal Competence" IN PRINT International Journal of Geriatric Psychiatry; Silberfeld, M. 1991. "Competency Assessments" 11(2), Estates and Trusts Journal, 165-175; Silberfeld, M. "Ethical Issues of Competence in the Older Patient" November, 1989. Medicine North America, 86-92.
10. Silberfeld, M. "Ethical Issues of Competence in the Older Patient" November, 1989. Medicine North America, 86-92.
11. Verdun-Jones, CS. 1994 Adult Guardianship Law In Canada 1-20. Ontario's new legislation includes the Health Care Consent Act, S.O. 1996, c.2, Sch. A; The Powers of Attorney Act, R.S.O. 1990, c. P.20 for which substantial amendments were proclaimed in force in April 1995, with amendments to the Mental Health Act made at the same time, and the Substitute Decisions Act, 1992, also proclaimed in force in April 1995.
12. Silberfeld, M. 1991. "The Value of Clinical Judgement in Competency Assessments." 11(2) Health Law in Canada, 68-83.
13. "ENQUIRY ON MENTAL COMPETENCY: FINAL REPORT 1990. Chairman, D. N. Weisstub, Toronto, 16-18.
14. For a comprehensive discussion of guardianship reform in all provinces refer to Verdun-Jones, S. 1994 Adult Guardianship Law in Canada 1-20. In the province of Ontario, a package of statutes consolidating the common law on consent to treatment and systemic advocacy was passed in April 1995 and 1996 including the Health Care Consent Act, S.O. 1996. c.2. Sch A; The Powers of Attorney Act. R.S.O. 1990 c P.20 and the Substitute Decisions Act 1992. British Columbia has introduced the Health Care (Consent) and Care Facility (Admission) Act, S.B.C. 1993, c.48. the Adult Guardianship Act, S.B.C., 1993, c.35, the Public Guardianship and Trustee Act, S.B.C. 1993, c.64 and the Representation Agreement Act, S.B.C. 1993, c.67. Similarly, new legislation is expected to be introduced in the Northwest Territories and in Manitoba.
15. Health Care Consent Act, 1996 c.2. Sch. A. s.s.4-7:10-12.
16. Silberfeld, M. 1991. "Competency Assessments" 11(2) Estates and Trust Journal, 165-175; Silberfeld, M. 1991. "New Directions in Assessing Mental Competence" 38 Canadian Family Family Physician 2365-2369.
17. Silberfeld, M. 1991. "Competency Assessments" 11(2) Estates and Trust Journal, 165-175; Silberfeld, M. 1991. "New Directions in Assessing Mental Competence" 38 Canadian Family Family Physician 2365-2369.
18. Silberfeld, M., Dickens, B., Harvey, W. C., Pepper-Smith, R. 1988. "A Competency Clinic for the Elderly" 10(1). Advocates Quarterly, 23-28.
19. Silberfeld, M. 1991. "Competency Assessments 11(2) Estates and Trusts Journal. 174; Corber, W. Checkland, D., Silberfeld, M. 1994. "Assessment of Mental Capacity: Qualitative Considerations" 10(1) Humane Medicine, 40-43.
20. Silberfeld, M. 1991. "Competency Assessments 11(2) Estates and Trusts Journal. 174; Corber, W. Checkland, D., Silberfeld, M. 1994. "Assessment of Mental Capacity: Qualitative Considerations" 10(1) Humane Medicine, 40-43.
21. Silberfeld, M., Finstad, M., Dickens, B. 1993. "Prescreening Competency Assessment" 26(3) Annals, The Royal College of Physicians and Surgeons, 165-168.
22. Pepper-Smith, R., Harvey, W. C., Silberfeld, M. 1992. "Consent to Competency Assessments," 15, International Journal of Law and Psychiatry, 13-23.
23. Abramovitch, R., Finstad, M., Silberfeld, M. 1993. "Preliminary Report on Informed Consent for Mental Capacity Assessments" 12(3) Canadian Journal of Aging, 373-381.
24. Section 15 of the Charter came into force in 1985. It received attention in R. V. Swain (1991) 63 C.C.C. (3d) 481 (C.C.C.) where the Supreme Court expressed the opinion that s. 15 could be used to protect the decision-making autonomy of the disabled and the elderly. Also, Section 24(1) offers individuals the right to apply to the court for remedies where any of the rights or freedoms of the Charter have been infringed. An excellent discussion of the application of the Charter especially of s.15 is found in Andrews v. Law Society of B.C. (1989) 2 W.W.R. 289 (S.C.C.). The effect of s.7 of the Charter is guaranteeing the right to personal security in mental health treatment decisions is critically demonstrated in Fleming v Reid (1991), 4 O.R. (3d) 74 (C.A.)