24. Canadian Legal Issues Flashcards
Describe this Common Form Under the Mental Health Act (in Ontario): Form 1: Application by physician to hospitalize a patient for psychiatric assessment against his/ her will in a schedule 1 facility (Form 42 given to patient)
- Who signs
- When
- Expiration Date
- Right of Patient to Review Board Hearing
- Options Before Form Expires
- Who signs: Any MD
- When: Within 7 d after having examined the patient
- Expiration Date: 72 h after hospitalization. Void if not implemented within 7 d
- Right of Patient to Review Board Hearing: No
- Options Before Form Expires: Form 3 and 30 or voluntary admission or send home ± follow-up
Describe this Common Form Under the Mental Health Act (in Ontario): Form 2: Order by Justice of the Peace to bring patient to a hospital for a psychiatric assessment against his/her will
- Who signs
- When
- Expiration Date
- Right of Patient to Review Board Hearing
- Options Before Form Expires
- Who signs: Justice of the Peace
- When: No statutory time restriction
- Expiration Date: 7 d from when completed Purpose of form is complete once patient brought to hospital
- Right of Patient to Review Board Hearing: No
- Options Before Form Expires: Form 1 and 42 or send home ± follow-up
Describe this Common Form Under the Mental Health Act (in Ontario):
Form 3: Certificate of involuntary admission
to a schedule 1 facility (Form 30 given to patient, notice to rights advisor)
- Who signs
- When
- Expiration Date
- Right of Patient to Review Board Hearing
- Options Before Form Expires
- Who signs: Any MD other than MD who completed Form 1
- When:
- Before expiration of Form 1
- Any time to change status of a voluntary inpatient
- Expiration Date: 14d
- Right of Patient to Review Board Hearing: Yes
- Options Before Form Expires: Form 4 and 30 or Voluntary admission (Form 5)
Describe this Common Form Under the Mental Health Act (in Ontario):
Form 4: Certificate of renewal of involuntary admission to a schedule 1 facility (original Form 30 given to patient, notice to rights advisor)
- Who signs
- When
- Expiration Date
- Right of Patient to Review Board Hearing
- Options Before Form Expires
- Who signs: Attending MD following patient on Form 3
- When: Prior to expiration of Form 3
- Expiration Date: First: 1 mo Second: 2 mo Third: 3 mo (max)
- Right of Patient to Review Board Hearing: Yes
- Options Before Form Expires: Form 4 and 30 or Voluntary admission (Form 5)
Describe this Common Form Under the Mental Health Act (in Ontario): Form 5: Change to informal/voluntary status
- Who signs
- When
- Expiration Date
- Right of Patient to Review Board Hearing
- Options Before Form Expires
- Who signs: Attending MD following patient on Form 3/4
- When: Whenever deemed appropriate
- Expiration Date: N/A
- Right of Patient to Review Board Hearing: N/A
- Options Before Form Expires: N/A
Describe this Common Form Under the Mental Health Act (in Ontario):
Form 30: Notice to patient that they are now under involuntary admission
on either Form 3 or 4. Original to the patient, copy to chart
- Who signs
- When
- Expiration Date
- Right of Patient to Review Board Hearing
- Options Before Form Expires
- Who signs: Attending MD
- When: Whenever Form 3 or Form 4 filled
- Expiration Date: N/A
- Right of Patient to Review Board Hearing: Yes
- Options Before Form Expires: N/A
Describe this Common Form Under the Mental Health Act (in Ontario):
Form 33: Notice to patient that patient is incapable of consenting to treatment, and/or management of property and/or disclosure of health information (original copy to patient)
- Who signs
- When
- Expiration Date
- Right of Patient to Review Board Hearing
- Options Before Form Expires
- Who signs: Attending MD
- When: Whenever deemed appropriate
- Expiration Date: N/A
- Right of Patient to Review Board Hearing: Yes
- Options Before Form Expires: N/A
Describe purpose: Community Treatment Order (CTO) (2)
- a CTO orders a person suffering from a serious mental disorder to receive treatment and supervision in the community.
- Based on a comprehensive plan outlining medications, appointments, and other care believed necessary to allow the person to live in the community (vs. in a psychiatric facility, where conditions are more restrictive)
Community Treatment Order intended for who? (4)
- due to their serious mental disorder, experience a pattern of admission to a psychiatric facility where condition is usually stabilized
- after being released, these patients often lack supervision and stop treatment, leading to destabilization
- due to the destabilization of their condition, these patients usually require re-admission to hospital
- if CTO violated (i.e. treatment not taken), patient brought in by police to hospital for treatment as per CTO
Name criteria for a physician to issue a Community Treatment Order (CTO) (5)
- patient with a prior history of hospitalization
- a community treatment plan for the person has been made
- examination by a physician within the previous 72 h before entering into the CTO plan
- ability of the person subject to the CTO to comply with it
- consultation with a rights advisor and consent of the person or the person’s substitute decision maker
A Community Treatment Order (CTO) is valid how long? (2)
- CTOs are valid for 6 mo unless they are renewed or terminated at an earlier date such as
- where the person fails to comply with the CTO
- when the person or his/her substitute decision-maker withdraws consent to the community treatment plan
Describe consent in Community Treatment Order (CTO) (1)
- CTO process is consent-based and all statutory protections governing informed consent apply
The rights of a person subject to a Community Treatment Order (CTO) incldue what? (5)
- the right to a review by the Consent and Capacity Board with appeal to the courts each time a CTO is issued or renewed
- a mandatory review by the Consent and Capacity Board every second time a CTO is renewed
- the right to request a re-examination by the issuing physician to determine if the CTO is still necessary for the person to live in the community
- the right to review findings of incapacity to consent to treatment
- provisions for rights advice
