Mental Health and Consent (Law 3) Flashcards
Capacity
person’s legal ability to exercise his or her legal rights
Criteria for existence of informed consent:
- Capacity
- Given freely
- Enlightened
Defects of consent (invalid consent)
Fear, underpressure or Error
2 requirements to the emergency exception to obtaining informed consent:
If the person’s life is in danger/intergrity is threatened AND consent cannot be obtained in time in order to avoid this threat to person’s life/bodily integrity.
Issues for which patients have a right to information include:
The condition of their health
Prognosis
Tx options
Consequences and risks associated with a given tx.
The Duty to inform: sign a document (waiver)
NOT ENOUGH, caregivers must ensure patient understand, received all relevant info and opportunity to ask/receive answers.
Motion for tx and/or placement:
Superior court
Motions for confinement in an institution OR for psychiatric evaluation:
Court of Qc
Must prove to uuthorization for Tx by the court that:
Person do not have capacity to consent
Pt best interest
Confinement in an institution: General principles
- Exceptional measure
- Serious and Immediate danger to themselves or others.
Assessment of dangerousness
- Immediate or present short term (doubt is not a real danger)
- Must be such that it justify to maintain his confinement. (fact that pt may become again dangerous after leaving the hospital is not sufficient to constitute danger)
Type of Forced confinement:
Preventive
Temporary
Motion for confinement
Preventive confinement:
- danger to himself or to others
- Physician order (court order is NOT REQUIRED)
- Danger GRAVE and IMMEDIATE
- Possible assistance from peace officer
When obtain a court order enxtending the ‘‘preventive confinement’’ to:
a ‘‘temporary confinement’’ (for the psychiatric assessment)
In the event that the person accepts to be examined, it must be carried out within
24 hours after be has been taken in charge by the institution
Temporary confinements:
- danger to himself or to others
- COURT ORDER REQUIRED
- Obtain if pt refuses to be evaluated by psychiatric
Duration of confinement:
30 days (less if not necessary) Released as soon they are not anymore dangerous to themselves or to others.
Receiving the diagnosis of mental illness is sufficient to a motion for confinement
IT IS NOT SUFFICIENT.
Renewal of confinement: After the expiration of 30 days period, it is possible to extend the confinement for a maximum of
a maximum of 90 additional days.
For renewal of confinement: We need a evaluation done by
TWO NEW PSYs at the latest 48 hours before the expiry of the 30 days period.
Right of the person under confinement:
- right to counsel
- right to appeal their decisions to Tribunal Administratif du Qc or Court of Appeal
- Right to communicate with outside persons (thrid parties) unless valid medical reason
- Right to see the application for confinement
Case: Charles Le Moyne c. E.(F.)
- Brought to hospital by police, acting in a hostile manner and accusing to hide a corpse in is appartment.
- Insufficient to lead to conclusion he represent a danger to himself/others to a confinement order.
Case: CSSS Cote-de-Gaspe c. P.(C.)
- Hospital seeking to renew her confinement order after 2 back-to-back 30days confinement.
- Lack of insight and judgement, with irritability and persecution complex.
- Motion dismissed. bc prior behaviour does not justify, danger must be present in short/medium term. Do not see any sign of danger.
Case: Hopital Maisonneuve-Rosemont c. H.(M.)
- Refuse to take antipsychotic medication via injection
- MH’s refusal is maintained bc does NOT mean a person lacks legal capacity (capable and right to refuse/accept tx)
