guardian). If the second doctor also finds you to be not competent, you may apply to
the Review Panel to review the Form 11 certificate. If you apply for a review, your
doctor can't treat you until the Review Panel considers your application, even if your
substitute decision-maker has given consent.
If the Review Panel agrees you are incompetent, your agent, guardian or nearest
relative will make treatment decisions for you and then you can be treated against your
will.
If I'm not competent, who can make treatment decisions on my behalf?
Someone who makes decisions for you must have had contact with you in the past 12
months, must be willing to take on the responsibility of making treatment decisions for
you and must make a written statement stating their relationship to you. Doctors will
ask either a guardian, an agent, or your nearest relative who meets these
requirements.
Before agreeing to a treatment, this person must also consider whether your mental
condition will likely get worse without treatment, is likely to improve with treatment,
whether the treatment benefits outweigh the possible risks and whether the treatment
is the least intrusive option that will make a positive difference in your life.
What is a Treatment Order?
If you are competent to make decisions about your treatment but refuse to be treated,
or, if you are not competent and your substitute decision-maker refuses to consent, the
doctor may fill out a Form 12 to request that the Review Panel order treatment for you.
Until the doctor gets a Treatment Order (Form 15), he or she may not go ahead with
treatment. Once a Treatment Order is issued, you may be treated against your will.
The Review Panel will only order treatment if it is satisfied that the doctor has
examined you, and that treatment is in your best interest based on the following four
conditions:
1. You are likely to improve with treatment.
2. You are likely to get worse without treatment.
3. The benefit of treatment outweighs the risks of the treatment.
4. The treatment is the least limiting and invading of all possible treatments that
meet the first three conditions.
The Review Panel may also ask for an outside opinion from a psychiatrist who is not
on staff at the hospital to see if the proposed treatment is in your best interests. If the
Review Panel decides that the doctor’s treatment plans are in your best interest, the
Panel will issue a Treatment Order, which allows you to be treated without your
consent.
Despite the fact that the Panel can order treatment, the Act states that psychosurgery
cannot be performed without both your consent and a Review Panel order.
Guardian - a guardian is a
person who has legally been
given authority to make
decisions on your behalf
through either the
Child, Youth
and Family Enhancement Act
(if you're under 18), or the
Adult Guardianship and
Trusteeship Act.
Agent - an agent is someone
you trust to make important
decisions for you when you
are not able to make decisions
for yourself. Legally, the agent
is named in a
Personal
Directive. The person may or
may not be a family member.
Nearest Relative - under the
Act, your nearest relative is an
adult who is a spouse or
common law partner, a son or
daughter, a parent, a brother
or sister, a grandparent, a
grandchild, aunt or uncle, or
nephew or niece.
Public Guardian - if there is
no agent, nearest relative or
guardian under the
Adult
Guardianship and Trusteeship
Act, the Office of the Public
Guardian makes decisions as
the decision-maker of last
resort for someone who is
deemed incompetent.
Psychosurgery - is surgery
done on the brain to change
behaviour or treat mental
disorders.
Note: Electro-Convulsive
Therapy (ECT) is not
considered psychosurgery
and may be given without a
Treatment Order. ECT is not
usually considered as a first or
usual treatment. It is most
often an alternative of last
resort.