Mental Health Act: Consent to Medical Treatment (14:VI) - Revision history

LSLAP: /* 1. Refusal to Sign Consent Treatment Form: Possible Consequences */

2025-09-22T07:27:56Z

1. Refusal to Sign Consent Treatment Form: Possible Consequences

← Older revision		Revision as of 07:27, 22 September 2025
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	A decision from Nova Scotia regarding guardianship found that some of the central provisions of the Incompetent Persons Act, RSNS, 1989, c 218 are unconstitutional ([https://www.canlii.org/en/ns/nssc/doc/2016/2016nssc180/2016nssc180.html?resultIndex=1 ''Webb v Webb''], 2016 NSSC 180 at paras 19–¬22). This legislation allows for the appointment of a guardian where a person is found incompetent (similarly to the ''PPA'') The court found the Act to be overbroad, as it did not allow a guardianship order to be tailored so that a person subject to that order could retain the ability to make decisions in respect of those areas in which they are capable. This case may be persuasive on the application of BC’s ''PPA'' in the future.		A decision from Nova Scotia regarding guardianship found that some of the central provisions of the Incompetent Persons Act, RSNS, 1989, c 218 are unconstitutional ([https://www.canlii.org/en/ns/nssc/doc/2016/2016nssc180/2016nssc180.html?resultIndex=1 ''Webb v Webb''], 2016 NSSC 180 at paras 19–¬22). This legislation allows for the appointment of a guardian where a person is found incompetent (similarly to the ''PPA'') The court found the Act to be overbroad, as it did not allow a guardianship order to be tailored so that a person subject to that order could retain the ability to make decisions in respect of those areas in which they are capable. This case may be persuasive on the application of BC’s ''PPA'' in the future.

	Sections 50 to 59 of the ''Adult Guardianship Act'', RSBC 1996, c 6 [''AGA''] allow for a person from a designated agency to make unilateral decisions which affect an adult’s support and assistance without their consent, including treatment and removal from a residence. For instance, section 56 allows a person from a designated agency to apply for a court order which can determine an adult’s mode of treatment. Furthermore, section 59 gives broad powers to a person from a designated agency, such as the power to enter an adult’s premises without a warrant, to remove them from their premises and convey them to “a safe place”, and to provide emergency medical care. This is permitted so long as these powers are exercised within the context of an emergency situation or a context where the adult is incapable of providing consent. See '''Chapter 15: Adult Guardianship''' for more information.		Sections 50 to 59 of the ''Adult Guardianship Act'', RSBC 1996, c 6 [''AGA''] allow for a person from a designated agency to make unilateral decisions which affect an adult’s support and assistance without their consent, including treatment and removal from a residence. For instance, section 56 allows a person from a designated agency to apply for a court order which can determine an adult’s mode of treatment. Furthermore, section 59 gives broad powers to a person from a designated agency, such as the power to enter an adult’s premises without a warrant, to remove them from their premises and convey them to “a safe place”, and to provide emergency medical care. This is permitted so long as these powers are exercised within the context of an emergency situation or a context where the adult is incapable of providing consent. See '''[[Introduction to Adult Guardianship and Substitute Decision-Making (15:I)\|Chapter 15: Adult Guardianship]]''' for more information.

	The facility could also proceed under the ''HCCFA'' by declaring the patient incapable of consenting, by using a TSDM, or by claiming that a state of emergency exists, such that the patient must be treated without their consent.		The facility could also proceed under the ''HCCFA'' by declaring the patient incapable of consenting, by using a TSDM, or by claiming that a state of emergency exists, such that the patient must be treated without their consent.

	{{LSLAP Manual Navbox\|type=chapters8-14}}		{{LSLAP Manual Navbox\|type=chapters8-14}}

LSLAP: /* D. Personal Guardians and Temporary Substitute Decision Makers */

2025-09-22T07:27:05Z

D. Personal Guardians and Temporary Substitute Decision Makers

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	If a personal guardian or representative refuses to consent, the health care may be provided despite the refusal in an emergency if the person refusing consent did not comply with their duties under the ‘‘HCCFA’’ or any other act (''HCCFA'', s 12.2).		If a personal guardian or representative refuses to consent, the health care may be provided despite the refusal in an emergency if the person refusing consent did not comply with their duties under the ‘‘HCCFA’’ or any other act (''HCCFA'', s 12.2).

	A temporary substitute decision maker (TSDM) can be chosen by the care provider in accordance with section 16 of the ''HCCFA''. See sections 16-19 of the ''HCCFA'' for the authority and duties of a TSDM. There is a statutory list of those assigned to be a TSDM, beginning with a spouse and moving down. More details can be found in Chapter 15: Adult Guardianship.		A temporary substitute decision maker (TSDM) can be chosen by the care provider in accordance with section 16 of the ''HCCFA''. See sections 16-19 of the ''HCCFA'' for the authority and duties of a TSDM. There is a statutory list of those assigned to be a TSDM, beginning with a spouse and moving down. More details can be found in [[Introduction to Adult Guardianship and Substitute Decision-Making (15:I)\|Chapter 15: Adult Guardianship]].

	In circumstances where a person with a mental health disorder is incapable of making a health care decision, the provisions for a substitute decision maker under the ''HCCFA'' continue to apply. However, if the person is declared an involuntary patient under section 22 of the ''MHA'', then psychiatric treatment can be provided under the deemed consent provisions of section 32 of the ''MHA''.		In circumstances where a person with a mental health disorder is incapable of making a health care decision, the provisions for a substitute decision maker under the ''HCCFA'' continue to apply. However, if the person is declared an involuntary patient under section 22 of the ''MHA'', then psychiatric treatment can be provided under the deemed consent provisions of section 32 of the ''MHA''.

LSLAP at 17:57, 19 August 2025

2025-08-19T17:57:21Z

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LSLAP at 02:36, 19 August 2025

2025-08-19T02:36:08Z

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LSLAP at 21:05, 21 August 2024

2024-08-21T21:05:23Z

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	{{REVIEWED LSLAP \| date= August 10, ~~2023~~}}		{{REVIEWED LSLAP \| date= August 14, 2024}}
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Clicklaw Editor: /* B. Care Provider’s Duty to Obtain Consent */

2023-08-15T19:45:22Z

B. Care Provider’s Duty to Obtain Consent

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	# Any alternatives to the procedure; and		# Any alternatives to the procedure; and
	# The likely prognosis of not having the procedure.		# The likely prognosis of not having the procedure.


	== C. Emergency Situations ==		== C. Emergency Situations ==

LSLAP at 03:23, 11 August 2023

2023-08-11T03:23:01Z

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	{{REVIEWED LSLAP \| date= ~~July 22~~, ~~2022~~}}		{{REVIEWED LSLAP \| date= August 10, 2023}}
	{{LSLAP Manual TOC\|expanded = mentalhealth}}		{{LSLAP Manual TOC\|expanded = mentalhealth}}

	The following subsections apply '''only''' to patients voluntarily admitted to a mental health facility or voluntarily receiving treatment from a health care/psychiatric service provider. Patients admitted involuntarily lose certain rights (see [[Mental Health Act: Involuntarily Admitted Patients (14:VII) \| Section VII]]).		The following subsections apply '''only''' to patients voluntarily admitted to a mental health facility or voluntarily receiving treatment from a health care/psychiatric service provider. Patients admitted involuntarily lose certain rights (see [[Mental Health Act: Involuntarily Admitted Patients (14:VII) \| '''Section VII''']]).

	== A. Adult’s Right to Consent ==		== A. Adult’s Right to Consent ==
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	A health care provider must not provide health care to an adult without consent, except in an emergency situation or when substitute consent has been given and the care provider has made every reasonable effort to obtain a decision from the adult (''HCCFA'', ss 5, 12).		A health care provider must not provide health care to an adult without consent, except in an emergency situation or when substitute consent has been given and the care provider has made every reasonable effort to obtain a decision from the adult (''HCCFA'', ss 5, 12).

	For consent to be valid, it must be related to the proposed health care, voluntary, not obtained by fraud or misrepresentation, informed (see ''HCCFA'', s 6(e)), and consent must be given after an opportunity to make inquiries about the procedure (''HCCFA'', s 6).		For consent to be valid, it must be related to the proposed health care, voluntary, not obtained by fraud or misrepresentation, informed (see ''HCCFA'', s 6(e)), and consent must be given after an opportunity to make inquiries about the procedure (''HCCFA'', s 6). Informed consent, according to ''[https://canlii.ca/t/1mjvr Reibl v Hughes]'', [1980] 2 SCR 880 (SCC), requires a medical practitioner to advise the patient of
			# The nature of the procedure;
			# The benefits and risks of the procedure;
			# Any alternatives to the procedure; and
			# The likely prognosis of not having the procedure.


	== C. Emergency Situations ==		== C. Emergency Situations ==
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	If a personal guardian or representative refuses consent, the health care may be provided despite the refusal in an emergency if the person refusing consent did not comply with their duties under the ''HCCFA'' or any other act (''HCCFA'', s 12.2).		If a personal guardian or representative refuses consent, the health care may be provided despite the refusal in an emergency if the person refusing consent did not comply with their duties under the ''HCCFA'' or any other act (''HCCFA'', s 12.2).

	A temporary substitute decision maker (TSDM) can be chosen by the care provider in accordance with ''HCCFA'', s 16. See ''HCCFA'', ss 16-19 for the authority and duties of a TSDM. There is a statutory list of those assigned to be a TSDM, beginning with a spouse, and moving down. More details can be found in Chapter 15: Adult Guardianship.		A temporary substitute decision maker (TSDM) can be chosen by the care provider in accordance with ''HCCFA'', s 16. See ''HCCFA'', ss 16-19 for the authority and duties of a TSDM. There is a statutory list of those assigned to be a TSDM, beginning with a spouse, and moving down. More details can be found in '''Chapter 15: Adult Guardianship'''.

	In circumstances where a ~~mentally ill~~ person is judged to be incapable of making a health care decision, the provisions for a substitute decision maker under the ''HCCFA'' continue to apply. However, if the person is declared an involuntary patient under s 22 of the ''MHA'', then psychiatric treatment can be provided under the deemed consent provisions of s 32 of the ''MHA''.		In circumstances where a person with a mental health disorder is judged to be incapable of making a health care decision, the provisions for a substitute decision maker under the ''HCCFA'' continue to apply. However, if the person is declared an involuntary patient under s 22 of the ''MHA'', then psychiatric treatment can be provided under the deemed consent provisions of s 32 of the ''MHA''.

	== E. Consent to Treatment Forms ==		== E. Consent to Treatment Forms ==
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	A person who refuses to sign the consent form may be deemed a patient who “could not be cared for or treated appropriately in the facility” under s 18(b) of the ''MHA''. This person runs the risk of being refused admission to the facility or being discharged if already admitted.		A person who refuses to sign the consent form may be deemed a patient who “could not be cared for or treated appropriately in the facility” under s 18(b) of the ''MHA''. This person runs the risk of being refused admission to the facility or being discharged if already admitted.

	Under the ''Patients Property Act'' (''PPA'') hospitals could circumvent the issue of consent by seeking a court order, supported by two medical opinions, to have the patient declared incapable of managing their personal affairs. Minor changes were made to the PPA in September 2011. Under the PPA, a legal guardian or public trustee is appointed as committee to give consent on behalf of the patient. It is not sufficient for a family member to give consent for a voluntary informal patient without first obtaining legal guardianship or committeeship, or becoming a Representative under the ''Representative Agreement Act'', or becoming a substitute decision maker under the ''HCCFA''.		Under the ''Patients Property Act'' (''PPA'') hospitals could circumvent the issue of consent by seeking a court order, supported by two medical opinions, to have the patient declared incapable of managing their personal affairs. Minor changes were made to the ''PPA'' in September 2011. Under the ''PPA'', a legal guardian or public trustee is appointed as committee to give consent on behalf of the patient. It is not sufficient for a family member to give consent for a voluntary informal patient without first obtaining legal guardianship or committeeship, or becoming a Representative under the ''Representative Agreement Act'', or becoming a substitute decision maker under the ''HCCFA''.

	A decision from Nova Scotia regarding guardianship found that some of the central provisions of the ''Incompetent Persons Act'', R.S.N.S., 1989, c. 218 are unconstitutional ([https://www.canlii.org/en/ns/nssc/doc/2016/2016nssc180/2016nssc180.html?resultIndex=1 ''Webb v Webb'', 2016 NSSC 180]). This legislation allows for the appointment of a guardian where a person is found incompetent (similarly to the ''PPA''), but it was found that the legislation was overbroad. It did not allow a court to tailor a guardianship order so that a person subject to that order could retain the ability to makes decisions in respect of those areas in which they are capable. This may have an impact on the application of BC's ''PPA'' in the future.		A decision from Nova Scotia regarding guardianship found that some of the central provisions of the ''Incompetent Persons Act'', R.S.N.S., 1989, c. 218 are unconstitutional ([https://www.canlii.org/en/ns/nssc/doc/2016/2016nssc180/2016nssc180.html?resultIndex=1 ''Webb v Webb'', 2016 NSSC 180]). This legislation allows for the appointment of a guardian where a person is found incompetent (similarly to the ''PPA''), but it was found that the legislation was overbroad. It did not allow a court to tailor a guardianship order so that a person subject to that order could retain the ability to makes decisions in respect of those areas in which they are capable. This may have an impact on the application of BC's ''PPA'' in the future.

	Sections 50 to 59 of the ''Adult Guardianship Act'', RSBC 1996, c 6 [''AGA''] allow for a person from a designated agency to make unilateral decisions which affect the adult’s support and assistance without their consent, including treatment and removal from a residence. For instance, section 56 allows a person from a designated agency to apply for a court order which can determine an adult’s mode of treatment. Furthermore, section 59 gives a person from a designated agency broad powers, such as the power to enter their premises without a warrant, to remove them from their premises and convey them to “a safe place”, and to provide emergency medical care. This is permitted so long as these powers are exercised within the context of an emergency situation or a context where the adult is incapable of providing consent. See [[Introduction_to_Adult_Guardianship_and_Substitute_Decision-Making_(15:I)\|Chapter 15: Adult Guardianship]] for more information.		Sections 50 to 59 of the ''Adult Guardianship Act'', RSBC 1996, c 6 [''AGA''] allow for a person from a designated agency to make unilateral decisions which affect the adult’s support and assistance without their consent, including treatment and removal from a residence. For instance, section 56 allows a person from a designated agency to apply for a court order which can determine an adult’s mode of treatment. Furthermore, section 59 gives a person from a designated agency broad powers, such as the power to enter their premises without a warrant, to remove them from their premises and convey them to “a safe place”, and to provide emergency medical care. This is permitted so long as these powers are exercised within the context of an emergency situation or a context where the adult is incapable of providing consent. See [[Introduction_to_Adult_Guardianship_and_Substitute_Decision-Making_(15:I)\|'''Chapter 15: Adult Guardianship''']] for more information.

	The facility could also proceed under the ''HCCFA'' by declaring the patient incapable of consenting, by using a TSDM and/or by claiming that a state of emergency exists such that the patient must be treated without their consent.		The facility could also proceed under the ''HCCFA'' by declaring the patient incapable of consenting, by using a TSDM and/or by claiming that a state of emergency exists such that the patient must be treated without their consent.

Clicklaw Editor: /* 1. Refusal to Sign Consent Treatment Form: Possible Consequences */

2022-10-10T21:39:43Z

1. Refusal to Sign Consent Treatment Form: Possible Consequences

← Older revision		Revision as of 21:39, 10 October 2022
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	Under the ''Patients Property Act'' (''PPA'') hospitals could circumvent the issue of consent by seeking a court order, supported by two medical opinions, to have the patient declared incapable of managing their personal affairs. Minor changes were made to the PPA in September 2011. Under the PPA, a legal guardian or public trustee is appointed as committee to give consent on behalf of the patient. It is not sufficient for a family member to give consent for a voluntary informal patient without first obtaining legal guardianship or committeeship, or becoming a Representative under the ''Representative Agreement Act'', or becoming a substitute decision maker under the ''HCCFA''.		Under the ''Patients Property Act'' (''PPA'') hospitals could circumvent the issue of consent by seeking a court order, supported by two medical opinions, to have the patient declared incapable of managing their personal affairs. Minor changes were made to the PPA in September 2011. Under the PPA, a legal guardian or public trustee is appointed as committee to give consent on behalf of the patient. It is not sufficient for a family member to give consent for a voluntary informal patient without first obtaining legal guardianship or committeeship, or becoming a Representative under the ''Representative Agreement Act'', or becoming a substitute decision maker under the ''HCCFA''.

	A decision from Nova Scotia regarding guardianship found that some of the central provisions of the ''Incompetent Persons Act'', R.S.N.S., 1989, c. 218 are unconstitutional ([https://www.canlii.org/en/ns/nssc/doc/2016/2016nssc180/2016nssc180.html?resultIndex=1 ''Webb v Webb'', 2016 NSSC 180]). This legislation allows for the appointment of a guardian where a person is found incompetent (similarly to the ''PPA''), but it was found that the legislation was overbroad. It did not allow a court to tailor a guardianship order so that a person subject to that order could retain the ability to makes decisions in respect of those areas in which they are capable. This may have an impact on the application of BC's ''PPA'' in the future		A decision from Nova Scotia regarding guardianship found that some of the central provisions of the ''Incompetent Persons Act'', R.S.N.S., 1989, c. 218 are unconstitutional ([https://www.canlii.org/en/ns/nssc/doc/2016/2016nssc180/2016nssc180.html?resultIndex=1 ''Webb v Webb'', 2016 NSSC 180]). This legislation allows for the appointment of a guardian where a person is found incompetent (similarly to the ''PPA''), but it was found that the legislation was overbroad. It did not allow a court to tailor a guardianship order so that a person subject to that order could retain the ability to makes decisions in respect of those areas in which they are capable. This may have an impact on the application of BC's ''PPA'' in the future.

	Sections 50 to 59 of the ''Adult Guardianship Act'', RSBC 1996, c 6 [''AGA''] allow for a person from a designated agency to make unilateral decisions which affect the adult’s support and assistance without their consent, including treatment and removal from a residence. For instance, section 56 allows a person from a designated agency to apply for a court order which can determine an adult’s mode of treatment. Furthermore, section 59 gives a person from a designated agency broad powers, such as the power to enter their premises without a warrant, remove them from their premises and convey them to “a safe place”, and to provide emergency medical care. This is permitted so long as these powers are exercised within the context of an emergency situation or a context where the adult is incapable of providing consent.		Sections 50 to 59 of the ''Adult Guardianship Act'', RSBC 1996, c 6 [''AGA''] allow for a person from a designated agency to make unilateral decisions which affect the adult’s support and assistance without their consent, including treatment and removal from a residence. For instance, section 56 allows a person from a designated agency to apply for a court order which can determine an adult’s mode of treatment. Furthermore, section 59 gives a person from a designated agency broad powers, such as the power to enter their premises without a warrant, to remove them from their premises and convey them to “a safe place”, and to provide emergency medical care. This is permitted so long as these powers are exercised within the context of an emergency situation or a context where the adult is incapable of providing consent. See [[Introduction_to_Adult_Guardianship_and_Substitute_Decision-Making_(15:I)\|Chapter 15: Adult Guardianship]] for more information.

	The facility could also proceed under the ''HCCFA'' by declaring the patient incapable of consenting, by using a TSDM and/or by claiming that a state of emergency exists such that the patient must be treated without their consent.		The facility could also proceed under the ''HCCFA'' by declaring the patient incapable of consenting, by using a TSDM and/or by claiming that a state of emergency exists such that the patient must be treated without their consent.

Clicklaw Editor: /* E. Consent to Treatment Forms */

2022-10-10T21:36:41Z

E. Consent to Treatment Forms

← Older revision		Revision as of 21:36, 10 October 2022
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	Under the ''HCCFA'', “An adult consents to health care if		Under the ''HCCFA'', “An adult consents to health care if
	:(a)the consent relates to the proposed health care,		:(a) the consent relates to the proposed health care,
	:(b)the consent is given voluntarily,		:(b) the consent is given voluntarily,
	:(c)the consent is not obtained by fraud or misrepresentation,		:(c) the consent is not obtained by fraud or misrepresentation,
	:(d)the adult is capable of making a decision about whether to give or refuse consent to the proposed health care,		:(d) the adult is capable of making a decision about whether to give or refuse consent to the proposed health care,
	:(e)the health care provider gives the adult the information a reasonable person would require to understand the proposed health care and to make a decision, including information about		:(e) the health care provider gives the adult the information a reasonable person would require to understand the proposed health care and to make a decision, including information about
	::(i) the condition for which the health care is proposed,		::(i) the condition for which the health care is proposed,
	::(ii) the nature of the proposed health care,		::(ii) the nature of the proposed health care,
	::(iii) the risks and benefits of the proposed health care that a reasonable person would expect to be told about, and		::(iii) the risks and benefits of the proposed health care that a reasonable person would expect to be told about, and
	::(iv) alternative courses of health care, and		::(iv) alternative courses of health care, and
	:(f)the adult has an opportunity to ask questions and receive answers about the proposed health care.” (s 6).		:(f) the adult has an opportunity to ask questions and receive answers about the proposed health care.” (s 6).

	Consent can be given in writing, orally, or inferred from conduct.		Consent can be given in writing, orally, or inferred from conduct.

Clicklaw Editor: /* E. Consent to Treatment Forms */

2022-10-10T21:36:08Z

E. Consent to Treatment Forms

← Older revision		Revision as of 21:36, 10 October 2022
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	Under the ''HCCFA'', “An adult consents to health care if		Under the ''HCCFA'', “An adult consents to health care if
	*(a)the consent relates to the proposed health care,		:(a)the consent relates to the proposed health care,
	*(b)the consent is given voluntarily,		:(b)the consent is given voluntarily,
	*(c)the consent is not obtained by fraud or misrepresentation,		:(c)the consent is not obtained by fraud or misrepresentation,
	*(d)the adult is capable of making a decision about whether to give or refuse consent to the proposed health care,		:(d)the adult is capable of making a decision about whether to give or refuse consent to the proposed health care,
	*(e)the health care provider gives the adult the information a reasonable person would require to understand the proposed health care and to make a decision, including information about		:(e)the health care provider gives the adult the information a reasonable person would require to understand the proposed health care and to make a decision, including information about
	**(i) the condition for which the health care is proposed,		::(i) the condition for which the health care is proposed,
	**(ii) the nature of the proposed health care,		::(ii) the nature of the proposed health care,
	**(iii) the risks and benefits of the proposed health care that a reasonable person would expect to be told about, and		::(iii) the risks and benefits of the proposed health care that a reasonable person would expect to be told about, and
	**(iv) alternative courses of health care, and		::(iv) alternative courses of health care, and
	*(f)the adult has an opportunity to ask questions and receive answers about the proposed health care.” (s 6).		:(f)the adult has an opportunity to ask questions and receive answers about the proposed health care.” (s 6).

	Consent can be given in writing, orally, or inferred from conduct.		Consent can be given in writing, orally, or inferred from conduct.