Court of Appeal of Quebec

G.J. c. Centre intégré de santé et de services sociaux de Laval

Mainville, Moore, Cournoyer

Appeal from a judgment of the Superior Court granting an application for authorization of care. Allowed in part.

Having ascertained the incapacity of the appellant, who suffers from a psychotic disorder, as well as his categorical refusal to receive care, the trial judge authorized the respondent to treat him against his will for a period of two years. The authorized program of care includes pharmacological treatment as well as outpatient psychiatric follow-up. The appellant does not challenge the conclusions with respect to his incapacity and his categorical refusal, but he challenges the content of the treatment plan, which according to him includes unnecessary treatments as well as broad and vague conclusions that [translation] “excessively” interfere with his fundamental rights. He challenges the conclusions authorizing the sharing of medical information with his immediate family as well as his hospitalization.

The appellant’s family is essential to the implementation of the treatment. It was therefore reasonable for the judge to authorize the sharing of medical information. The wording of the conclusion is, however, too vague. Even if it is limited to only the [translation] “immediate” family, the authorization is open to interpretation and is difficult to enforce. With this type of order, it is better to identify a specific person or specific persons. In this case, the sharing of medical information is authorized with the appellant's mother.

The authorization of hospitalization is one of the measures necessary for the order to be enforced. The terms of this conclusion must, however, be specified. The paragraph of the order authorizing the appellant’s hospitalization to [translation] “start, adjust, and continue treatment in a supervised and safe environment” is therefore withdrawn. Indeed, the medical report refers to the need for possible hospitalization only if the appellant’s mental health deteriorates. Moreover, an authorization for non-immediate hospitalization should not be included as an incidental and automatic effect of every treatment plan. The authorization must set out the reasons that may lead to hospitalization and set a limit on its duration. Accordingly, the respondent is authorized to hospitalize the appellant in the event of decompensation or a significant deterioration in his mental state, for the sole purpose of stabilizing his condition, but for a maximum period of one month.

Last, there is no need to intervene as to the duration of the treatment order.

Text of the decision: http://citoyens.soquij.qc.ca

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