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Consent and Capacity - Key Forms

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Form D
Form E
Form F
Form H
Form 18
Form 48
Legislation
 


Form A: Application to the Board to Review a Finding of Incapacity under Subsection 32(1), 50(1) or 65(1)of the Act

If you want to request the Consent and Capacity Board (CCB) to review a decision about your capacity to make decisions relating to your health care, use Form A.

To request this review, you must have already been found to be an incapable person under the Health Care Consent Act, which means somebody else (such as a family member) has to make decisions for you about any of the following:

  • Admission into a care facility;
  • Personal assistance services; or
  • Treatment or treatment plans (including a course of treatment or a community treatment plan).

How to Apply

In order to apply to the CCB to have a decision of incapacity reviewed, you must fill out a copy of Form A. You must also sign the bottom of the form. 

Please note: you cannot apply to the CCB using Form A if any of the following apply to you:

  1. You have a court-appointed guardian for personal care who already has the authority to make the decision for you.
  2. You have signed a special power of attorney for personal care, where you have waived your right to apply to the CCB.
  3. You have applied to the CCB within the past 6 months. If you have, then you will need the CCB's permission to re-apply. In this case, please call the CCB to find out more information on re-applying.

To get help filling out and submitting your form to the CCB you can ask a family member or friend you trust, your lawyer or social worker, an advocacy group or a care provider.

Once you have filled out and signed the form, you must fax it directly to the CCB:

Fax number: 416-924-8873
Toll-Free number for assistance: 1-800-461-2036

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Form D: Application to the Board for Directions under Subsection 35(1), 52(1) or 67(1) of the Act

This section applies where a substitute decision-maker of a person found to be incapable (or another appropriate applicant) wants the CCB to review the person’s wishes in one of the following areas:

  1. Admission into a care facility;
  2. Personal services; or
  3. Treatment.

The person who has been found "incapable" must have expressed his or her wishes to one of the above areas, but:

  1. The wish was not clear;
  2. It is not clear if the wish applies in this situation;
  3. It is not clear if the wish was expressed when the person was capable; or
  4. It is not clear if the wish was expressed after the person was 16 years or older.

Form D is called: Application to the Board for Directions under Subsection 35(1), 52(1), or 67(1) of the Health Care Consent Act.

How to Apply

To apply to the CCB with a Form Dyou must first take some preliminary steps.

  1. A Finding of Incapacity: In order to apply to the CCB for directions, there must have already been a finding of incapacity for the person the application form is about.
  2. List of Proper Persons as Applicants:  There are 4 types (or categories) of people who can apply using Form D. These people are:
    1. The substitute decision-maker of a person who has had a finding of incapacity.
    2. A health-care professional who proposed the treatment that is the subject of the application.
    3. An official at the Community Care Access Centre (CCAC) who is responsible for authorizing admission into the care facility.
    4. A member of the service provider’s staff who is responsible for providing personal assistance services.

A health-care professional, an official of the CCAC, or a member of a service provider's staff cannot bring a Ford D application to the CCB unless they have first informed the substitute decision-maker.

Access Form D here.

Once you have filled out and signed the form, you must fax it to the Board:

Fax number: (416) 924-8873
Toll Free number for assistance: 1-800-461-2036

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Form E: Application to the Board for Permission to Depart from Wishes under Subsection 36(1), 56(1) or 68(1) of the Act

How to Apply

To use Form E to apply to the CCB, you must be a proper applicant.

The CCB sets out a list of who can apply using Form E, to depart from the wishes of an individual who has been found incapable.

List of Proper Persons as Applicants

  1. The substitute decision-maker of the person with a finding of ‘incapacity.’
  2. A health-care professional who proposed the treatment that is the matter of the application.
  3. An official at the Community Care Access Centre (CCAC) who is responsible for authorizing admission into the care facility.
  4. A member of the service provider’s staff who is responsible for providing personal assistance services.

A health-care professional, an official of the CCAC, or a member of a service provider’s staff cannot bring a Form E application to the Board unless they have first informed the substitute decision-maker.

Once steps 1 and 2 above are met, the applicant must then fill out application Form E and submit it by fax to the Board.

Access Form E here.

Once you have filled out and signed the form, you must fax it to the CCB:

Fax number: 416-924-8873
Toll-free number for assistance: 1-800-461-2036

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Form F: Application to the Board with Respect to Place of Treatment under Subsection 34(1) of the Act

If you disagree with a decision made by someone else to admit you to a facility for treatment (hospital, psychiatric or other facility), you may use Form F to request a hearing.

Normally, in using this form, you are asking the CCB to review your capacity. But, if the CCB has ruled on your capacity in the past 6 months, it will now consider only whether this admission is right and fair. It will not look at your capacity.

Remember: the purpose of the CCB hearing is NOT to review your doctor’s clinical decision, but to see if, in making a Community Treatment Order, the criteria were followed.

How to Apply

First, note that:

Children between age 12 and 16 who want to challenge their admission must apply under s. 13(1) of the Mental Health Act.

Persons 16 years and older who want to challenge their admission must apply under s. 34(1) of the Health Care Consent Act.

  • Whichever applies, you must complete Form F. Note that the law and bases for decisions listed below are different for children and adults.
  • To ask for a hearing you must fill out all the parts of Form F and sign at the bottom. Make sure that the information you use is complete and correct.

How often you can apply: Once a Form F application has been made and disposed, a person cannot re-apply for 6 months. The only exception is if you can show the board that there has been a material change in your situation to the point that, in order to be fair, your admission must be reconsidered.

Children’s admission will automatically be reconsidered every six months.

Access Form F here 

Once you have filled out and signed the form, you must fax it to the Board:

Fax number: (416) 924-8873
Toll Free number for assistance: 1-800-461-2036

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Form H: Application to the Board to Amend the Conditions of or Terminate the Appointment of a Representative under Subsection 33(7) and (8), 51(6) or 66(6) of the Act

The CCB may place conditions on a representative appointed to make decisions for an incapable person. This form can be used to request the CCB to change those conditions or to end the appointment of the representative. This form can also be used to request the appointment of a representative for admission to a health-care facility 51(6) or a representative for personal assistance 66(6).

How to Apply

To ask for a hearing you must fill out all the parts of Form 48 and sign at the bottom. Make sure that the information you use is complete and correct.

Access Form H here.

Once you have filled out and signed the form, you must fax it to the Board:

Fax number: 416-924-8873
Toll Free number for assistance: 1-800-461-2036

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Form 18: Application to the Board to Review a Finding of Incapacity to Manage Property under Section 60 of the Act

If you have been found incapable of managing your property by an assessor or a doctor, you may be able to challenge that finding and regain some or all control of your property and have a statutory guardianship ended. There are a few different ways to get these results:

  • An assessor can decide that you are now capable of managing your property. You may ask to see an assessor if you have not been assessed for at least 6 months.
  • If you have a statutory guardianship as the result of a decision by a doctor in a psychiatric facility, a doctor may assess you and decide that you are now capable.
  • You can ask a court to end the statutory guardianship.
  • You can apply to the CCB for a hearing to review the finding of incapacity. To begin that review, fill out Form 18.  

You may apply only if you have been assessed in the past six months (This rule does not apply if you are a patient in a psychiatric facility and a doctor signed a certificate of incapacity during your current stay). You cannot apply more than once every six months.

*** You can find more information about statutory guardianship and substitute decision-making here.

To ask for a hearing you must fill out all the parts of Form 18 and sign at the bottom. Make sure that the information you use is complete and correct.

Access Form 18 here.

Once you have filled out and signed the form, you must fax it to the Board:

Fax number: 416-924-8873
Toll Free number for assistance: 1-800-461-2036

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Form 48: Application to Board to Review Community Treatment Order (s.39.1(1) and Notice to Board by Physician of Need to Schedule Mandatory Review of Community Treatment Order (s.39.1(4))

If you have been given a Community Treatment Order (Form 45), you must set meetings with the doctor who made the order and follow the treatment plan he or she set out for you to live in the community. If you no longer want to follow, or would like to change, your treatment plan, you may use Form 48 to request a hearing.

Remember, the purpose of the CCB hearing is NOT to review your doctor’s clinical decision, but to see if, in making a Community Treatment Order, the criteria were followed.

How to Apply

You may apply to the CCB once each time your doctor fills out a Community Treatment Order. As soon your doctor fills out a second Community Treatment Order, and every time after that, a hearing will take place.

To ask for a hearing you must fill out all the parts of Form 48 and sign at the bottom. Make sure that the information you use is complete and correct. If you are less than 18 years of age, you can seek help from the Child and Family Service Advocacy office at 1-800-263-2841.

Otherwise, access Form 48 here.

Once you have filled out and signed the form, you must fax it to the Board:

Fax number: 416-924-8873
Toll Free number for assistance: 1-800-461-2036

CCB Rules of Practice

The CCB also has Rules of Practice which, like the legislation, are rules that the CCB has to follow. The Rules of Practice are in place to make sure that all applicants have a fair process with the Board, from the application process to the hearing stage.

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Legislation

Since the CCB hears and adjudicates on a variety of issues relating to consent and capacity matters, there are many legal rules (called legislations or acts) that the CCB must follow.

In the chart below are the important pieces of legislation that say what rules the CCB must follow.

The links beside each piece of legislation will take you straight to the legislation itself.

There are also regulations that the CCB has to follow; you will find those in the chart below, with links to the regulations themselves.

Legislation Link

Regulation Link

Health Care Consent Act

Evaluators

Mental Health Act

General

A Practical Guide to Mental Health and the Law in Ontario, October 2012

Health Services Restructuring Commission - Mental Health Act

Substitute Decisions Act

General

Register
Accounts and Records of Attorneys and Guardians

Capacity Assessment

Personal Health Information Protection Act

General

Mandatory Blood Testing Act

General

Statutory Powers Procedure Act

Forms

 

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Consent and Capacity - The Hearing

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Preparing for a Consent and Capacity Hearing: for Families
Lawyers
Witnesses
The Hearing Process
The Decision
 


Preparing for a Consent and Capacity Hearing: For Patients

There may not be a lot of time between when you send in your application form and when you go to your hearing. This means you will need to prepare quickly. The following information will help you prepare for your hearing, and explain what to expect during the hearing.

There are different types of application forms, and each one is based on different legal guidelines. To learn more about the specific legal tests for each type of hearing, see the legislation and case law sections of this resource (found in the Key Forms section). In general, all applicants are seen by the panel as having capacity. This is true even if the panel has earlier found an applicant to be incapable. It is up to the other side to prove otherwise. The panel will listen to all the evidence and decide, using something called the balance of probabilities, whether a patient can make health care decisions, manage property, etc.

In most cases, the Board will have to review a decision of incapacity made by your doctor assessor. This may mean that you, or your lawyer, will have to question your doctor.

Each type of hearing tries to answer a specific legal question. Often, the panel will decide whether you can understand the relevant information and grasp the impact of decisions you want to make. To make your case you can call witnesses and/or show official documents.

Remember: there is a lot happening at a CCB hearing – both legally and emotionally. It’s important to prepare!

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Preparing for a Consent and Capacity Hearing: For Families

As a family member, your involvement in the hearing will vary depending on whether or not you are a party to the proceeding. In some types of CCB cases, family members are automatically parties. If not, you will have to request party status in accordance with the CCB’s Rules of Procedure.

If you become a party, you will then have the right to submit evidence and call witnesses before the panel. You are not required to have a lawyer, but it might be a good idea.

If you are not a party, there are still other ways to influence the process and make your concerns known, like:

  • Asking the counsel for the doctor or care facility's lawyer if you can testify
  • Talking with the doctor to ensure that he or she has the complete context for the patient’s circumstances and knows all the relevant details.
  • Finding any documents, such as letters or reports, that may shed light on the patient’s condition and sharing these with the lawyers. Keep in mind that any document you share with the lawyer for one party will also have to go to all the others.
  • Asking the panel to permit you to make a statement. The presiding member can consider your remarks as a part of their decision-making process.
  • Talking with the patient; try to express your concerns and listen to the patient's point of view.

Documents

You can give any document that relates to the specific issues you have raised. Examples might be email, doctor’s charts, nurse’s notes or interview records. Remember: general documents that are not about the patient’s issues or the alleged incapacity (e.g., found on the Internet or in a newspaper) are not usually allowed as evidence. The Board has the power to accept hearsay evidence (e.g. nurse’s notes or letters from family members).

Make sure to gather and prepare any medical documents that are important in proving your capacity and/or ability to consent. Letters from your family doctor, psychologist, or social worker should be considered. You should ask your health-care professionals for these letters before you apply to the CCB, or right after you submit your application form.

Documents should be gathered ahead of time and then presented at the CCB hearing. You should present the CCB with any relevant documentation that will help prove capacity. Also, you should gather any documents or notes that show flaws in the doctor’s process. Such documents might include proof of shortcuts in carrying out an assessment or evidence that the needed steps were not taken. Three copies of any type of written evidence should be made, and brought to the hearing: 1 for the presiding member, 1 for the other side to the case, and 1 for you.

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Lawyers

Although you do not need a lawyer to present your case to the CCB, it may be a good idea to speak to one before your CCB hearing. You can obtain free legal advice by obtaining a Legal Aid certificate. You can contact the Lawyer Referral Service at 1-800-268-8326, or obtain a lawyer through Legal Aid Ontario at 1-800-668-8258.

In some cases, the CCB may order that legal representation be provided to you before your hearing is scheduled. In this case, if you come to the hearing without a lawyer, the Board may arrange for you to meet with a lawyer before proceeding with the hearing.

If you are currently living in a psychiatric facility, you should speak with a rights advisor about your legal rights in the hearing process.

Getting to Know the Law

It is important for your story to be supported by the rules and the law and the other decisions made by the CCB.  Links to the legislation, and some key decisions are contained in the Key Forms section of this web page.

  • Read these sections and think about ways in which the other side’s request/order goes against the law and/or the other CCB decisions.
  • Write down the names of these cases and sections of the law.

NOTE: Places where this finding of incapacity doesn’t line up with the law should be central to your case and to the questions you ask your witnesses.

Laying Out the Issues

Think about any facts or arguments that might help prove something did or did not happen.

Think about the doctor’s side of the story: In what ways do you disagree? What did the doctor leave out? How do you respond?

Think about the purpose for each type of hearing and make a checklist. Depending on the type of hearing, these questions might include:

  • Has your condition been explained?
  • Were the reasons for the guardianship explained to you?
  • If you have been admitted to a facility, and you think there is a better place for you to get your treatment, say why, and make your suggestion for a better place.
  • What you find wrong or unfair about the facility into which you have been admitted?
  • What other, more suitable, plan for treatment do you have?

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Witnesses

  • If you are the only person with first-hand information about your side of the story, you may NOT need other witnesses. Also, it's fine if you and your lawyer decide that you should not testify.
  • If you do testify, what you say will be important. Stay calm and answer questions honestly and directly. You will likely not face cross-examination from the doctor or the doctor's lawyer. The CCB, however, may ask you some questions.
  • If someone else has experience or information that supports your side, then you may want to bring that person as a witness.
  • Remember: people with good reputations and information about your specific case make the best witnesses.
  • Write down questions you want to ask your witness(es). These questions should help the witness to talk about what you think is important for making your case.
  • Meet with the witness(es), tell them why you have asked them to speak for you, and practise asking them your list of questions.

Each party, as well as the CCB panel members, will take turns asking questions of each witness. Your doctor and/or substitute decision-maker will try to explain why the decision that was made is right and fair.

Watch for inconsistent or outdated assessments. You and your lawyer may also cross-examine your doctor and any other witnesses. When cross-examining the doctor, consider:

  • What is the doctor's justification for the decision they have made about you?
  • What notes does the doctor talk about?
  • Is the doctor confused about any details?
  • Is the doctor rude or disdainful?

To cross-examine the doctor, you can ask tough questions and questions that challenge what he or she is saying. Focus on any hearsay evidence or contradictory statements. But remember, you cannot "put words into a witnesse's mouth" or be rude at any time.

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The Hearing Process

There are 3 panel members at a CCB hearing; a psychiatrist, a community member and a lawyer (the presiding member). Both the applicant and the other side can bring people with them for emotional or moral support. You can bring a family member or a trusted friend to support you at your hearing.

The presiding member starts the hearing by introducing all the parties and explains how the hearing will happen. The presiding member also explains the sequence in which each party gets to speak. These rules can be found in the CCB practice directions.

If you are making your case without a representative, begin by telling the panel who you are, why you are there and what decision you would like the panel to make.

Each party, as well as the CCB panel members, takes turns asking questions of each witness. Your doctor will give information to help the panel decide the questions about your consent and/or capacity.

At the end of the hearing each party is invited to summarize and the presiding member will then end the hearing. Each side is asked to explain, based on the information that came out at the hearing, and on the law, why a decision should be made in their favour.

  • Be prepared in advance with an outline of what you want to say.
  • This is not the time to testify all over again.
  • Instead, go over the best evidence that supports your side of the story and review the reasons why the other side’s case is weak.
  • Focus on the places where the other side’s order or request is not in line with the law.
  • Tell the CCB what you would like them to remember as they leave to make their decision.

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The Decision

After the hearing ends, the presiding member will look at all of the evidence that both parties presented at the hearing. The presiding member will issue a decision in writing one day after the hearing. Remember, the presiding member also has to follow the law in making his or her decision.

The presiding member will look at all of the facts and the evidence presented, and will make a decision based on the very specific facts and evidence in each case. The decision will go in favour of the side that proved their case on a balance of probabilities.

If you are unsuccessful, you may need to continue to work with the doctor and/or the person who gave the order.

If you are not happy with the CCB’s decision, you can appeal the decision to the Superior Court of Justice. It is a good idea to talk to a lawyer before taking this step. 

Ombudsman Ontario

The Ombudsman does not have the power to overturn decisions or change tribunal decisions, but if you believe an administrative tribunal treated you unfairly you can make a formal complaint with the Ombudsman.  If the Ombudsman agrees, he can make recommendations to the tribunal to address the problem, and he can also make recommendations about government legislation, policies or programs.  For more information on the powers of the Ombudsman over tribunals, go to: Ombudsman Ontario.

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Tribunal Number: 

Consent and Capacity - Working With Others

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For Patients Working with Lawyers


Information for Families

It is important to understand that the job of the lawyers who may be representing an adult, or the institution where he or she may reside, is to represent the client, from whom they will take instructions. As a result, depending on the situation, families might feel frustration toward the lawyer for the hospital or their relative. If this is the case, the Consent and Capacity Board (CCB) encourages both formal and informal mediation. Try to communicate your concerns to the lawyers representing your relative and the hospital. 

If you do not feel comfortable dealing directly with lawyers, you may want to get a representative of your own. Parties and witnesses are allowed to have a lawyer or agent to represent them. It is up to you to decide if you should have a lawyer or agent. If you are a party to the hearing, your lawyer or agent may ask questions of all witnesses and make submissions. If you are a non-party witness, your lawyer may only be actively involved in the presentation of your evidence or in the facilitation of mediation.

For Families Working with Doctors

Your family member’s doctor has a great deal of power in the CCB process. However, it is important to remember that part of a doctor’s obligation in aiding the CCB process is to listen to all sides and carefully consider the outcome of the treatments they prescribe. Here too, as with the lawyers, mediation can be the most effective way to communicate.

You have the right to be heard and, if you feel that the doctor is not respecting this right, you should tell the panel.  Also, you may request to be made a party, if necessary. If you decide to do so, you should contact the CCB as soon as possible. The CCB will decide if making you a party is appropriate in the circumstances, taking into account CCB's Rules of Practice.

Ultimately, whether or not you agree with the doctor’s approach, try to remember that no matter the outcome of the hearing, the doctor will likely still be directing your family member's treatment. An open and cooperative relationship with the doctor is most helpful to everyone.

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For Patients Working with Lawyers

In most cases, it may be a good idea to have a lawyer to represent you. You may contact a lawyer on your own or through the Lawyer Referral Service. You may also discuss getting legal counsel with the rights advisor assigned to your case.

In some cases, the CCB can order legal representation to be arranged for you before the hearing is scheduled. If you come to the hearing without a lawyer, the CCB may order legal representation to be arranged for you. This is done so that your story can by supported by reference to the law.

Unlike other people involved with your case, your lawyer’s job is to explain the law to you and to take instructions from you. You may have only a short time to meet with your lawyer before your hearing. It is important to tell your lawyer your concerns and desires before the hearing. Anything you say to your lawyer is privileged. The term privileged means that what you say is private and cannot be shared with anyone. A lawyer is a great resource for you. You should ask the lawyer about the law and listen to his or her advice about your situation.

Remember, though, that you have the right to disagree with your lawyer. For example, if you want to testify and your lawyer disagrees, tell the lawyer this. In extreme cases, you have the right to fire your lawyer and get another lawyer.

On the other hand, the lawyers working for the other parties do not have to take instructions from you or keep your conversations private. If you are approached, be careful what you say and try to have your lawyer present when you speak to people with other parties. The lawyers and the parties can try mediation before the hearing. Mediation is often a good way to exchange concerns and talk about possible solutions.

For Patients Working With Doctors

Your doctor has a great deal of power in the CCB process. Try to explain your concerns to your doctor in a calm and considered way. Often, if patients and doctors speak in a respectful way, they can come to a compromise before the hearing. Here, too, mediation can be an effective way to encourage communication.

However, you have the right to be heard and be involved with your treatment plan. If you do not feel that the doctor is respecting this right, you should tell the panel. You may, if necessary, cross-examine your doctor. If you decide to do so, you should take note of the exact ways and times in which your doctor was disrespectful and unprofessional. Be prepared to share this information with your lawyer.

Whether or not you agree with the doctor’s approach, try to remember that no matter what happens in or after the hearing, this doctor will likely still be directing your treatment. Being civil and respectful with the doctor will help to avoid awkwardness down the road.

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Tribunal Number: 

Consent and Capacity - People Involved

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Witnesses
 


The people involved with Consent and Capacity Board (CCB) hearings fall into 5 main groups: parties, representatives, witnesses, panel members and observers

Parties

Parties are those who have the right to present evidence at a hearing and will usually be impacted by the outcome. Only parties are entitled to examine and copy all documents, including those in medical and other records, that will be used at the hearing. Parties often include:

  • the patient
  • the person responsible for authorizing admissions to the care facility or the doctor who treats the patient
  • the substitute decision-maker
  • any other person whom the CCB specifies. (See: 1996, c. 2, Sched. A, s. 54 (2))

Note: A person's spouse, partner, parents, children and brothers and sisters are all automatically parties if a hearing is held to consider:

  • the appointment of a representative to consent to or refuse treatment, admission to a care facility or personal assistance services
  • a request to change or end the appointment of a representative
  • the appointment of a representative to control a patient’s personal health information

Representatives

At the CCB, the term representative has two meanings:

  1. Person who provides legal counsel (usually a lawyer or paralegal). This person is a legal representative.
  2. Person who has been appointed to make specific decisions about the patient’s treatment and care. This person is a representative decision-maker

Your legal representative is present to take your instructions, give advice about the law and make arguments on your behalf. It may be a good idea to have a lawyer represent you but you do not have to have one. You may contact a lawyer on your own or through the Law Society of Upper Canada Lawyer Referral Service. If you are in a psychiatric facility, you may also ask to speak with a rights adviser. A rights adviser can explain your rights, help you to apply to the CCB, and help you find a lawyer. In some cases, the CCB may order that legal representation be set up for you before the hearing is scheduled. If you come to the hearing without a lawyer, the CCB  may order legal representation to be set up for you.

Your representative decision-maker may be called to testify if his or her decisions or ability to stand in for you are being reviewed.

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Witnesses

In a CCB hearing, both sides have the right to bring people in who can help support their side of the story. Witnesses do not have the right to make arguments or review exhibits and must not be in the hearing room until it is their turn to speak. This is done to ensure that witnesses will not be influenced by other evidence. Witnesses are allowed to remain in the hearing room after giving evidence. 

Panel Members

At the hearing there will be 3 panel members (1 lawyer, 1 psychiatrist, 1 community member) who will decide the case. These panel members are neutral and are not supposed to be swayed by emotion or allegiance to one side or the other. Their job is to consider the facts and arguments and apply them to the law. The panel may ask questions but it cannot help either side to make arguments.

Observers

The CCB encourages family members, partners and friends to attend the hearing, even if they are not parties to the hearing. Family members may be asked to give evidence or they may ask the Board for permission to speak.

The hearing is generally open to anyone who wishes to attend. Sometimes the CCB will order that the hearing be closed in order to protect privacy. If this happens, everyone except for the parties and their lawyers may be excluded from the hearing.

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< Back to Overview          Continue to Working With Others >

Tribunal Number: 

Consent and Capacity - Overview

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Health Care Consent Act
 


The information presented in this overview aims to help people understand how the Consent and Capacity Board (CCB) deals with appeals under several acts relating to medical treatment, mental health treatment, guardianship, and substitute decision-making.

There is also an overview of the more common forms used in appeals.

More detailed information is available on the CCB website.

If your issue is complicated or difficult to explain, you may want to see a lawyer to help you with your appeal.

To obtain free legal advice, you can contact:

Legal Aid Ontario
Toronto Line: 416-979-1446
Toll-free: 1-800-668-8258

The Lawyer Referral Service
Toronto Line: 416-947-3330
Toll-free: 1-800-268-8326

Is The Consent and Capacity Board for you?

The CCB oversees issues involving decision-making ability, terms of treatment and control of property. The CCB tries to balance the rights of people in care, whether they are in an institution or in the community, with the need for public safety. It looks at the facts of a case and decides, based on evidence, whether the steps and factors laid down in law were applied correctly. Most applications to the CCB fall into two groups:

  • Those who, against their wishes, are committed to a mental health facility
  • Those who want to review their capacity to make decisions about their treatment

The rest of the applications cover a number of other situations governed by different acts. Some of the most common reasons for an application are listed below. For a complete list see the Consent and Capacity Board website.

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Health Care Consent Act

  • Covers the capacity of a person to consent to treatment, admission to a care facility or personal assistance service.
  • Covers the choosing of a representative to make decisions for an incapable person about treatment, admission to a care facility or a personal assistance service.


Mental Health Act

  • Covers a person who has been committed to a mental health facility
  • Covers the terms of a treatment plan for a person in the community
  • Covers a finding that a person is incapable of looking after their property


Substitute Decisions Act

  • Covers a statutory guardianship for property


The Consent and Capacity Board

It is important to note that most CCB hearings do not try to decide what is most fair, or even what is in the general best interest of the parties. Instead, the CCB’s job is to compare the facts and evidence with the law, and decide a very narrow question based on the law, such as:

  • Does the patient understand enough of the information needed to make a decision about his or her care?
  • Does the patient understand the things that will likely happen following the decisions he or she wants to make?
  • Is the suggested treatment the least restrictive of the useful options?
  • Does the benefit the person is expected to get from the treatment outweigh the risk of harm to him or her?
  • Did the practitioner who wrote the order follow all the steps set down in law?

The CCB has the power to change or uphold the situation under review. For example, the CCB can:

  • Release a patient or continue to enforce his or her hospitalization
  • Change a treatment order or affirm its terms
  • Overturn an earlier finding of incapacity or extend an incapable status

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