This is the Executive Summary of the Law Commission of Ontario’s (LCO) Final Report on legal capacity, decision-making and guardianship in Ontario. The Final Report contains the LCO’s analysis and recommendations regarding provincial legislation, policies and practices in this far-reaching and important area of law.

Legal capacity, decision-making and guardianship laws can have a profound influence over some of the most important and intimate legal decisions and choices in a person’s life. Persons who have been determined to lack legal capacity may lose their right to make decisions about their personal care, their finances, their living arrangements, or many other decisions that each of us must make every day.

Legal capacity, decision-making and guardianship laws affect thousands of Ontarians and their families every day. Most obviously, these laws affect the approximately 17,000 Ontarians who are currently subject to some kind of a guardianship order or the thousands of others whose capacity is assessed as part of obtaining consent to health care treatments, for admission to residency to a long term care home, or as part of the provision of many other services. In addition, every Ontarian who has ever granted or been given a power of attorney is affected by this area of law.

Legal capacity, decision-making and guardianship touches upon some of the most profound and consequential issues in law. It is suffused with questions and controversies regarding personal independence, a person’s right to make choices and take risks, legal accountability for decision-making, and the balance between a person’s autonomy and his or her safety and security. The law also touches upon the some of our most intimate and close personal relationships.

The Final Report is the most comprehensive analysis of Ontario’s legal framework in this area in almost thirty years. The Final Report assess the objectives, policies, structures, legal instruments, and procedures governing capacity, decision-making and guardianship in Ontario. The Final Report makes recommendations that build on the strengths of the current system and improve areas where necessary. The LCO’s recommendations are practical, achievable, and should benefit persons affected, their families, institutions, and service provides across the province.


The LCO is Ontario’s leading law reform agency. The LCO provides independent, balanced, and authoritative advice on some of Ontario’s most complex and far- reaching legal policy issues. The LCO evaluates laws impartially, transparently and broadly. The LCO’s work is informed by legal analysis; multidisciplinary research; public consultations; social, demographic and economic conditions; and the impact of technology.

LCO reports include principled, practical, “problem-solving” recommendations informed by broad consultations and tested through a transparent, comprehensive review process that engages a broad range of individuals, experts, and institutions. The LCO gives a voice to marginalized communities and others who should have an important role in law reform debates and discussions.

More information about this project and the LCO is available on the LCO’s website at


Ontario’s current statutory regime for legal capacity, decision-making and guardianship took shape as a result of a comprehensive and thoughtful law reform effort spanning the late 1980s and early 1990s.

Ontario’s legislative regime for capacity, decision-making and guardianship is set out in three statutes: the Substitute Decisions Act, 1992 (SDA), the Health Care Consent Act, 1996 (HCCA), and, to a lesser extent, the Mental Health Act (MHA). In addition, there are also countless policies, guidelines, and practices designed to implement this legislation. These laws and policies are administered by a wide range of government ministries, health care institutions, community agencies, professionals, financial institutions, courts and tribunals, and many others across the province.


This LCO considers several important and overlapping questions in this project:

Does the System Reflect Contemporary Law and Values?

Several important and far-reaching choices underpin Ontario’s legal capacity, decision-making and guardianship laws. New ideas and developments both within and outside Ontario challenge many of these choices. For example, many agree with the current law’s conceptual framework but believe that the system can do more to promote autonomy, social inclusion, rights protection, and participation in decision- making. Others are urging a fundamental re-examination of the Ontario’s substitute decision-making model. The LCO considers these and related questions at length in the Final Report.

Does the System Reflect Contemporary Needs?

Over the years, Ontarians have developed increasingly nuanced and sensitive understandings of the needs and capabilities of the individuals, families, and others affected by these laws. The Final Report considers whether the system in Ontario reflects and responds to these understandings. The LCO considers needs from multiple perspectives, including persons directly affected, families, service providers and professionals, and others. The LCO also considers needs in light of demographic and social trends, changing family structures, and Ontario’s cultural and linguistic diversity.

Is the System Working on the Ground?

The LCO’s Final Report discusses the legislative framework and objectives of Ontario’s capacity, decision-making and guardianship system at length. The Final Report considers whether Ontario achieves these objectives in practice. In other words, the project considers whether there is gap between the formal law – as expressed in statutes – and lived experience of the legislation. Understanding and addressing the “implementation gap” is an important theme in the Final Report.

Are the System’s Legal Protections Adequate and Accessible?

Meaningful access to justice underpins the entire legal capacity, decision-making and guardianship system. Effective and appropriate mechanisms for dispute resolution and rights enforcement are therefore a priority in the Final Report.


The LCO’s analysis and recommendations in the Final Report are independent, evidence-based, and impartial. The research and consultations on this project were the most extensive and complex in LCO history. The Report builds upon and extends the analysis in three earlier LCO projects, the Framework for the Law as It Affects Older Adults, the Framework for the Law as It Affects Persons with Disabilities and the LCO’s recently completed Capacity and Legal Representation for the Federal RDSP.

The LCO wishes to extend special thanks to the project’s Advisory Group; to the dozens of agencies and institutions involved in the project; to the authors of the project’s commissioned research papers; and, most importantly, to the thousands of Ontarians who participated in meetings, consultations, or focus groups.


Ontario has now had almost a generation’s worth of experience with its capacity, decision-making and guardianship laws. The LCO was able, with the benefit of extensive research and consultations, to make many important observations and findings about the objectives and operation of this system. These findings are the basis for the LCO’s final recommendations.

Strengths and Attributes

The LCO has concluded that the legal capacity, decision-making and guardianship regime in Ontario has many important strengths or attributes. These include:

  • Ontario’s capacity, decision-making and guardianship laws aim to promote self- determination and personal autonomy.
  • The system promotes a nuanced and contextual approach to legal capacity.
  • Ontario has clear and largely appropriate legal duties for substitute decision- makers.
  • There are many important legal protections for persons lacking or who may be lacking legal capacity.
  • Powers of attorney are simple and accessible.
  • The legislation acknowledges the important role of families.
  • The Consent and Capacity Board is an accessible forum for dispute resolution.
  • The Public Guardian and Trustee is a necessary and important institution.

Areas of Concern

The LCO’s research and consultations also revealed several important areas of concern. This is perhaps not surprising, given the complexity of the system and the length of time since the last major law reform effort. The LCO’s areas of concern will be familiar to many of the individuals and institutions who work in the system today. Many of these concerns overlap with one another. These include:

  • The system is confusing and complex.
  • The system lacks coordination.
  • There is a lack of clarity and consistency for capacity assessments.
  • There is a need for legal tools that are less binary and more responsive to the range of needs of those directly affected.
  • Individuals, families, and service providers need more supports.
  • Guardianships are insufficiently limited, tailored and flexible.
  • Oversight and monitoring mechanisms for substitute decision-makers need to be improved.
  • There are signi