Endnotes2017-03-03T21:48:48+00:00

[1] Law Commission of Ontario, A Framework for the Law as It Affects Older Adults: Advancing Substantive Equality for Older Persons through Law, Policy and Practice (Toronto: April 2012). Online: http://www.lco-cdo.org/en/older-adults-final-report [LCO, Framework for the Law as It Affects Older Adults].

[2] Law Commission of Ontario, A Framework for the Law as It Affects Persons with Disabilities: Advancing Substantive Equality for Persons with Disabilities through Law, Policy and Practice (Toronto: September 2012). Online: http://www.lco-cdo.org/en/disabilities-final-report [LCO, Framework for the Law as It Affects Persons with Disabilities].

[3] Substitute Decisions Act, 1992, S.O. 1992, c. 30 [SDA].

[4] Health Care Consent Act, 1996, S.O. 1996, c. 2, Schedule A [HCCA].

[5] Personal Health Information Protection Act, 2004, S.O. 2004, c. 3, Schedule A [PHIPA].

[6] Mental Health Act, R.S.O. 1990, c. M.7 [MHA].

[7] The concept of progressive realization emphasizes that the fulfilment of the principles is an ongoing process, as circumstances, understandings and resources develop, Efforts to improve the law should be undertaken, such that changes to law and policy respect and advance the principles, principles are realized to the greatest extent possible at the current time, and there is a focus on continuous advancement. The Frameworks further elaborate on the concept of progressive realization: LCO, Framework for the Law as It Affects Older Adults, note 1, 7; LCO, Framework for the Law as It Affects Persons with Disabilities, note 2, 96.

[8] Queensland Law Reform Commission, Assisted and Substituted Decisions: Decision-Making by and for People with a Decision-Making Disability (Brisbane: June 1996), 1. Online: http://www.qlrc.qld.gov.au/reports/r49v1Ch1_6.pdf.

[9] For a comprehensive overview of Ontario’s laws prior to the reforms of the 1990s, see David N. Weisstub, Enquiry on Mental Competency: Final Report (Toronto: Publications Ontario, 1990), Appendices II – V.

[10] Advisory Committee on Substitute Decision Making for Mentally Incapable Persons, Final Report of the Advisory Committee on Substitute Decision Making for Mentally Incapable Persons (Toronto: 1987), vii [Fram Report].

[11] Fram Report, note 10, 39-47.

[12] Weisstub, Enquiry, note 9, 55.

[13] Weisstub, Enquiry, note 9, 19.

[14] Ontario, Legislative Assembly, Official Report of Debates (Hansard), 33rd Parl, 2nd Sess, No 81 (16 December 1986), 4255-56 (Hon Ian Scott) [Hansard]. See also Review of Advocacy for Vulnerable Adults, Terms of Reference, January 1987 in Sean O’Sullivan, You’ve Got a Friend: A Review of Advocacy in Ontario (Toronto: Ontario Ministry of the Attorney General, 1987), 162.

[15] You’ve Got a Friend, note 14, 121-22.

[16] Canadian Centre for Elder Law Studies, A Comparative Analysis of Adult Guardianship Laws in BC, New Zealand and Ontario (Vancouver: British Columbia Law Institute, 2006), 43. Online: http://www.bcli.org/bclrg/publications.

[17] Advocacy Act, 1992, S.O. 1992, c. 26.

[18] Ernie S. Lightman & Uri Aviram, “Too Much, Too Late: the Advocacy Act in Ontario” (2000) 22:1 Law & Pol’y 25, 40.

[19] Convention on the Rights of Persons with Disabilities, 13 December 2006, 2515 UNTS 3, GA Res 61/106 (entered into force 3 May 2008, ratified by Canada 11 March 2010) [CRPD].

[20] CRPD, note 19, Art. 4.

[21] Lana Kerzner, “Paving the way to Full Realization of the CRPD’s Rights to Legal Capacity and Supported Decision-Making: A Canadian Perspective” (Paper prepared for the In From the Margins: New Foundations for Personhood and Legal Capacity in the 21st Century symposium at the University of British Columbia, April 2011), 19.

[22] Kerzner, note 21, 21.

[23] United Nations Treaty Collection, “Status of Treaties: Convention on the Rights of Persons with Disabilities.” Online:  https://treaties.un.org/Pages/ViewDetails.aspx?src=TREATY&mtdsg_no=IV-15&chapter=4&lang=en.

[24] Godbout v. Longueuil (City), [1997] 3 S.C.R. 844, para. 66. See also R.B. v. Children’s Aid Society of Metropolitan Toronto, [1995] 1 S.C.R. 315.

[25] New Brunswick (Minister of Health and Community Services) v. G.(J.), [1999] 3 S.C.R. 46, paras 58-60.

[26] Fleming v. Reid (1990), 73 O.R. (2d) 169 (Dist. Ct.), rev’d (1991), 4 O.R. (3d) 74, 82 D.L.R. (4th) 298 (C.A.), para. 60.

[27] In R. v. Kapp, the Supreme Court of Canada stated that “Sections 15(1) and 15(2) work together to promote the vision of substantive equality that underlies [section] 15 as a whole”: [2008] 2 S.C.R. 483, 2008 SCC 41, para. 16.

[28] Human Rights Code, R.S.O. 1990, c. H.19, s. 47(2).

[29] Human Rights Code, note 28, Preamble.

[30] For explication of the nature, content and limits of duty to accommodate, see Ontario Human Rights Commission, Policy and Guidelines on Disability and the Duty to Accommodate (Toronto: 2000). Online: http://www.ohrc.on.ca.

[31] For example, the Commissioner for Human Rights for the Council of Europe has recommended the creation of an explicit legal obligation for government and key institutions (such as health care and financial service providers) to “provide reasonable accommodation to persons with disabilities who wish to access their services. Reasonable accommodation includes the provision of information in plain language and the acceptance of a support person communicating the will of the individual concerned”: Commissioner for Human Rights, Who Gets to Decide? Right to Legal Capacity for Persons with Intellectual and Psychosocial Disabilities (Strasbourg: 2012), 5. Mona Paré has also made this argument: Mona Paré, “Of Minors and the Mentally Ill: Re-Positioning Perspectives on Consent to Health Care” (2011) 29:1 Windsor Y.B. Access Just. 107, 121.

[32] Ontario Human Rights Commission, Minds That Matter: Report on the consultation on human rights, mental health and addictions (Toronto: 2012), 92. Online: http://www.ohrc.on.ca/sites/default/files/Minds%20that%20matter_Report%20on%20the%20consultation%20on%20human%20rights%2C%20mental%20health%20and%20addictions.pdf.

[33] Accessibility for Ontarians with Disabilities Act, 2005, S.O. 2005, c. 11. Online: http://www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_05a11_e.htm [AODA].

[34] HCCA, note 4, s. 1.

[35] Note 4, ss. 10, 25.

[36] Note 4, ss. 10-11, 15.

[37] Note 4, s. 20.

[38] Note 4, s. 21.

[39] Note 4, Parts III, IV.

[40] Note 4, ss. 40, 57.

[41] Note 4, s. 70.

[42] Note 4, s. 75.

[43] SDA, note 3, s. 7.

[44] Note 3, ss. 46, 49.

[45] Note 3, ss. 7(7.1), 8, 46(8), 47.

[46] SDA, note 3; O Reg 460/05.

[47] SDA, note 3, ss. 16-17.

[48] Note 3, ss. 22, 55.

[49] Note 3, ss. 32, 38, 66-67.

[50] MHA, note 6, s. 54. There is an exception where the patient is already under guardianship or a power of attorney for property under the SDA.

[51] MHA, note 6, ss. 59-60.

[52] Note 6, s. 20, especially s. 20(1.1).

[53] HCCA, note 4, s. 4; SDA, note 3, s. 2.

[54] SDA, note 3, s. 3; HCCA, note 4, s. 81.

[55] British Columbia Law Institute, Report on Common-Law Tests of Capacity (Vancouver: September 2013).

[56] PHIPA, note 5, s. 4.

[57] Personal Information Protection and Electronic Documents Act, S.C. 2000, c. 5 [PIPEDA].

[58] Long-Term Care Task Force on Resident Care and Safety, Report: Long-Term Care Task Force on Resident Care and Safety (May 2012), 16. Online: http://longtermcaretaskforce.ca/images/uploads/LTCFTReportEnglish.pdf.

[59] Long-Term Care Homes Act, 2007, S.O. 2007, c.8.

[60] Services and Supports to Promote the Social Inclusion of Persons with Developmental Disabilities Act, 2008, S.O. 2008, c. 14 [SIPDDA].

[61] SIPDDA, note 60, s. 3.

[62] SIPDDA, note 60, s. 4.

[63] SIPDDA, note 60, s. 11.

[64] Statistics Canada, Social and Aboriginal Statistics Division, Participation and Activity Limitation Survey 2006: Analytical Report (Ottawa: Minister of Industry, 2007), 34 [PALS 2006 Analytical Report].

[65] Note 64, 30.

[66] Kerri Joffe (ARCH Disability Law Centre), Enforcing the Rights of People with Disabilities in Ontario’s Developmental Services System (Toronto: Law Commission of Ontario, June 2010), 13.

[67] National Advisory Council on Aging, “Seniors on the Margins: Aging with a Developmental Disability,” (Ottawa: Minister of Public Works and Government Services Canada, 2004), 8. Online: http://publications.gc.ca/collections/Collection/H88-5-2-2004E.pdf.

[68] Statistics Canada, Social and Aboriginal Statistics Division, Participation and Activity Limitation Survey 2006: Tables (Ottawa: Minister of Industry, 2008), 12, 19. Online: http://www.statcan.gc.ca/pub/89-628-x/89-628-x2008011-eng.pdf [PALS 2006 Tables].

[69] Statistics Canada, Social and Aboriginal Statistics Division, Participation and Activity Limitation Survey 2006: Labour Force Experience of People with Disabilities in Canada (Ottawa: Minister of Industry: 2008), 13. Online: http://www.statcan.gc.ca/pub/89-628-x/89-628-x2008007-eng.pdf.

[70] National Advisory Council on Aging, note 67, 11.

[71] Note 67, 9.

[72] Edward F. Ansello & Peggy O’Neill, “Abuse, Neglect, and Exploitation: Considerations in Aging with Lifelong Disabilities,” (2010) 22 Journal of Elder Abuse and Neglect, 105, 110.

[73] According to Statistics Canada, in 2003, 37 per cent of individuals aged 65 and older considered themselves to be in very good or excellent health, as compared to 63 per cent of those aged 25 to 54: Martin Turcotte & Grant Schellenberg, A Portrait of Seniors in Canada (Ottawa: Minister of Industry, 2007), 43-51. Online: http://www.statcan.gc.ca/pub/89-519-x/89-519-x2006001-eng.pdf [Turcotte & Schellenberg].

[74] Alzheimer Society of Canada, Rising Tide: The Impact of Dementia on Canadian Society (Toronto: 2010), 18. Online: http://www.healthyenvironmentforkids.ca/sites/healthyenvironmentforkids.ca/files/Rising%20Tide_Full%20Report_Eng_FINAL_Secured%20version.pdf.

[75] Note 74, 17.

[76] LCO, Framework for the Law as It Affects Older Adults, note 1, 73.

[77] Note 1, 77-78.

[78] The rate of low-income among older adults is relatively low. However, unattached older woman are a group that is at particular risk of low-income, as historic gender roles resulted in many women who were dependent on their spouses for income security, such that widowhood or divorce might result in a slide into low income: See

Chantal Collin & Hilary Jensen, A Statistical Profile of Poverty in Canada (Ottawa: Library of Parliament, September 2009), Chart 6. Online: http://www.parl.gc.ca/content/lop/researchpublications/prb0917-e.htm; Turcotte & Schellenberg, note 73, 95. Also see André Bernard & Chris Li, Death of a Spouse: The Impact on Income for Senior Men and Women (Ottawa: Minister of Industry, July 2006); Chris Li, Widowhood: Consequences on Income for Senior Women (Ottawa: Statistics Canada, July 2004).

[79] Research on the incidence of elder abuse in Canada is sparse. A 1992 study found that approximately 4 per cent of the Canadian senior population reported experiencing one or more forms of abuse, with financial abuse being the most prevalent form: Elizabeth Podnieks, “National Survey on Abuse of the Elderly in Canada” (1993) Journal of Elder Abuse and Neglect 4:1-2, 58. The 1999 General Social Survey found a prevalence rate of elder abuse of 7 per cent, emotional abuse was the most common, followed by financial abuse at 1 per cent. An overview of the research may be found in Christine A. Walsh & Yongjie Yon “Developing an Empirical Profile for Elder Abuse Research in Canada” (2012) 24:2 Journal of Elder Abuse and Neglect, 104, 108.

[80] See Turcotte & Schellenberg, note 73, 138.

[81] According to a recent survey, almost 80 per cent of Canadians surveyed believed that aging at home offers a better quality of life, citing greater comfort, independence and the opportunity to be closer to family. The older the survey respondents, the more strongly they expressed their preference to remain at home as they age. Acrobat Research, National Survey on Aging in Place (Living Assistance Services: December 2009). Online: http://www.laservices.ca.

[82] See Turcotte & Schellenberg, note 73, 138.

[83] For a thorough examination of the barriers that older adults living in congregate settings may experience in accessing the law, see Advocacy Centre for the Elderly, Research Paper for the Law Commission of Ontario: Congregate Living and the Law as It Affects Older Adults (Law Commission of Ontario: August 2009).

[84] For a review of some of these issues see Susan Stobert & Kelly Cranswick, Looking after Seniors: Who Does What for Whom? (Ottawa: Statistics Canada, 2004), 2; Judith A. Frederick & Janet E. Fast, Eldercare in Canada: Who Does How Much? (Ottawa: Statistics Canada, 1999) 26; Kelly Cranswick & Derrick Thomas, Elder Care and the Complexities of Social Networks (Ottawa: Statistics Canada, 2005) 10.

[85] Mireille Vézina & Martin Turcotte, Caring for a Parent Who Lives Far Away: the Consequences (Ottawa: Statistics Canada, 2010), 3-13.

[86] LCO, Framework for the Law as It Affects Older Adults, note 1, 41-42.

[87] Ontario Human Rights Commission, Minds That Matter, note 32, 23.

[88] According to Statistics Canada, in 2006, the median income of a person age 15 or older with an “emotional” disability (which includes emotional, psychiatric and psychological conditions) was $14,544 as compared to $27,496 for persons without a disability: PALS 2006 Tables, note 68, 8, 19.

[89] The recent consultation report of the Ontario Human Rights Commission, Minds That Matter, note 32 provides an overview of the barriers faced by persons with mental health disabilities in a wide range of areas.

[90] Canadian Institute for Health Information, Ontario Trauma Registry 2012 Report: Hospitalizations for Major Injury in Ontario, 2010-2011 Data (October 2012), 1.6—TBI by GCS. Online: https://secure.cihi.ca/estore/productFamily.htm?pf=PFC1926&lang=en&media=0.

[91] Canadian Institute for Health Information, The Burden of Neurological Diseases, Disorders and Injuries in Canada (2007), 59. Online: https://secure.cihi.ca/estore/productFamily.htm?pf=PFC830&lang=en&media=0.

[92] Ontario Brain Injury Association, The OBIA Impact Report 2012: A statistical Snapshot of Acquired Brain Injury and its Effects on Survivors and Caregivers (2012), 26-27, 32-33. Online: http://www.obia.ca/ImpactReport/ImpactReportOnline-Dec2012.pdf.

[93] A recent study found that 57% of caregivers choose to provide care. 40% report that there is no one else to do it: Linda Duxbury, Christopher Higgins & Bonnie Schroeder, Balancing Paid Work and Caregiving Responsibilities: A Closer Look at Family Caregivers in Canada (January 2009), 9. Online: http://www.cprn.org/doc.cfm?doc=1997&l=en.

[94] In one study, 73 per cent of caregivers of persons with dementia (interviewed for this report) reported finding a positive aspect of caregiving, and 6.9 per cent found more than one positive aspect of caregiving. Commonly reported positive aspects of caregiving included the following: companionship (22.5 per cent), fulfilment/rewarding experience (21.8 per cent), enjoyment (12.8 per cent), love for recipient (5.5 per cent): Carole A. Cohen, Angela Colantonio & Lee Vernich, “Positive Aspects of Caregiving: Rounding out the caregiver experience” (2002) 17:2 Int J Geriatr Psychiatry, 184, 186.

[95] World Health Organization and Alzheimer’s Disease International, “Dementia: A Public Health Priority” (2012), 73. Online: http://www.alz.co.uk/WHO-dementia-report.

[96] See, for example, The Change Foundation, “Because this is the Rainy Day: A Discussion Paper on Home Care and Informal Caregiving for Seniors with Chronic Heart Conditions” (February 2011), 3.

[97] Bonnie Laschewicz et al, Understanding and Addressing Voices of Adults with Disabilities within Their Family Caregiving Contexts: Implications for Capacity, Decision-Making and Guardianship (Toronto: Law Commission of Ontario, January 2014). See, for example, the description of facilitative family interactions at 20–22.

[98] Note 97, 22.

[99] Note 97, 7.

[100] Note 97, 23-26. Note that the names used in the case studies are not those of the actual individuals.

[101] SDA, note 3, s. 32(1.2).

[102] Note 3, s. 32(5).

[103] The number of individuals age 65 and older increased by 14 per cent between 2006 and 2011. In 2011, there were nearly 5 million Canadians age 65 and older, making up almost 15 per cent of the population: Statistics Canada, The Canadian Population in 2011: Age and Sex (Ottawa: Minister of Industry, 2012), 3. The most rapidly growing age group was that between 60 and 64, indicating that population aging will accelerate in Canada in the coming years. Growth rates are also very significant for those age 85 and older: p. 5.

[104] In 2008, approximately 1.5 per cent of Canada’s population was living with dementia. It is estimated that this will increase to approximately 2.8 per cent of the population by 2038. The incidence of dementia increases with age: in 2008, 7 per cent of those over age 60 had been diagnosed with some form of dementia, with the incidence rising to 49 per cent of those age 90 and older. See Alzheimer Society of Canada, note 74, 17-18.

[105] Statistics Canada indicated that in 2006 approximately 15.5 per cent of Ontario’s population reported an activity limitation. The disability rate is increasing across all age groups: PALS 2006 Analytical Report, note 64, 16.

[106] This shift is discussed at some length in Law Commission of Ontario, Preliminary Consultation Paper: Approaches to Defining Disability (Toronto: June 2009).

[107] For example, the reports of both the Queensland Law Reform Commission and of the Victorian Law Reform Commission have articulated a set of principles and purposes that should underlie reform of the capacity and guardianship laws of their respective states, see: Queensland Law Reform Commission, A Review of Queensland’s Guardianship Laws: Report Volume 1 (Brisbane: 2010), Ch 4 [Queensland Law Reform Commission, volume 1]; and Victorian Law Reform Commission, Guardianship: Final Report (Melbourne, Australia: 2012), ch 6, 88 and following [VLRC].

[108] For example, the law reform commissions for the Australian states of Victoria and of Queensland have recently completed comprehensive reviews of their respective capacity and guardianship regimes. Ireland has recently proposed new capacity and guardianship legislation, which if passed will represent significant change from its previous laws. In Canada, Alberta has recently significantly revised its law in this area, as has the Yukon. Law reform agencies in British Columbia, Alberta and Nova Scotia have recently reviewed aspects the law, with a particular focus on powers of attorney.

[109] See, for example, Rannveig Traustadóttir, “Disability Studies, the Social Model and Legal Developments” in  Oddný Mjöll Arnardóttir & Gerard Quinn, eds., The UN Convention on the Rights of Persons with Disabilities: European and Scandinavian Perspectives (Leiden: Martinus Nijhoff Publishers, 2009) 3; Commissioner for Human Rights, note 31, 2; Michael Bach & Lana Kerzner, A New Paradigm for Protecting Autonomy and the Right to Legal Capacity (Toronto: Law Commission of Ontario, October 2010) [Bach & Kerzner, A New Paradigm]; Kerzner, note 21; Penelope Weller, “Developing Law and Ethics: The Convention on the Rights of Persons with Disabilities” (2010) 35:1 Alt. L. J. 8; Penelope Weller, “The Convention on the Rights of Persons with Disabilities and the social model of health: new perspectives” (2011) Special Ed. J. Mental Health L. 74; and many others.

[110] The Ontario Bar Association has noted that “When the Substitute Decisions Act and the Health Care Consent Act, 1996, were passed into law, they did not anticipate the degree to which these laws would be applied in the context of ‘high conflict’ families. A significant number of court applications now involve substitute decision making for incapable adults and pit family members against each other. The legislation was never intended to address conflicts of this degree and type, and the current processes do not lend themselves to timely or appropriate resolutions”: Ontario Bar Association, OBA Submission on the Law Commission of Ontario’s The Law as it Affects Older Adults — Consultation Paper: Shaping the Project (July 2008), 18 [OBA Submission].

[111] See Ontario Ministry of the Attorney General, Powers of Attorney (Toronto: Queen’s Printer for Ontario, 2012). Online: http://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/poa.pdf [MAG, Powers of Attorney]. The Ontario Bar Association has stated that “the Substitute Decisions Act … is intended to protect the vulnerable. However, it makes the appointment of substitute decision makers and creation of powers of attorney an unsupervised process, while making the scrutiny of appointments and the abusive acts of the substitute decision makers, inaccessible, complex, slow, and expensive. As a result powers of attorney are vulnerable to misuse and abuse, and justice delayed in the curtailing of abuse of these powers, is almost certainly justice denied.” OBA Submission, note 110, 16.

[112]  Capacity Assessment Office, Ontario Ministry of the Attorney General, Guidelines for Conducting Assessments of Capacity (Toronto: 2005), II.1 [MAG, Guidelines].

[113] Weisstub, Enquiry, note 9, 27; Tina Minkowitz, “Abolishing Mental Health Laws to Comply with the Convention on the Rights of Persons with Disabilities,” in Bernadette McSherry & Penelope Weller, eds., Rethinking Rights-Based Mental Health Laws (Oxford: Hart Publishing, 2010), 159-60.

[114] Weisstub, Enquiry, note 9, 27.

[115] Lawrence A. Frolik, “Commentary: Statutory Definitions of Incapacity: The Need for a Medical Basis” in Marshall B. Kapp et al, eds, Older Adults’ Decision-Making and the Law (New York: Springer Publishing Company, Inc., 1996) 41.

[116] Margaret Isabel Hall, “Mental Capacity in the (Civil) Law: Capacity, Autonomy, and Vulnerability” (2012) 58:1 McGill L. J. 61, 65.

[117] Charles P. Sabatino & Erica Wood, “The Conceptualization of Capacity of Older Persons in Western Law” in Israel Doron & Ann Snoden, eds., Beyond Elder Law: New Directions in Law and Aging (Heidelberg: Springer, 2012) 36.

[118] D’Arcy Hiltz & Anita Szigeti, A Guide to Consent and Capacity Law in Ontario, 2013 Edition, (Lexis Nexis: Markham, Ontario, 2012), 1 [Hiltz & Szigeti].

[119] For a discussion of this distinction see International Disability Alliance, Legal Opinion on Article 12 of the CRPD (June 2008). Online: http://www.internationaldisabilityalliance.org/.

[120] Office of the High Commissioner for Human Rights, Legal Capacity: Background Paper (New York and Geneva, 2005), 13.

[121] Thus, the provision in the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) requiring States parties to “accord to women, in civil matters, a legal capacity identical to that of men and the same opportunities to exercise that capacity”: CEDAW, 18 December 1979, 1249 U.N.T.S. 13, Can. T.S. 1982 No. 31 (entered into force 3 September 1981), Art 15.

[122] See, for example, Bach & Kerzner, A New Paradigm, note 109, 15-18.

[123] Weisstub, Enquiry, note 9, 31.

[124] See, for example, the extended discussion by the Queensland Law Reform Commission, volume 1, note 107, 264-69. A very helpful outline of the evolution of these approaches can be found in Kristin Booth Glen, “Changing Paradigms: Mental Capacity, Legal Capacity, Guardianship, and Beyond” (2012) 44 Colum. Hum. Rts. L. Rev. 93-169.

[125] Although this of course raises the question of how “lunacy” and “idiocy” were defined and assessed. Weisstub provides a helpful outline of the development of the terms and of this area of the law in general in Enquiry, note 9, Appendix III.

[126] For example, the United Kingdom’s Mental Capacity Act includes a requirement that impairment of decision-making ability be shown to be because of an impairment or disturbance in the functioning of the mind or brain: Mental Capacity Act 2005 (UK), c. 9, s. 2(1).

[127] Queensland Law Reform Commission, volume 1, note 107, 265.

[128] Weisstub, Enquiry, note 9.

[129] An overview of the Recommendations can be found at Weisstub, Enquiry, note 9, 5-21. Not all of the recommendations are summarized here: recommendations relevant to assessment protocols and procedural protections are summarized at the relevant points in this Paper.

[130] HCCA, note 4, s. 4; SDA, note 3, s. 2.

[131] Starson v. Swayze, [2003] 1 S.C.R. 722, 2003 SCC 32 [Starson], para. 80.

[132] Weisstub, Enquiry, note 9, 421-22.

[133] SDA, note 3, s. 16.

[134] Note 3, s. 8.

[135] Note 3, s. 47.

[136] Note 3, s. 45.

[137] HCCA, note 4, s. 4(1).

[138] For a general discussion of some of the practical difficulties attendant on putting the legal theory of capacity into practice, see M. B. Kapp, “Decisional Capacity in Theory and Practice: Legal Process versus ‘Bumbling Through’” (2002) 6:4 Aging & Mental Health 413-17.

[139] Starson, note 131, para. 80.

[140] Brian F. Hoffman, The Law of Consent to Treatment in Ontario, 2d ed (Toronto: Butterworths, 1997), 21.

[141] Weisstub, Enquiry, note 9, 422.

[142] Starson, note 131, para. 80.

[143] Note 131, para.15.

[144] Monique W. Dull, “Starson v Swayze, 2003 – 2008: Appreciating the Judicial Consequences” (2009) 17 Health LJ 51, 61; Jessica W. Berg et al, Informed Consent: Legal Theory and Clinical Practice, 2nd ed. (New York: Oxford University Press, 2001), 102.

[145] Berg et al, note 144, 102.

[146] Loren H. Roth, Alan Meisel & Charles W. Lidz, “Tests of Competency to Consent to Treatment” (1977) 134:3 Am J Psychiatry 279, 281.

[147] Dull, note 144, 61.

[148] Starson, note 131, para. 78.

[149] Dull, note 144.

[150] See International Disability Alliance, “IDA Letter on Functional Capacity,” Correspondence from the International Disability Alliance to Professor Ronald McCallum, UN Committee on the Rights of Persons with Disabilities (July 2010). Online: http://www.chrusp.org/home/resources.

[151] Bach and Kerzner, for example, state that “The CRPD breaks the link between mental capacity and legal capacity, by prohibiting discrimination on the basis of disability in the enjoyment and exercise of legal capacity. On their face, mental capacity statutory provisions which articulate cognitive tests for having one’s legal capacity recognized and protected appear to be in violation of the CRPD.” Bach & Kerzner, A New Paradigm, note 109, 67.

[152] Note 109, 55-58.

[153] See, for example, Adult Guardianship and Trusteeship Act, S.A. 2008, c. A-4.2, s. 4(1) [AGTA].

[154] Mental Capacity Act 2005, note 126, ss. 3(1)(a)–(c).

[155] MAG, Guidelines, note 112.

[156] Note 112, II.3.

[157] Bach & Kerzner, A New Paradigm, note 109, 65-66.

[158] Representation Agreement Act, R.S.B.C. 1996, c. 405, s. 8(2). Note that Newfoundland and Labrador have, in legislative amendments related to access to Registered Disability Savings Program accounts, adopted a very similar test: Bill 3, An Act to Amend the Enduring Powers of Attorney Act, 1st Sess, 47th Leg., Newfoundland, 2012, s.15(2) (assented to June 27, 2012), S.N.L. 2012, c. 4. 

[159] VLRC, note 107, ch 7, 120.

[160] Personal Directives Act, R.S.A. 2000, c. P-6, ss. 7(1), 9(2) [PDA].

[161] Office of the Public Guardian, Guide to Capacity Assessment under the Personal Directives Act (Edmonton: 2008), 3. Online: http://humanservices.alberta.ca/documents/opg-personal-directives-publication-opg1642.pdf [Office of the Public Guardian, Guide to Capacity].

[162] PDA, note 160; Alta Reg 26/98, Schedule 2.

[163] PDA, note 160, s. 9(2).

[164] Weisstub, Enquiry, note 9, 35-36. He notes, however, that some submissions recommended the use of boards that combined legal, social and medical expertise. 

[165] For example, the SDA, note 3, does not require an assessment by a designated capacity assessor to determine whether an individual has capacity to complete a power of attorney. Nor is such an assessment required to determine capacity to make a will, or to instruct counsel. However, LCO interviews with several capacity assessors indicated that these and other non-legislatively required assessments make up a considerable portion (and for some the majority) of the assessments that they carry out. Similarly, psychiatrics and geriatric psychiatrists indicated in interviews with the LCO that they are often requested by other medical colleagues to assess the ability of patients to consent to treatment, although the HCCA, note 4, s. 10 specifies that the “health practitioner who proposes a treatment” shall only administer that treatment if “he or she is of the opinion” that either the individual is capable with respect to the treatment and has given consent, or that the individual is incapable and a substitute decision maker has given consent.

[166] Mona Paré, note 31, 114.

[167] Department for Constitutional Affairs, Mental Capacity Act 2005 Code of Practice (London: TSO, 2007), 53. Online: http://www3.imperial.ac.uk/pls/portallive/docs/1/51771696.PDF  [COP].

[168] Note 167, 69-70.

[169] Note 167, 189.

[170] AGTA, note 153; Alta Reg 219/2009, Part I.

[171] Alexandra Carling-Rowland & Judith Wahl, “The Evaluation of Capacity to Make Admission Decisions: Is it a Fair Process for Individuals with Communication Barriers?” (2010) 10:3 Medical Law International 180.

[172] Note 171, 181.

[173] Flynn et al v. Flynn, (18 December 2007) 03-66/07 (Ont SCJ), cited in Abrams v. Abrams (2008), 173 A.C.W.S. (3d) 410, 173 A.C.W.S. (3d) 606, para. 50 (Ont SCJ) [Abrams].

[174] Abrams, note 173, para. 50.

[175] Weisstub, Enquiry, note 9, 39.

[176] Note 9, 70.

[177] VLRC, note 107, 113.

[178] AGTA, note 153; Alta Reg 219/2009, s. 3(1)(a).

[179] AGTA, note 153; Alta Reg 219/2009, s. 4(2)(a).

[180] AGTA, note 153; Alta Reg 219/2009, s. 3. This applies to all capacity assessments.

[181] Weisstub, Enquiry, note 9, 35.

[182] See, for example, Alberta, Legislative Assembly, Hansard, 27th Parl, 1st Sess, No 40a (28 October 2008) at 1590 (Laurie Blakeman).

[183] AGTA, note 153, s. 27; PDA, note 160, s. 10.1. See Office of the Public Guardian, Guide to Capacity, note 161, 12-17.

[184] PDA, note 160, s. 21(1).

[185] Guardianship and Administration Act 1986 (Vic), ss. 61(1), 63(1).

[186] VLRC, note 107, 243.

[187] MHA, note 6, ss. 54-60.

[188] The person must have a guardian under the SDA, but with respect to the power of attorney, the physician must believe “on reasonable grounds” that such a document exists: note 6, s. 54(6).

[189] Note 6, s. 54(2).

[190] Cancellation of a certificate is issued using form 23, which only requires the patient’s name and identifying information and the physician’s signature: Ontario Ministry of Health, Form 23, Mental Health Act – Notice of Cancellation of Certificate of Incapacity to Manage One’s Property under Section 56 of the Act (Toronto: Queen’s Printer for Ontario, 2013). Online: http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetFileAttach/014-6442-41~1/$File/6442-41E.pdf.

[191] MHA, note 6, s. 57(2).

[192] MHA, note 6, s. 54(3). The finding of incapacity may be found invalid if this requirement is not met: Hiltz & Szigeti, note 118, 316 citing A.P. (Re), 2004 CanLII 34872 (ON CCB).

[193] Ontario Ministry of Health, Form 21, Mental Health Act – Certificate of Incapacity to Manage One’s Property under Subsection 54(4) of the Act (Toronto: Queen’s Printer for Ontario, 2013). Online: http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetFileAttach/014-6440-41~1/$File/6440-41E.pdf.

[194] Ontario Ministry of Health, Form 22, Mental Health Act – Financial Statement Section 55 of the Act (Toronto: Queen’s Printer for Ontario, 2013). Online: http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetFileAttach/014-6441-41~1/$File/6441-41E.pdf.

[195] Ontario Ministry of Health, Form 24, Mental Health Act – Notice of Continuance of Certificate of Incapacity to Manage One’s Property under Subsection 57(2) of the Act (Toronto: Queen’s Printer for Ontario, 2013). Online: http://www.forms.ssb.gov.on.ca/mbs/ssb/forms/ssbforms.nsf/GetFileAttach/014-6443-41~1/$File/6443-41E.pdf.

[196] MHA, note 6, s. 54(4).

[197] SDA, note 3, s. 15.

[198] Consent and Capacity Board, Review of Capacity to Manage Property (Form 18), 2. Online: www.ccboard.on.ca/english/publications/documents/form18.pdf.

[199] SDA, note 3, s. 6: “A person is incapable of managing property if the person is not able to understand information that is relevant to making a decision in the management of his or her property, or is not able to appreciate the reasonably foreseeable consequences of a decision or lack of decision.”

[200] Khan v. St Thomas Psychiatric Hospital (1992), 7 O.R. (3d) 303, 87 D.L.R. (4th) 289 (CA) adapted the test for financial competence set out in the Weisstub Report for the purposes of interpreting provisions regarding a certificate of incompetence to manage an estate. Roy v. Furst (1999), 87 A.C.W.S. (3d) 1225, [1999] OJ no 1490 (SCJ) adopted the test from the Weisstub Report as set out in Khan. J.T. (Re), 2008 CanLII 5623 (ON CCB) considered the test in detail, and outlined a six point test, based on the decision of the Psychiatric Review Board  In the Matter of SH and the North Bay Psychiatric Hospital (a copy of this decision is on file with the LCO). This six-point test has been widely adopted.

[201] This in indicated by the use of binding language (“a physician shall examine” as opposed to “the physician may examine”): MHA, note 6, s. 54(1).

[202] Note 6, s. 59(1).

[203] Note 6, s. 59(2).

[204] Psychiatric Patient Advocate Office, Annual Report 2011: Rights Protection in a Time of Change (Toronto: 2011), 6. Online: www.sse.gov.on.ca/mohltc/ppao/en/Documents/PPAO%20Annual%20Report%202011.pdf [PPAO, Annual Report].

[205] R.R.O. 1990, Reg. 741, s 14.2(1).

[206] Psychiatric Patients Advocate Office, “Mental Health Rights Advice”. Online: http://www.sse.gov.on.ca/mohltc/ppao/en/Pages/AboutthePPAO/OurServices_B.aspx?openMenu=smenu_OurServices [PPAO, Rights Advice]. 

[207] MHA, note 6, s. 60(1).

[208] MHA, note 6, s. 60(2). However, an examination prior to discharge ‘resets the clock’—a patient who is re-examined prior to discharge has the right to apply for a review of the continuance even if they have made an application to the Board in the prior six months: see S.L.G. (Re), 2005 CanLII 56686 (ON CCB).

[209] MHA, note 6, s. 60(3).

[210] Henry Olders, “Comprehensive Assessments of Competence: A Psychiatrist’s Perspective” (2011) 5:2 McGill JL & Health 283, 284.

[211] V. (Re), 2009 CanLII 13471 (ON CCB).

[212] Jude Bursten, “Mental Health Law in the Community: A rights Protection Framework That Falls Apart?” in Psychiatric Patient Advocate Office, Mental Health and Patients’ Rights in Ontario: Yesterday, Today and Tomorrow (Toronto: Queen’s Printer for Ontario, 2003) 69. Online: https://ozone.scholarsportal.info/bitstream/1873/13331/1/283377.pdf. During preliminary consultations, some stakeholders raised similar concerns about potential improper use of MHA examinations as a compulsory alternative to SDA assessments. Some commented that this was generally well-intentioned. For example, the costs associated with SDA assessments make them impractical in some circumstances. However, the LCO did not locate any documented instances of this kind of practice.

[213] Note 212, 69.

[214] Note 212, 69.

[215] HCCA, note 4, s. 10.

[216] Note 4, s. 4(3).

[217] S.O. 1992, c. 31. Repealed by HCCA, note 4, s. 2(2).

[218] HCCA, note 4, s. 15(1).

[219] Note 4, s. 15(2).

[220] Note 4, s. 2(1).

[221] Regulated Health Professions Act, 1991, S.O. 1991, c. 18. The Regulated professions are listed in Schedule 1 of the Act. They are: audiology and speech-language therapy, chiropody, chiropractic, dental hygiene, dental technology, dentistry, denturism, dietetics, massage therapy, medical laboratory technology, medical radiation technology, medicine, midwifery, nursing, occupational therapy, opticianry, optometry, pharmacy, physiotherapy, psychology, and respiratory therapy.

[222] HCCA, note 4, s. 21.

[223] O Reg 865/93, s. 1.

[224] See for example, College of Physicians and Surgeons of Ontario, “Determining Capacity to Consent: Guiding Physicians through Capacity and Consent to Treatment” (CPSO, 2007) Dialogue 32, online: http://www.cpso.on.ca/uploadedFiles/policies/policies/policyitems/Consent.pdf; College of Physicians and Surgeons of Ontario, “Consent to Medical Treatment, Policy 4-05” (January/February 2006). Online: http:// http://www.cpso.on.ca/policies/policies/default.aspx?ID=1544 [CSPO, Consent to Treatment]; College of Nurses of Ontario, Practice Guideline: Consent (2009), online: www.cno.org/Global/docs/policy/41020_consent.pdf‎ [College of Nurses of Ontario, Consent]; College of Dieticians of Ontario, “Guidelines: Health Care Consent Act (HCCA).” Online: http://www.cdo.on.ca/en/pdf/publications/guidelines/hcca.pdf; College of Dieticians of Ontario, “The Jurisprudence Handbook for Dietitians in Ontario” (Fall 2012). Online: www.cdo.on.ca/en/pdf/Publications/…/Jurisprudence%20Handbook.pdf; College of Occupational Therapists of Ontario,  Guide to the Health Care Consent and Substitute Decisions Legislation for Occupational Therapists (1996), online: www.coto.org/pdf/hcca_guide.pdf. Online: http://www.coto.org/pdf/hcca_guide.pdf [College of Occupational Therapists of Ontario, Consent]; College of Respiratory Therapists of Ontario, “Responsibilities Under Consent Legislation” (December 2011). Online: http://www.crto.on.ca/pdf/PPG/UnderConsent.pdf; College of Physiotherapists of Ontario, “Health Care Consent Act: Briefing Note” (2005, updated 2007). Online:  http://www.collegept.org/Assets/registrants’guideenglish/briefing%20notes/BNhealthCareConsentAct.pdf; College of Chiropractors of Ontario, “Standard of Practice: Consent” (Amended November 2004). Online: http://ccholive.v51.com/site_documents/S-013%20Consent.pdf.

[225] Ontario Ministry of Health and Long-Term Care, Community Care Access Centres: Client Services Policy Manual (Toronto: 2006, updated 2007), ch 4. Online: http://www.health.gov.on.ca/english/providers/pub/manuals/ccac/ccac_mn.html.

[226] Dr. E. Etchells, Aid to Capacity Evaluation (ACE) (Joint Centre for Bioethics, University of Toronto, nd). Online: http://www.jointcentreforbioethics.ca/tools/documents/ace.pdf.

[227] Katharine Byrick & Barbara Walker-Renshaw, A Practical Guide to Mental Health and the Law in Ontario (Toronto: Ontario Hospital Association, 2012). Online: www.blg.com/en/Expertise/Documents/MentalHealthLaw_1033.pdf‎.

[228] National Initiative for the Care of the Elderly, Tool on Capacity & Consent: Ontario Edition (Toronto: Advocacy Centre for the Elderly, 2003). Online:  http://www.nicenet.ca/files/NICE_Capacity_and_Consent_tool.pdf.

[229] MHA, note 6, ss. 38, 59.

[230] HCCA, note 4, s. 32.

[231] HCCA, note 4, ss. 32(1)-(2), (5)-(6); Consent and Capacity Board, CCB Rules of Practice, rule 32.

[232] Hiltz & Szigeti, note 118, 182.

[233] Judith Wahl, “25 Common Misconceptions about the Substitute Decisions Act and Health Care Consent Act” (Advocacy Centre for the Elderly, updated November 2008), 17-24. Online: http://www.advocacycentreelderly.org/appimages/file/25%20Common%20Misconceptions.pdf.

[234] Note 233, 19-20.

[235] Note 233, 17-24.

[236] Hiltz & Szigeti, note 118, 178. For an example of this dynamic, see A.F. (Re), 2005 CanLII 3201 (ON CCB).

[237] Daniel J. Dochylo & Michel Silberfeld, “Capacity, Consent and Health Care Decision-Making” in Ann Soden, ed., Advising the Older Client (Markham: Lexis Nexis, 2005), 133, 162.

[238] Advocacy Centre for the Elderly, note 83, 25.

[239] HCCA, note 4, s. 2(1).

[240] Hiltz & Szigeti, note 118, 194.

[241] Heuberger v. Stenn, [2002] O.J. No 1285, [2002] O.T.C. 216 (SCJ).

[242] HCCA, note 4, s. 2.

[243] O Reg 264/00.

[244] Judith Wahl, “Capacity and Capacity Assessment in Ontario” (prepared for the CBA Elder Law Programme, Ottawa, Ontario, March 24-25, 2006), 13. Online: http://www.practicepro.ca/practice/PDF/Backup_Capacity.pdf [Wahl, Capacity].

[245] Jeffrey Cole & Noreen Dawe, Assessing Capacity for Admission to Long-Term Care Homes: A Training Manual for Evaluators (Community Care Access Centre, 2010, revised 2011), iii. Online: www.ccac-ont.ca/Upload/central/General/ConsentandCapacityTrainingManual.pdf. It is not clear to which study they are referring, unfortunately.

[246] Carling-Rowland & Wahl, note 171, 171.

[247] Note 171, 182.

[248] The origins of this form are not documented and recollections differ as to its original development. However, it appears to have been in use from the very beginning of the current regime, and has been widely treated as an “official” document.

[249] H. (Re), 2005 CanLII 57737 (ON CCB) states, “Merely asking those five questions and getting (or not getting) answers is not a fair test of a person’s capacity.” See, for example, Starson, note 131, paras 77, 81 (evaluators must displace the presumption of capacity on a balance of probabilities and demonstrate that an individual lacks the ability to appreciate the foreseeable consequences of the decision); Saunders v. Bridgepoint Hospital, 2005 CanLII 47735 (ON SC) [Saunders], para. 121 (procedural fairness requires that evaluators inform individuals about the capacity assessment process on an ongoing basis).

[250] Wahl, Capacity, note 244, 18.

[251] Cole & Dawe, note 245, iii.

[252] Note 245.

[253] The Dementia Network of Ottawa, “A Practical Guide to Capacity and Consent Law of Ontario for Health Practitioners Working with People with Alzheimer Disease”. Online: http://www.community-networks.ca/uploads/L%20consentlawOttAlzheimers.pdf.

[254] Alexandra Carling-Rowland, “Communication Aid to Capacity Evaluation – CACE: A Communicatively Accessible Capacity Evaluation to Make Admissions Decisions” (2012).

[255] Health Care Consent Act – Evaluation of Capacity for Admission to a Long-Term Care Home (Ministry of Health and Long-Term Care).

[256] In Koch (Re), Quinn J imported some of the procedural safeguards from the SDA into the admissions context, specifically, the right to be informed of the significance of a finding of incapacity, the right to have counsel or a trusted friend present during the evaluation, the right to refuse the evaluation, and the right to be informed of these rights prior to the evaluation: Koch (Re) (1997), 33 O.R. (3d) 485, 70 A.C.W.S. (3d) 712 (Gen Div) [Koch (Re)]. However, some consider these comments to be obiter and the Board has not always considered itself bound by them: Hiltz & Szigeti, note 118, citing I.L.A. (Re), 2004 CanLII 29716 (ON CCB).

[257] Saunders, note 249, para. 118.

[258] HCCA, note 4, ss. 50(1)-(2).

[259] Hiltz & Szigeti, note 118, 193, citing In the matter of MD, TO-10-0096, TO-10-5182, TO-10-5163.

[260] See Wahl, Capacity, note 244, 19-21. Also see A.B. (Re), 2004 CanLII 29602 (ON CCB) and
S.S.; File TO-05-4570 (Re), [2005] O.C.C.B.D. No .19 for illustrations of troubling shortfalls in the capacity evaluation process.

[261] Carling-Rowland & Wahl, note 171, 172, 178, 180.

[262] Advocacy Centre for the Elderly, note 83, 26.

[263] SDA, note 3, s. 16(1).

[264] Note 3, s. 79.

[265] Note 3, s. 1(1).

[266] O Reg 460/05, ss. 2(1)(a), 2(2).

[267] SDA, note 3, s. 17(1).

[268] Note 3, s. 24(5).

[269] Note 3, s. 55(1).

[270] O Reg 460/05, ss. 2(1)(b), 4.

[271] O Reg 460/05, ss. 2(1)(c), 5(1).

[272] O Reg 460/05, ss. 2(1)(c), 5(2).

[273] O Reg 460/05, ss. 2(1)(d), 6.

[274] MAG, Guidelines, note 112.

[275] O Reg 460/05, ss. 3(1)-(2).

[276] O Reg 460/05, s. 3(3).

[277] SDA, note 3, ss. 78(1)-(3).

[278] Note 3, ss. 78(1)-(3).

[279] Note 3, s. 78(2).

[280] Note 3, ss. 78(5), 16(4).

[281] Note 3, ss. 16(5)-(6).

[282] SDA, note 3, s. 20.2. Note that persons who are found incapable of managing property and who then fall under a continuing power of attorney do not have this avenue open to them. Nor are there rights of review for a finding of incapacity for personal care. See the discussion in Hiltz & Szigeti, note 118, 32, 43-44.

[283] Sarita Verma & Michel Silberfeld, “Approaches to Capacity and Competency: The Canadian View” (1997) 20:1 Int JL & Psychiatry 35, 42.

[284] Olders, note 210, 285.

[285] Michel Silberfeld et al, “Capacity Assessments for Requests to Restore Legal Competence” (1995) 10:3 International Journal of Geriatric Psychiatry 191, 196.

[286] See, for example, Koch (Re), note 256, where a husband requested evaluation of his wife’s capacity following the production of a draft separation agreement by his wife’s lawyer. Urbisci v. Urbisci, 2010 ONSC 6130, 67 E.T.R. (3d) 43, also involved a request for assessment in the midst of separation proceedings, when Mrs. Urbisci decided that her husband and daughter were more concerned about her money then her well-being and decided to revoke an existing power of attorney in favour of her husband. Deschamps v. Deschamps (1997), 52 O.T.C. 154, 75 A.C.W.S. (3d) 1130 (Gen Div) [Deschamps], involved a son seeking to be appointed guardian of property for his father as part of an extensive effort to prevent him from re-marrying.

[287] Verma & Silberfeld, note 283, 41.

[288] SDA, note 3, s. 2(1).

[289] Note 3, s. 2(2).

[290] Note 3, s. 2(3).

[291] An individual can make a POA for personal care that contains a provision waiving the grantor’s right to apply to the CCB for review of decisions under the HCCA or authorizing the attorney to use reasonable force to determine whether the grantor is incapable, to take the grantor to any place for care or treatment or to admit them. In order for any of these provisions to be valid, the grantor must be assessed as capable of managing personal care within 30 days of signing the POA and must also make a statement in the prescribed form indicating that she understands the effect of the provisions and that she understand that the POA can only be revoked if she is assessed as capable of managing personal care within 30 days of the revocation. This is the only circumstance in which an individual is statutorily required to be assessed to make a POA. SDA, note 3, s. 50.

[292] Carole A. Cohen & Kenneth I. Shulman, “Capacity Assessments and the Role of the Clinical Expert: The Ontario Experience” (1998) 19:1 Health L Can 19, 21; James E. Spar & Andrew S. Garb, “Assessing Competency to Make a Will” (1992) 149:2 The American Journal of Psychiatry 169, 174.

[293] See R.V. (Re), 2003 CanLII 25699 (ON CCB).

[294] Knox v. Burton, 2004 CanLII 35099 (ON SC).

[295] Wahl, Capacity, note 244, 19-20.

[296] Spar & Garb, note 292, 172-73.

[297] Olders, note 210, 285.

[298] See, for example, Weisstub, Enquiry, note 9, 73-74, 81.

[299] VLRC, note 107, ch 7, 120.

[300] Mental Capacity Act 2005, note 126.

[301] Kerri Joffe & Edgar-Andre Montigny (ARCH Disability Law Centre), Decisions, Decisions: Promoting and Protecting the Rights of Persons with Disabilities Who are Subject to Guardianship (Toronto: Law Commission of Ontario, January 2014), 97 [Joffe & Montigny].

[302] Advocacy Centre for the Elderly, note 83, 25-26.

[303] LCO, Framework for the Law as It Affects Persons with Disabilities, note 2, 48.

[304] Advocacy Centre for the Elderly, note 83, 24.

[305] Hiltz & Szigeti, note 118, 182.

[306] LCO, Framework for the Law as It Affects Older Adults, note 1, 166-67.

[307] These issues are discussed in more depth in LCO, Framework for the Law as It Affects Older Adults, note 1, 32, 61-66, 159; and LCO, Framework for the Law as It Affects Persons with Disabilities, note 2, 34-37, 54-58.

[308] Minkowitz, note 113.

[309] See for instance: Michael Bach, The Right to Legal Capacity under the UN Convention on the Rights of Persons with Disabilities: Key Concepts and Directions from Law Reform (Toronto: Institute for Research on Inclusion and Society, 2009), 5-6.

[310] United Nations Treaty Collection, note 23.

[311] Note 23.

[312] Note 23.

[313] Jennifer L. Wright, “Guardianship for Your Own Good: Improving the Well-Being of Respondents and Wards in the USA” (2010) 33 International Journal of Law and Psychiatry 350, 354.

[314] Leslie Salzman, “Guardianship for Persons with Mental Illness – A Legal and Appropriate Alternative?” (2011) 4 St. Louis U. J. Health L. & Pol’y 279, 291.

[315] CRPD, note 19, Preamble.

[316] Terry Carney, “Clarifying, Operationalising, and Evaluating Supported Decision Making Models” (2014) 1:1 Research and Practice in Intellectual and Developmental Disabilities (Forthcoming) [Carney, Models]. For example, an evaluation of a two-year Pilot Project by the South Australian Office of the Public Advocate that involved 26 “decision-ready” individuals (not under guardianship) with intellectual disabilities or an acquired brain injury found generally positive reviews by consumers, supporters and service providers. It also pointed to some operational challenges. Staff overseeing the program found that fairly intensive case management was required to support the development of the process Some staff recommended that “vulnerability indicators” be used to pre-screen participants to determine appropriateness of inclusion in the program: Margaret Wallace, Evaluation of the Supported Decision Making Project (South Australia Office of the Public Advocate, November 2012).

[317] See, for example, Nina A. Kohn, Jeremy A. Blumenthal & Amy T. Campbell, “Supported Decision-Making: A Viable Alternative to Guardianship?” (2013) 117:4 Penn St. L. Rev., 1111-57; Anthony Mason, “Foreword” (2013) 36:1 UNSWLJ, 170-74; Carney, Models, note 316.

[318] Kohn, Blumenthal & Campbell, note 317, 1114. Similar concerns are noted in Nidus Personal Planning Resource Centre and Registry, A Study of Personal Planning in British Columbia: Representation Agreements with Standard Powers (2010), 4. Online: http://www.nidus.ca/PDFs/Nidus_Research_RA7_InAction.pdf.

[319] Krista James & Laura Watts (Canadian Centre for Elder Law), Understanding the Lived Experiences of Supported Decision-Making in Canada (Toronto: Law Commission of Ontario, March 2014), 78.

[320] See, for example, United Nations, Office of the United Nations High Commissioner for Human Rights & Inter-Parliamentary Union, From Exclusion to Equality: Realizing the Rights of Persons with Disabilities – Handbook for Parliamentarians on the Convention on the Rights of Persons with Disabilities (Geneva: United Nations, 2007), 90: “Even when an individual with a disability requires total support, the support person(s) should enable the individual to exercise his/her legal capacity to the greatest extent possible, according to the wishes of the individual.” See also Minkowitz, note 113,  157-58: “Even in quite extreme situations such as the conditions known as persistent vegetative state and coma, or loss of consciousness, the principles of support can be applied so as to give full respect to any present communications by the person (which can sometimes be discerned by close associates though missed by others), and if such communications are indeterminate, following the person’s previously expressed wishes, abiding values and experience with similar situations.”

[321] Bach & Kerzner, A New Paradigm, note 109, 86-89.

[322] Gerald Quinn, “Personhood & Legal Capacity, Perspectives on the Paradigm Shift of Article 12 CRPD” (HPOD Conference, Harvard Law School, 20 February 2010). Quinn notes that “what’s worse:  stretching a fiction (100% support) to the point that it is visibly at odds with reality – a factor that is only likely to be seized on by States acting out of abundant caution and enter declarations or reservations ring-fencing substitute decision-making – or, admitting the obvious and then using our talents to lock in the exception and transform how decisions are ‘made for’ people?”

[323] Office of the Public Advocate, Supported Decision-Making, Background and Discussion Paper (Melbourne, Australia: November 2009), 24 [Office of the Public Advocate, Supported Decision-Making].

[324] Mental Capacity Act 2005, note 126, s. 1(3).

[325] Guardianship and Trusteeship Act, S.N.W.T. 1994, c. 29, ss. 2(3), 29.

[326] Adult Protection and Decision-Making Act, S.Y. 2003, c. 21, Schedule A.

[327] Note 326, s. 4.

[328] VLRC, note 107, 128, s. 8.17.

[329] In the Yukon, a third party can make an application to set aside an agreement reached with an adult who did not consult with his or her supporter. For Lecturer Shih-Ning Then this provision creates an uneasy compromise: “Here, a clear tension exists between protecting the adult and allowing that adult to make ‘bad’ decisions. This is particularly so because decision-making capacity is explicitly preserved by these agreements.” Shih-Ning Then, “Evolution and Innovation in Guardianship Laws: Assisted Decision-Making” (2013) 35:1 Sydney L. Rev. 133, 150.

[330] Government of Alberta, “Supported Decision-Making: Adult Guardianship and Trusteeship Act”, 2. Online: http://humanservices.alberta.ca/documents/opg-guardianship-brochure-opg5609.pdf.

[331] Yukon Health and Social Services, “Adult Protection and Decision-Making Act – Supported Decision-Making Agreements”. Online: http://www.hss.gov.yk.ca/supported_agreements.php.

[332] AGTA, note 153, s. 4(1); Adult Protection and Decision-Making Act, note 326, s. 6. 

[333] AGTA, note 153, s. 3; Adult Protection and Decision-Making Act, note 326, ss. 1, 9.

[334] AGTA, note 153, s. 4(2); Adult Protection and Decision Making Act, note 326, s. 5(1).

[335] AGTA, note 153, s. 4(2); Adult Protection and Decision Making Act, note 326, s. 5(1).

[336] AGTA, note 153, s. 4(2); Adult Protection and Decision Making Act, note 326, s. 5(1).

[337] Adult Protection and Decision Making Act, note 326, s. 5(1)

[338] Note 326, s. 5(1).

[339] Note 326, s. 5(1).

[340] Note 326, ss. 5(2), 11.

[341] AGTA, note 153, s. 6(2).

[342] AGTA, note 153, s. 10(1); Adult Protection and Decision Making Act, note 326, s. 13(2).

[343] Adult Protection and Decision Making Act, note 326, s. 13(2).

[344] Adult Protection and Decision Making Act, note 326, s. 12.

[345] Michelle Browning, Report to Investigate New Models of Guardianship and the Emerging Practice of Supported Decision-Making (Winston Churchill Memorial Trust of Australia, 2010), 22, 27; Consultation with Seniors’ Services and Adult Protection Unit, Yukon Health and Social Services. 

[346] Browning, note 345, 23.

[347] VLRC, note 107, 128.

[348] Consultation with Seniors’ Services and Adult Protection Unit, Yukon Health and Social Services; Browning, note 345, 28-29; VLRC, note 107, 129.

[349] United Nations, note 320, 90.

[350] A.J. McClean, Review of Representation Agreements and Enduring Powers of Attorney Undertaken for the Attorney General of the Province of British Columbia (Victoria: Attorney General, 2002). See also: Glen, note 124, 147-48; VLRC, note 107, 130, para. 8.31, distinguishing BC’s approach from supported decision making.

[351] YOIC 2005/78, s. 5. Investing funds is limited to investing funds that are protected by the Canada Deposit Insurance Corporation.

[352] The Adult Protection and Decision-Making Act states that they can be used “to enable an adult to agree to allow two or more trusted friends or relatives to make a limited range of daily living decisions … for and on behalf of the adult” where he or she “does not need guardianship” and “is capable of managing most of all of their affairs under some circumstances but has difficulty doing so under other circumstances.” Adult Protection and Decision-Making Act, note 326, ss. 14-15.

[353] Yukon Health and Social Services, Representation Agreements: Do I Need One?, 2. Online: www.hss.gov.yk.ca/pdf/rep_agreement_booklet.pdf‎.

[354] Consultation with Seniors’ Services and Adult Protection Unit, Yukon Health and Social Services; Adult Protection and Decision-Making Act, note 326, ss. 6, 15.

[355]  Enduring Power of Attorney Act, R.S.Y. 2002 c. 73, s. 3.

[356] Consultation with Seniors’ Services and Adult Protection Unit, Yukon Health and Social Services. 

[357] The CEP awarded former students on average $19,412 per person across Canada. Aboriginal Affairs and Northern Development Canada, “Statistics on the Implementation of the Indian Residential Schools Settlement Agreement”. Online: http://www.aadnc-aandc.gc.ca/eng/1315320539682/1315320692192. 

[358] Consultation with Seniors’ Services and Adult Protection Unit, Yukon Health and Social Services. 

[359] McClean, note 350, 4.

[360] Office of the Ombudsperson, Province of British Columbia, No Longer Your Decision: British Columbia’s Process for Appointing the Public Guardian and Trustee to Manage the Financial Affairs of Incapable Adults (Public Report No. 49 to the Legislative Assembly of British Columbia, February 2013).

[361] Representation Agreement Act, note 158, s. 9(g). This version of the Representation Agreement Act was amended in 2007. As of September 1, 2011, this provision is no longer available. Robert M. Gordon, The 2008 Annotated British Columbia Representation Agreement Act, Adult Guardianship Act and Related Statutes (Thomson Carswell Ltd.: Toronto, 2008), 1; Nidus Personal Planning Resource Centre and Registry, “Representation Agreement Act Amendments” (March 2012). Online: http://www.nidus.ca/PDFs/Nidus_01Sept2011_Amendments_and_RA.pdf.

[362] Representation Agreement Act, note 158, s. 7.

[363] Note 158, s. 7.

[364] Consultation with Nidus Personal Planning Resource Centre and Registry. See also the voluntary form produced by the British Columbia Attorney General that allows an adult to choose one scope of power or both, as well as to customize which types of decisions for which the representative has authority to act. British Columbia Attorney General, “Representation Agreement (Section 7) Form”. Online: http://www.ag.gov.bc.ca/incapacity-planning/pdf/Representation_Agreement_S7.pdf.

[365] Representation Agreement Act, note 158, ss. 9.1, 15.

[366] Note 158, s. 8(2).

[367] Representation Agreement Act, note 158, s. 8(2); Mona Paré, note 31, 122-23.

[368] Nidus Personal Planning Resource Centre and Registry, note 318. There are few other sources with empirical evidence about representation agreements. Wendy Harrison conducted a detailed study of RAs that provides a wealth of information on non-standard agreements for personal care and advance health care directives. See Wendy Harrison, Representation Agreements in British Columbia: Who is Using them and Why? (Project submitted in partial fulfillment of the requirements for the degree of Master of Gerontology, Simon Fraser University, Fall 2008). See also: Kohn, Blumenthal & Campbell, note 317.

[369] See Community Living British Columbia, “Guide to Individualized Funding – Supporting Choice and Innovation” (May 2009), 7. Online: http://www.communitylivingbc.ca/individuals-families/support-for-adults/individualized-funding/.

[370] See, for instance, Mary B. Hamilton, “Incapacity Planning: The New Law Planning for Personal Care Decisions” Prepared for the Continuing Legal Education Society of  British Columbia (June 2011), 3.1.6; Law Society of British Columbia, “The Representation Agreement Act.” Online:  http://www.lawsociety.bc.ca/page.cfm?cid=1209&t=The-Representation-Agreement-Act; Browning, note 345, 31.

[371] Inclusion Europe, Justice, Rights and Inclusion for People with Intellectual Disability (Brussels: 2007), 5-6. Online: http://digitalcommons.ilr.cornell.edu/cgi/viewcontent.cgi?article=1279&context=gladnetcollect; Stanley S. Herr, “Self-Determination, Autonomy, and Alternatives for Guardianship” in Stanley S. Herr, Lawrence O. Gostin & Harold Hongju Koh, eds., The Human Rights of Persons with Intellectual Disabilities: Different But Equal (Oxford: Oxford University Press, 2003), 433.

[372] Herr, note 371, 433; Inclusion Europe, note 371, 6.

[373] Herr, note 371, 433.

[374] Inclusion Europe, note 371, 6.

[375] Note 371, 6.

[376] Herr, note 371, 434.

[377] Note 371, 434.

[378] Inclusion Europe, note 371, 6.

[379] Note 371, 6.

[380] Herr, note 371, 433.

[381] Note 371, 433.

[382] Note 371, 434.

[383] Herr, note 371, 434; Inclusion Europe, note 371, 6.

[384] Bach & Kerzner, A New Paradigm, note 109.

[385] Michael Bach & Lana Kerzner, Fulfilling the Promise, Ensuring Alternatives to Guardianship  [Bach & Kerzner, Fulfilling the Promise]. This description is based on an unpublished version of this Paper, received in March 2014. A revised version of this Paper will be available from the IRIS Institute for Research and Development on Inclusion and Society in the early summer of 2014.

[386] This is a summary of the requirements, which are set out in full elsewhere in this Paper and which are found in the SDA, note 3, s. 66.

[387] Advocacy Centre for the Elderly, Comments on the Discussion Paper: Capacity of Adults with Mental Disabilities and the Federal RDSP (February 28, 2014), 9.

[388] Joffe & Montigny, note 301, 66.

[389] James & Watts, note 319, 77.

[390] Terry Carney, “Guardianship, “Social” Citizenship and Theorising Substitute Decision-Making Law” in Israel Doron & Ann M. Soden, eds., Beyond Elder Law: New Directions in Law and Aging (Berlin: Springer, 2012) ch 1, 10 [Carney, Guardianship].

[391] Office of the Public Advocate, Supported Decision-Making, note 323, 24.

[392] Joffe & Montigny, note 301, 92.

[393] This issue is explored throughout the paper prepared by James & Watts, note 319. See in particular the discussion at pages 49, 59-60, 77.

[394] Terry Carney has commented that, “People already have but very fuzzy understanding of adult guardianship or health powers, so some level of misuse and misunderstanding is surely inevitable under a more sophisticated system”: Carney, Guardianship, note 390, 11.

[395] See, for example, James & Watts, note 319, 8.

[396] Carney, Guardianship, note 390, 12.

[397] Then, note 329, 151.

[398] VLRC, note 107, 152.

[399] Then, note 329, 151.

[400] AGTA, note 153, s. 13; Alberta Human Services, “Co-Decision Making Brochure”. Online: http://humanservices.alberta.ca/documents/opg-guardianship-brochure-opg5610.pdf; The Adult Guardianship and Co-decision-making Act, S.S. 2000, c. A-5.3, ss. 13, 39.

[401] The Adult Guardianship and Co-decision-making Act, note 400, s. 40.

[402] AGTA, note 153, s. 13(4).

[403] VLRC, note 107, 156.

[404] Note 107, ch. 9, 151-69.

[405] Note 107, 1159, ss 9.53-54.

[406] The Adult Guardianship and Co-decision-making Act, note 400, s. 42. In Alberta, “A co-decision-maker shall not refuse to sign a document…if a reasonable person could have made the decision and the decision is not likely to result in harm to the assisted adult”: AGTA, note 153, s. 18(5).

[407] The Adult Guardianship and Co-decision-making Act, note 400, s. 41. In Alberta, the Court may specify whether a contract is voidable if it is not in writing and signed by both parties: AGTA, note 153, s. 17(5).

[408] VLRC, note 107, 155-56.

[409] Note 107, 156.

[410] Note 107, 157.

[411] Note 107, 158.                                                                                                    

[412] Terry Carney & Fleur Beaupert, “Public and Private Bricolage – Challenges Balancing Law, Services and Civil Society in Advancing CRPD Supported Decision-Making” (2013) 36:1 UNSW Law Journal 175, 184.

[413] Consultation with the Public Trustee for Alberta.

[414] SDA, note 3, ss. 32(1), 38.

[415] Note 3, ss. 66(1), 67.

[416] SDA, note 3, ss.37, 66(3)-(4); HCCA, note 4, ss. 21, 42, 59.

[417] SDA, note 3, ss. 32, 66.

[418] Note 3, ss. 32, 66.

[419] Note 3, ss. 33, 38.

[420] Bach & Kerzner, A New Paradigm, note 109, 80.

[421] SDA, note 3, ss. 5, 44.

[422] Note 3, ss. 12(1)(a), 53(1)(a).

[423] Note 3, ss. 7(3), 46(2).

[424] Note 3, s. 46(3).

[425] Note 3, s. 17(1).

[426] Note 3, s. 17(4)-(5).

[427] Note 3, ss. 22, 55.

[428] The exception to this being for summary disposition applications, which are uncontested.

[429] SDA, note 3, ss. 24, 57.

[430] HCCA, note 4, ss. 20(1), 41, 58.

[431] Note 4, s. 20(2).

[432] Note 4, s. 20(5).

[433] Figures provided by the Office of the Public Guardian and Trustee, based on the Register of Guardians maintained by the Public Guardian and Trustee as required by Regulation 99/96 under the Substitute Decisions Act.

[434] Office of the Public Guardian and Trustee, The Role of the Office of the Public Guardian and Trustee (Queen’s Printer for Ontario, 2006, reprinted 2013), 3 [OPGT, The Role].

[435] Figures provided by the Office of the Public Guardian and Trustee, based on the Register of Guardians maintained by the Public Guardian and Trustee as required by Regulation 99/96 under the Substitute Decisions Act.

[436] Figures provided by the Office of the Public Guardian and Trustee, based on the Register of Guardians maintained by the Public Guardian and Trustee as required by Regulation 99/96 under the Substitute Decisions Act.

[437] Office of the Public Guardian and Trustee, When the Office of the Public Guardian and Trustee Becomes Your Guardian of Property (Queen’s Printer for Ontario: 2006, reprinted 2013), 3-4.

[438] Ernest J. Weinrib, “The Fiduciary Obligation” (1975) 25:1 UTLJ 1, 4.

[439] Support & Trustee Advisory Services, “What We Do”. Online: http://mystas.ca/what.

[440] Note 439.

[441] Support & Trustee Advisory Services “Trustee and Advisory Services Brochure”. Online: http://mystas.ca/sites/default/files/user_files/pdf/STAS_brochure.pdf.

[442] Cal Bus & Prof Code § 6530 (2014) [CPFA]. (Chapter 6 of the Business & Professions Code is known as the Professional Fiduciaries Act, pursuant to § 6500).

[443] CPFA § 6538(a).

[444] CPFA § 6538(b).

[445] Professional Fiduciaries Bureau, “Pre-Licensing Education Information”. Online: Professional Fiduciaries Bureau http://www.fiduciary.ca.gov/forms_pubs/prelicreq.shtml.

[446] CPFA § 6510.

[447] CPFA §§ 6518, 6520.

[448] CPFA § 6536.

[449] CPFA §§ 6580, 6582.5.

[450] CPFA § 6580.

[451] Professional Fiduciary Association of California. Online: http://www.pfac-pro.org.

[452] CPFA § 6580(c).

[453] CPFA § 6560.

[454] CPFA § 6561.

[455] Office of the Public Advocate, Annual Report 2012 – 2013 (Victorian Government Printer: 2013), 12 [OPA, Annual Report].

[456] Office of the Public Advocate, Community Guardianship Manual, 7.

[457] Note 456, 10, 16.

[458] Note 456, 18.

[459] Note 456, 19

[460] Note 456, 37.

[461] Note 456, 21-22.

[462] Note 456, 23-24.

[463] Assisted Decision-Making (Capacity) Bill 2013 (July 13, 2012), ss. 23(3), 61 [Bill 2013].

[464] Herr, note 371, 441; see also, Kees Blankman, “Guardianship Models in the Netherlands and Western Europe” (1997) 20:1 International Journal of Law and Psychiatry 47 at 54; Inclusion Europe, note 371, 8.

[465] Herr, note 371, 443; Inclusion Europe, note 371, 8.

[466] Inclusion Europe, note 371, 8. See also, Herr, note 371, 443.

[467] Herr, note 371, 443- 44.

[468] Note 371, 443-44.

[469] Herr, note 371, 443; Inclusion Europe, note 371, 9.

[470] Inclusion Europe, note 371, 8.

[471] Note 371, 8.

[472] Bach & Kerzner, Fulfilling the Promise, note 385, 154.

[473] Herr, note 371, 434.

[474] Herr, note 371, 434; Inclusion Europe, note 371, 6.

[475] Herr, note 371, 434.

[476] Note 371, 440.

[477] The Powers of Attorney Act, 2002, S.S. 2002, c. P-20.3, s. 8 [Saskatchewan Powers of Attorney Act].

[478] Law Reform Commission of Saskatchewan, Consultation Paper on Enduring Powers of Attorney, (Saskatoon: January 2001), 28. Online: Law Reform Commission of Saskatchewan http://www.lawreformcommission.sk.ca/Papers.htm.

[479] The Adult Guardianship and Co-decision-making Act, note 400, s. 30.

[480] Ontario Disability Support Program Act, 1997, S.O. 1997, c. 25, Schedule B, s. 12(1).

[481] Note 480, s. 12(2).

[482] Social Security Advisory Board, “Disability Programs in the 21st Century: The Representative Payee Program” (2010) 2:1 Social Security Advisory Board Issue Brief Series, 5.

[483] Bach & Kerzner, Fulfilling the Promise, note 385, 37.

[484] Vela Canada, “Microboards”. Online: http://www.velacanada.org/vela-microboards.

[485] David and Faye Wetherow, “Microboards and Microboard Association Design, Development and Implementation” (Revised August 2004). Online: http://www.communityworks.info/articles/microboard.htm.

[486] Vela Canada, note 484.

[487] Office of the Public Advocate, Supported Decision-Making, note 323, 24.

[488] Joffe & Montigny, note 301, 105.

[489] Healthcare practitioners may, for example, be unaware of or confuse the rankings in the hierarchy, may not understand that where there are two persons who are equally ranked in the hierarchy they are not entitled to select between them, may be confused as to the steps to take when there is doubt about the legal capacity of the top-ranked person in the hierarchy, may be confused as to the extent of the efforts that must be taken to ensure that the top-ranked hierarchical person is willing and available, may misunderstand the scope or effect of a power of attorney and so on. For a discussion of these issues see Judith Wahl, Mary Jane Dykeman & Brendan Gray, Health Care Consent and Advance Care Planning in Ontario (Toronto: Law Commission of Ontario, January 2014), 244 and following. 

[490] A brief history of Ontario’s legislative regime is provided in Chapter II of this Paper.

[491] See, for example, SDA, note 3, ss. 7(3), 46(2).

[492] Note 3.

[493] Note 3, s. 7(2).

[494] Note 3, s. 4.

[495] Note 3, s. 8(1).

[496] Note 3, s. 9(1).

[497] Note 3, s. 8(2).

[498] Note 3, s. 5.

[499] Note 3, s. 7(4).

[500] Note 3, s. 7(5).

[501] Note 3, s. 7(3).

[502] Note 3, s. 11.

[503] Note 3, s. 12.

[504] Note 3, s. 7(7.1).

[505] MAG, Powers of Attorney, note 111.

[506] SDA, note 3, s. 7(1).

[507] Note 3, s. 10.

[508] Note 3, s. 9(3).

[509] Note 3, s. 45.

[510] Note 3, ss. 46(6)-(7).

[511] Note 3, s. 50.

[512] Note 3, s. 43.

[513] Note 3, s. 47.

[514] Note 3, ss. 46(8)-(9).

[515] Note 3, s. 48.

[516] Hiltz & Szigeti, note 118, 39.

[517] SDA, note 3, ss. 45, 49.

[518] Note 3, s. 49.

[519] Note 3, s. 44.

[520] Note 3, s. 46(2)

[521] Note 3, s. 46(3).

[522] Note 3, s. 46(4)

[523] Note 3, s. 46(5).

[524] Note 3, s. 52.

[525] Note 3, s. 53.

[526] Alberta Law Reform Institute, Enduring Powers of Attorney: Safeguards against Abuse, Final Report No. 88 (Edmonton, Alberta: February 2003), 6-7.

[527] For a fuller discussion of this issue, see Jan Goddard, “Powers of Attorney – Safekeeping & Other Practical Considerations”, The Six-Minute Estates Lawyer 2013.

[528] Enduring Power of Attorney Act, note 355, ss. 3(1)(b), 4.

[529] Western Canada Law Reform Agencies, Enduring Powers of Attorney: Areas for Reform, Final Report (2008) [WCLRA], 20, 25; Law Reform Commission of Nova Scotia, Final Report, Enduring Powers of Attorney in Nova Scotia, (Halifax: 1999), 18.

[530] Saskatchewan Powers of Attorney Act, note 477, s. 12(1).

[531] Alberta Law Reform Institute, note 526, 7-9.

[532] Submission by Caxton Legal Centre Inc., quoted in Queensland Law Reform Commission, A Review of Queensland’s Guardianship Laws: Report Volume 3 (Brisbane: September 2010), 164 [Queensland Law Reform Commission, volume 3].

[533] http://greyflagcampaign.com/poa-qa.html.

[534] Ontario Law Reform Commission, Report on Powers of Attorney (Toronto: Department of Justice, 1972), 26.

[535] The Powers of Attorney Act, C.C.S.M., c. P97, s. 12.

[536] Powers of Attorney Act, S.Nu. 2005, c. 9, s. 14(1) [Nunavut Powers of Attorney Act].

[537] Powers of Attorney Act, S.N.W.T. 2001, c. 15, s. 15 [N.W.T. Powers of Attorney Act].

[538] Nidus Personal Planning Resource Centre and Registry. Online: http://www.nidus.ca/?page_id=238.

[539] Mental Capacity Act 2005, note 126, s. 9. For more information on the Register, see Office of the Public Guardian, https://www.gov.uk/government/publications/register-a-lasting-power-of-attorney (Updated 1 October 2013).

[540] VLRC, note 107, ch 16. 

[541]  Ontario, Legislative Assembly, Official Report of Debates (Hansard), 39th Parl, 2nd Sess, No 16 (15 April 2010) at 1530 (David Zimmer). Online: http://hansardindex.ontla.on.ca/hansardeissue/39-2/l016.htm.

[542] Note 541 (Khalil Ramal).

[543] Alberta Law Reform Institute, note 526, 21.

[544] The Powers of Attorney Act, note 535, s. 22. 

[545] Saskatchewan Powers of Attorney Act, note 477, s. 17.

[546] N.W.T. Powers of Attorney Act, note 537, s. 23; Nunavut Powers of Attorney Act, note 536, s. 25(1).

[547] Alberta Law Reform Institute, note 526, 10-16.

[548] Note 526, 21-22.

[549] WCLRA, note 529, 55-64.

[550] New Zealand Law Commission, Misuse of Enduring Powers of Attorney, Report No. 17 (Wellington, New Zealand: April 2001), 15. 

[551] Queensland Law Reform Commission, volume 3, note 532, 191.

[552] Representation Agreement Act, note 158, ss. 12(1), (4). 

[553] Note 158, ss. 12(6), (8).

[554] Note 158, s. 20(1).

[555] Note 158, ss. 20(2)-(3).

[556] Note 158, s. 20(4).

[557] Note 158, s. 20(5).

[558] VLRC, note 107, 203.

[559] Queensland Law Reform Commission, volume 3, note 532, 218-19.

[560] HCCA, note 4, ss. 33, 51, 66.

[561] Fram Report, note 10, 104.

[562] SDA, note 3, s. 18(1)-(2).

[563] Note 3, ss. 24, 57.

[564] Note 3, s. 59.

[565] Note 3, s. 70.

[566] Note 3, s. 69.

[567] Summary disposition applications require the filing of two pieces of evidence containing an opinion that the adult is incapable. At least one of these must contain an opinion that it is necessary for decisions to be made on the adult’s behalf and at least one must be undertaken by a capacity assessor. See SDA, note 3, ss. 72, 77-78.

[568] Note 3, s. 69.

[569] “Role of the Office of the Public Guardian and Trustee”, Paper prepared for the Law Society of Upper Canada Program, Advocacy for the Senior Client (September 24, 2003); OPGT, The Role.

[570] SDA, note 3, ss. 72-77.

[571] Consultation with Brendon Pooran.

[572] Consultation with Saara Chetner and Risa Stone (Counsel for the Office of the Public Guardian and Trustee).

[573] Law Society of Upper Canada, “How to Have a Guardian of Property Appointed through Court Application”, online: http://www.lsuc.on.ca/For-Lawyers/Manage-Your-Practice/Practice-Area/Trusts-and-Estates-Law/How-to-Have-a-Guardian-of-Property-Appointed-through-Court-Application/ (last accessed: September 25, 2013).

[574] Consultation with Brendon Pooran.

[575] SDA, note 3, s. 77(3).

[576] Note 3, ss. 25(1), 58(1).

[577] Note 3, ss. 24, 57.

[578] See for example, Covello v. Sturino [2007] O.J. No 2306 158; Deschamps, note 286.

[579] Koch (Re), note 256.

[580] A “Ulysses contract” allows a person creating a power of attorney for personal care to waive rights to challenge a finding of incapacity or to permit the use of force to facilitate treatment. Not surprisingly, the requirements for the creation of a “Ulysses contract” are stringent: see SDA, note 3, s. 50; HCCA, note 4, s. 32(2).

[581] Ontario, Legislative Assembly, Committee Transcripts: Standing Committee on Administration of Justice, “Bill 74, Advocacy Act, 1992, and Companion Legislation” (October 5, 1992).

[582] Bach & Kerzner, Fulfilling the Promise, note 385, 17-18.

[583] SDA, note 3, ss. 27, 62.

[584] Note 3, ss. 27, 62.

[585] Note 3, s. 20.

[586] Note 3, s. 20.

[587] Note 3, s. 20.1.

[588] Note 3, s. 20.

[589] Note 3, s. 20.3.

[590] Note 3, ss. 28-29, 63-64.

[591] Bach & Kerzner, A New Paradigm, note 109, 8.

[592] Kohn, Blumenthal & Campbell, note 317, 1117-18.

[593] Doug Surtees, “How Goes the Battle? An Exploration of Guardianship Reform” (2012) 50:1 Alta. L. R. 115-27.

[594] Figures provided by the Office of the Public Guardian and Trustee, based on the Register of Guardians maintained by the Public Guardian and Trustee as required by Regulation 99/96 under the Substitute Decisions Act

[595] Bach & Kerzner, Fulfilling the Promise, note 385, 90.

[596] Joffe & Montigny, note 301, 61.

[597] Note 301, 61.

[598] AGTA, note 153, s. 54(5).

[599] VLRC, note 107, 192.

[600] Note 107, 264.

[601] Bill 2013, note 463, s. 27.

[602] Guardianship and Administration Act 1986 (Vic) ss. 61(1), 63(1).

[603] VLRC, note 107, 243. 

[604] AGTA, note 153, ss. 33(8), 54(7).

[605] Joffe & Montigny, note 301, 98.

[606] Note 301, 98-99.

[607] Queensland Law Reform Commission, volume 3, note 532, 97, 108.

[608] Note 532, 109-10.

[609] Consultation with Doug Surtees.

[610] Alberta Human Services, “Trusteeship Order” (Edmonton, Alberta: Created April 4 2013). Online:  http://humanservices.alberta.ca/guardianship-trusteeship/agta-trusteeship-order.html.

[611] Consultation with the Public Trustee for Alberta.

[612] SDA, note 3, ss. 22(3), 55(2).

[613] AGTA, note 153. Section 46(5) for trusteeships. Section 26(5) makes parallel provision for guardians.

[614] Alta Reg. 219/2009, s. 4(2).

[615] Note 614, s. 4(5).

[616] Bach & Kerzner, Fulfilling the Promise, note 385, 88.        

[617] Note 385, 151-53.

[618] Cameron Crawford, When Bad Things Happen: Violence, Abuse, Neglect and Other Mistreatments against Manitoban Women with Intellectual Disabilities (Winnipeg: Community Living – Manitoba, 2007), 45.

[619] BC Adult Abuse/Neglect Prevention Collaborative, Vulnerable Adults and Capability Issues in BC, Provincial Strategy Document (January 2009), 24. Online: http://www.bcli.org/sites/default/files/Vanguard_(16May09).pdf [Vanguard Project].

[620] Note 619, 23.

[621] National Initiative for the Care of the Elderly, Defining and Measuring Elder Abuse and Neglect: Synthesis of Preparatory Work Required to Measure the Prevalence of Abuse and Neglect of Older Adults in Canada (Toronto: 2012). Online: file:///C:/Users/Maria/Downloads/mcdonald_defining-measuring%20elder%20abuse_synthesis_final.pdf

[622] Vanguard Project, note 619, 23.

[623] Joffe & Montigny, note 301, 48.

[624] Podnieks, note 79.

[625] Charmaine Spencer, Diminishing Returns: An Examination of Financial Abuse of Older Adults in British Columbia (Gerontology Research Centre, Simon Fraser University: 1998), 26.

[626] John B. Bond et al, “The Financial Abuse of Mentally Incompetent Older Adults: A Canadian Study” (1999) 11:4 Journal of Elder Abuse and Neglect 23, 33.

[627] Note 626, 27, 32.

[628] Statistics Canada, Criminal Victimization and Health: A Profile of Victimization Among Persons with Activity Limitations or Other Health Problems by Samuel Perreault, Cat no 85F0033MIE2009021, ISSN 1496-4562, ISBN 978-1-100-12686-9 (Ottawa, Canadian Centre for Justice Statistics: 2009), 8-9. Online: http://www5.statcan.gc.ca/bsolc/olc-cel/olc-cel?catno=85F0033MIE2009021 [Perreault].

[629] Crawford, note 618, 59.

[630] Note 618, 58.

[631] See LCO, Framework for the Law as It Affects Older Adults, note 1, ch VI  and LCO, Framework for the Law as It Affects Persons with Disabilities, note 2, ch V.

[632] Joffe & Montigny, note 301, 57.

[633] Alzheimer’s Society (U.K.), Short changed: Protecting people with dementia from financial abuse (December 2011) 46.

[634] Note 633, 20, 46.

[635] PIPEDA, note 57.

[636] Note 57, s. 3.

[637] Note 57, Schedule 1, Principle 4.3.

[638] Note 57, s. 7(3)(d)(i).

[639] SDA, note 3, s. 83(1)(f).

[640] Bill C-12, An Act to amend the Personal Information Protection and Electronic Documents Act (Ministry of Industry, September 29, 2011).

[641] Interview with Doug Melville, OBSI, December 21, 2013.

[642] Linda Routledge, “Protecting Bank Clients from Financial Abuse” Forum on the Financial Abuse of Seniors, March 26, 2013, 11. Online: http://www.ifa-fiv.org/wp-content/uploads/2013/03/Routledge-Protecting-Bank-Clients-from-Financial-Abuse-March-26-2013.pdf.

[643] For example, the Canadian Bankers Association has launched a financial literacy program aimed at seniors, with a particular focus on financial abuse: see http://www.cba.ca/en/media-room/65-news-releases/688-canadian-bankers-association-to-launch-financial-literacy-program-for-seniors.

[644] See, for example, Criminal Code, R.S.C., 1985, c. C-46, ss. 215, 264, 323, 328-332, 334, 336, 346, 366, 380, 423.

[645] Note 644, s. 718.2.

[646] Margaret Hall, Developing an Anti-Ageist Approach Within Law, (Law Commission of Ontario: July 2009), 37. Online: http://wwww.ontla.on.ca/library/repository/mon/24009/304765.pdf.

[647] Selina Lai, Final Report: Community Mobilization Empowering Seniors Against Victimization to the National Crime Prevention Centre of Canada Public Safety Canada (United Seniors of Ontario: March 2008), 11. Also see Donald Poirier & Norma Poirier, Why is it so difficult to combat elder abuse, and in particular, financial exploitation of the elderly? (Law Commission of Canada: July 1999), section 5.3.3. Online: http://epe.lac-bac.gc.ca/100/206/301/law_commission_of_canada-ef/2006-12-06/www.lcc.gc.ca/research_project/99_elder_2-en.asp#p14.

[648] For example, in R. v. Khelawon, the manager of a retirement home was accused of assaulting five residents; however, by the time the matter reached trial, four of the victims had died and the remaining victim was no longer competent to testify. The Supreme Court of Canada ruled that the videotaped statements made by the victims after the assaults were inadmissible as being unreliable, and as a result, the accused was acquitted.  Ontario’s “Justice on Target” initiative aims to reduce delays in the justice system, and has seen some improvements in the timeliness and efficiency. Initiatives include streamlined disclosure process, providing earlier access to information to support timely decision-making, increased availability of plea courts, on-site legal aid, and many others. Information on the Justice on Target initiative can be found at http://www.attorneygeneral.jus.gov.on.ca/english/jot/.

[649] For example, the Ministry of the Attorney General has developed a Vulnerable Victims and Family Fund to provide financial and court-based supports for victims of crime and families of homicide victims, and this includes coverage for disability-related supports, such as sign-language interpretation or real-time captioning, to enable equal participation in the criminal justice system.

[650] Perreault, note 628,, Cat no 85F0033MIE2009021, ISSN 1496-4562, ISBN 978-1-100-12686-9 11.

[651] DAWN – RAFH Canada, Response to the Law as it Affects Older Adults Consultation Paper (Toronto: Law Commission of Ontario: 7 July 2008), 1.

[652] Perreault, note 628, 10.

[653] For more information on Ontario’s Strategy to Combat Elder Abuse, see the website of the Ontario Seniors’
Secretariat at http://www.seniors.gov.on.ca/en/elderabuse/strategy.php and that of the Ontario Network for the Prevention of Elder Abuse at http://www.onpea.org/english/elderabuse/helpforseniors.html.

[654] Long Term Care Home Act 2007, S.O. 2007, c. 8, s. 24(1).

[655] Note 655, s. 24(5).

[656] Note 655, ss. 24 (3)-(4).

[657] Note 655, ss. 25-26.

[658] Health Professions Procedural Code, Schedule 2, Regulated Health Professions Act, 1991, note 221, ss. 85.1 and following.

[659] SIPDDA, note 60; O Reg 299/10, s. 8.

[660] SDA, note 3, ss. 32(1), 38.

[661] Note 3, ss. 32(1.1), 38.

[662] Note 3, s. 40.

[663] Note 3, ss. 32(7)-(8), 38.

[664] Note 3, ss. 33, 38.

[665] Note 3, ss. 37, 38.

[666] SDA, note 3, ss. 32(6), 38; O Reg 100/96, Accounts and Records of Attorneys and Guardians.

[667] SDA, note 3, ss. 32(2)-(5).

[668] Note 3, s. 20.1.

[669] Note 3, ss. 66(2)-(3).

[670] Note 3, ss. 66(9)-(10).

[671] Note 3, s. 66(2).

[672] Note 3, s. 66(5).

[673] Note 3, s. 66(6).

[674] Note 3, s. 66(8).

[675] Note 3, s. 66(7).

[676] SDA, note 3, s. 66(4.1); O Reg 100/96, Accounts and Records of Attorneys and Guardians.

[677] SDA, note 3, s. 51.

[678] Note 3, ss. 82-83.

[679] Note 3, ss. 39, 68.

[680] Note 3, s. 42.

[681] Note 3, s. 69.

[682] OPGT, The Role.

[683] O Reg 100/96, Accounts and Records of Attorneys and Guardians, ss. 5(2), (4).

[684] O Reg 99/96, Register.

[685] For a thorough discussion of concerns related to abuse by guardians and of options for reform, see Joffe & Montigny, note 301.

[686] Joffe & Montigny, note 301, 63.

[687] HCCA, note 4, ss. 37, 54, 69.

[688] VLRC, note 107, 413.

[689] Joffe & Montigny, note 301, 100-101.

[690] VLRC, note 107, 414.

[691] Joffe & Montigny, note 301, 63.

[692] VLRC, note 107, 414.

[693] Note 107, 423.

[694] Mental Capacity Act 2005, note 126, ss. 49, 58, 61.

[695] COP, note 167, 248.

[696] Bill 2013,  note 463, ss. 56, 59.

[697] Guardianship and Administration Act 2000 (QLD), ss. 222-24.

[698] Note 697, s. 224.

[699] Joffe & Montigny, note 301, 103-104. 

[700] Guardianship and Administration Act 2000 (QLD), s. 179.

[701] VLRC, note 107, 424.

[702] SDA, note 3, s. 83.

[703] Note 3, s. 62(1).

[704] Note 3, s. 27(1).

[705] Ziskos v. Miksche, [2007] O.J. No. 4276 (S.C.J.), para. 238.

[706] Philippa Geddie, “Guardianship Investigations by the Public Guardian and Trustee: What They Are and What They Aren’t” (Ontario Bar Association: January 2013), 1.

[707] Figures provided by the Office of the Public Guardian and Trustee, based on the Register of Guardians maintained by the Public Guardian and Trustee as required by Regulation 99/96 under the Substitute Decisions Act.

[708] Advocacy Centre for the Elderly, note 83, 26.

[709] Joffe & Montigny, note 301, 67. 

[710] Mental Capacity Act 2005, note 126, s. 58(1).

[711] COP, note 167, 250-51.

[712] Guardianship and Administration Act 2000 (QLD) s. 224(3).

[713] Note 700, s. 227.

[714] Note 700, s. 180.

[715] Note 700, s. 183(1).

[716] Note 700, s. 193.

[717] Joffe & Montigny, note 301, 104-105.

[718] In Lac Minerals Ltd. v. International Corona Resources Ltd., [1989] 2 S.C.R. 574, paras. 146-47, La Forest J noted that there are certain common threads running through fiduciary duties that arise from relationships marked by discretionary power and trust, such as loyalty and “the avoidance of a conflict of duty and interest and a duty not to profit at the expense of the beneficiary”. In Manitoba Métis Federation Inc. v. Canada (Attorney General), [2013] 1 S.C.R. 623, 2013 SCC 14, para. 47, the SCC reaffirmed that “…a fiduciary is required to act in the best interests of the person on whose behalf he is acting, to avoid all conflicts of interest, and to strictly account for all property held or administered on behalf of that person.”

[719] Powers of Attorney Act 1998 (Qld), s. 73.

[720] Guardianship and Administration Act 2000 (Qld), s. 152.

[721] Powers of Attorney Act 1998 (Qld), s. 118.

[722] Alberta Law Reform Institute, note 526, 37-38.

[723] Queensland Law Reform Commission, volume 3, note 532, 240-41.

[724] Note 532, 245.

[725] VLRC, note 107, 187.

[726] Note 107, xlviii.

[727] The Public Guardian and Trustee Act, S.S. 1983, c P-36.3, ss. 40.5–40.9.

[728] Alberta Law Reform Institute, note 526, 23.

[729] VLRC, note 107, 485.

[730] This issue was considered at some length, for example, in Listening to Ontarians, Report of the Ontario Civil Legal Needs Project (The Ontario Civil Legal Needs Project Steering Committee, May 2010). Online: http://www.lsuc.on.ca/media/may3110_oclnreport_final.pdf.

[731] Bill 14, Access to Justice Act, 2006, S.O. 2006, c. 21.

[732] For a description of this service, see the Law Society of Upper Canada website at: http://www.lsuc.on.ca/faq.aspx?id=2147486372.

[733] For a description of the organization and the services provided, visit the Pro Bono Law Ontario website at: http://www.pblo.org.

[734] See the JusticeNet website at: http://www.justicenet.ca/directory/search/.

[735] Weisstub, Enquiry, note 9.

[736] Fram Report, note 10.

[737] Weisstub, Enquiry, note 9, 244.

[738] Note 9, 240.

[739] Fram Report, note 10, 74.

[740] OBA Submission, note 110, 18.

[741] Abrams v. Abrams, [2010] O.J. No. 787, 2010 ONSC 1254, para. 28.

[742] Note 741, para. 34.

[743] Note 741, para. 35.

[744] Dale Brazao, “Sister battles caregiver for care of intellectually challenged brother” (Toronto Star: November 20, 2012); Dale Brazao, “Guardianship battle for intellectually challenged man settled” (Toronto Star: October 17, 2013).

[745] LCO, Framework for the Law as It Affects Older Adults, note 1, ch II C; LCO, Framework for the Law as It Affects Persons with Disabilities, note 2, ch II C.

[746] Joffe & Montigny, note 301, 108.

[747] Adapted from Step 6 of both Frameworks.

[748] LCO, Framework for the Law as It Affects Older Adults, note 1, ch VI provides a detailed description and analysis of the provisions of the HCCSA, including the complaint and enforcement requirements, in light of the Framework.

[749] See the Ombudsman for Banking Services and Investments website at: www.obsi.ca.

[750] Advocacy Centre for the Elderly, note 83, 24.

[751] Note 83, 24.

[752] HCCA, note 4, s. 70.

[753] Consent and Capacity Board, “Mandate & Mission Statement” (February 28, 2012). Online: CCB <http://www.ccboard.on.ca>.

[754] HCCA, note 4, s. 32.

[755] Note 4, ss. 50, 65.       

[756] SDA, note 3, s. 20.1.

[757] HCCA, note 4, ss. 33, 51, 66.

[758] Note 4, ss. 35, 53, 68.

[759] Note 4, ss. 37, 54, 69.

[760] Note 4, ss. 35, 52, 67.

[761] Note 4, ss. 34, 53.1, 54.2. Note that the provisions with respect to secure units are not yet in force.

[762] For the fiscal year 2011-2012, over 80 per cent of all applications fell into these categories: Consent and Capacity Board, Annual Report 2011 – 2012, 5.

[763]  Nyranne Martin “The Ethical and Practical Advocate: Considerations for Hospital Counsel in the Mental Health Context” (Canadian Bar Association National Health Law Summit, Montreal: May 2011) 5.

[764] HCCA, note 4, s. 80.

[765] Cuthbertson v. Rasouli, [2013] 3 S.C.R. 341, 2013 SCC 53 [Cuthbertson], paras 97-103.

[766] See, for example, Richard O’Reilly, “Is An Adversarial System Suitable For Committal And Capacity Reviews?” in Psychiatric Patient Advocate Office, Mental Health and Patients’ Rights in Ontario: Yesterday, Today and Tomorrow” (Toronto: Queen’s Printer for Ontario, 2003), 43; Gray J.E., O’Reilly R.L. & Clements G.W. “Protecting the Rights of People with Mental Illness: Can we Achieve Both Good Legal Process and Good Clinical Outcomes?” (2002) 23:2 Health Law in Canada 25 at 30-31.

[767] O’Reilly, note 766, 43-44.

[768] Gray, O’Reilly & Clements, note 766, 30-31. See also Lois Hutchinson, “Finding The Balance: Mental Health Treatment And Patients’ Rights From A Psychiatrist’s Perspective” in Psychiatric Patient Advocate Office, Mental Health and Patients’ Rights in Ontario: Yesterday, Today and Tomorrow” (Toronto: Queen’s Printer for Ontario, 2003), 41.

[769] See Gray, O’Reilly & Clements, note 766, 30.

[770] See Hutchinson, note 768, 41.

[771] See, for example, John J. Ensminger & Thomas D. Liguori, “The Therapeutic Significance of the Civil Commitment Hearing: An Unexplored Potential” (1978) 6 J. Psychiatry & L. 5, 6.

[772] Note 771, 17, 20.

[773] Bruce J Winick, “Therapeutic Jurisprudence and the Civil Commitment Hearing” (1999) 10 J. Contemp. Legal Issues 37 at 44.

[774] Note 773, 46-47.

[775] Lorra Patton, “‘These Regulations Aren’t Just Here to Annoy You:’ The Myth of Statutory Safeguards, Patient Rights and Charter Values in Ontario’s Mental Health System” (2008) 25 Windsor Rev Legal & Soc Issues 9.

[776] Justice Edward F. Ormston, “The Role and Function of the Consent and Capacity Board in the Mental Health System – Issues and Trends” in Psychiatric Patient Advocate Office, Honouring the Past, Shaping the Future: 25 Years of Progress in Mental Health Advocacy and Rights Protection (Toronto: Queen’s Printer for Ontario, 2008), 224.

[777] Aaron A. Dhir, “Relationships of Force: Reflections on Law, Psychiatry and Human Rights” (2008) 25 Windsor Review of Legal and Social Issues 103, 110.

[778] Jennifer Chambers, “Empowerment and Recovery — Are they Connected?” in Psychiatric Patient Advocate Office, Honouring the Past, Shaping the Future: 25 Years of Progress in Mental Health Advocacy and Rights Protection (Toronto: Queen’s Printer for Ontario, 2008), 107.

[779] Note 778, 107.

[780] See Ruby Dhand, “Access to Justice for Ethno-Racial Psychiatric Consumer/Survivors in Ontario” (2011) 29:1 Windsor Y.B. Access Just. 127, 139. It should be noted that Statistics Canada found that Ontario has the highest percentage of immigrants among seniors. See Turcotte & Schellenberg, note 73, 23.

[781] Ormston, note 776, 224.

[782] Canadian Centre for Elder Law, Elder and Guardianship Mediation Report, (Vancouver, B.C.: 2011) 32.

[783] Lorne Sossin, “Human Rights, Access to Justice & Innovation”, January 25, 2013. Online: http://www.bcli.org/sites/default/files/EGM_Report_Jan_30_2012_0.pdf.

[784] For a review of the implementation of active adjudication by the OHRT, see Andrew Pinto, Report of the Ontario Human Rights Review 2012 (Toronto: Queen’s Printer for Ontario, 2012).

[785] See JA Jolowicz “Adversarial and Inquisitorial Models of Civil Procedure” (2003) 52:2 ICLQ 281; Bruce P Archibald, “Progress in Models of Justice: From Adjudication/Arbitration through Mediation to Restorative Conferencing (and Back)” in Ronalda Murphy & Patrick A. Molinari, eds, Doing Justice: Dispute Resolution in the Courts and Beyond (Canadian Institute for the Administration of Justice, 2009) 129; Michael King et al, Non-Adversarial Justice (Leichhardt: The Federation Press, 2009) 1.

[786] SDA, note 3, ss. 39, 68.

[787] Note 3, ss. 39(4), 68(4).

[788] Note 3, ss. 42(7)-(8).

[789] Joffe & Montigny, note 301, 58-59.

[790] Note 301, 62-63

[791] Note 301, 67.

[792] See Toronto Mental Health Court, “Overview of the Court” (2008). Online: www.mentalhealthcourt.ca; Justice Richard D. Schneider, “Mental Health Courts” in Psychiatric Patient Advocate Office, Honouring the Past, Shaping the Future: 25 Years of Progress in Mental Health Advocacy and Rights Protection (Toronto: Queen’s Printer for Ontario, 2008), 186-88.

[793] Judiciary of England and Wales, Court of Protection Report 2010, 6.

[794] Note 793, 6.

[795] Mental Capacity Act 2005, note 126, s. 51.

[796] Note 126, s. 42.

[797] Note 126, s. 49.

[798] Note 126, s. 49.

[799] Note 126, s. 51(2).

[800] Joffe & Montigny, note 301.

[801] James & Watts, note 319, 81.

[802] Bach & Kerzner, A New Paradigm, note 109, 120-23; Bach & Kerzner, Fulfilling the Promise, note 385, 166.

[803] Terry Carney & David Tait, The Adult Guardianship Experiment: Tribunals and Popular Justice (Sydney: The Federation Press, 1997), 86.

[804] Note 803, 112.

[805] Note 803, 136.

[806] Note 803, 197.

[807] Victorian Civil & Administrative Tribunal, VCAT Annual Report 2012 – 2013, 2. Online: http://www.vcat.vic.gov.au/system/files/2012-13_complete_annual_report.pdf [VCAT, Annual Report].

[808] Victorian Civil and Administrative Tribunal Act 1998, Act No. 53/1998, ss. 8-14.

[809] Note 807, 5.

[810] Note 807, 42-43. Of the 10,942 applications to VCAT in 2012 – 2013, 7,288 (66.6 per cent) were reassessments.

[811] VLRC, note 107, 468.

[812] Note 107, 468.

[813] Note 107, 493.

[814] VCAT, Annual Report, note 807, 42.

[815] Note 807, 42-43.

[816] VLRC, note 107, 469.

[817] Note 107, 485-86.

[818] You’ve Got a Friend, note 14, 72.

[819] See, for example, Barry Gray & Robin Jackson, “Introduction: Advocacy and Learning Disability” in Advocacy and Learning Disability, Barry Gray & Robin Jackson, eds. (Philadelphia: Jessica Kingsley Publishers, 2002) 7, 9. Also see Enabling Living Independently Today and Everyday, Advocacy Definition, 4-5. Online: http://www.elitestaffordshire.co.uk/uploads/file/Advocacy%20Definition.pdf.

[820] Hansard, note 14, 4255-56. See also You’ve Got a Friend, note 14, 162.

[821] Fram Report, note 10, 75-80.

[822] You’ve Got a Friend, note 14, 43-47.

[823] Note 14, 121-22.

[824] Advocacy Act, 1992, note 17, s. 1; repealed HCCA, note 4, s. 1.

[825] Advocacy Act, 1992, note 17, ss. 2-3; repealed HCCA, note 4, s. 1.

[826] Advocacy Act, 1992, note 17, s. 3; repealed HCCA, note 4, s. 1.

[827] Advocacy Act, 1992, note 17, s. 7; repealed HCCA, note 4, s. 1.

[828] Advocacy Act, 1992, note 17, s. 19(1); repealed HCCA, note 4, s. 1.

[829] Advocacy Act, 1992, note 17, s. 17; repealed HCCA, note 4, s. 1.

[830] Advocacy Act, 1992, note 17, s. 19(2); repealed HCCA, note 4, s. 1.

[831] Lightman & Aviram, note 18, 33.

[832] MHA, note 6; R.R.O. 1990, Reg. 741, ss. 14-14.1.

[833] PPAO, Rights Advice, note 206.

[834] Linda Carey, “Rights Advice” in Psychiatric Patient Advocate Office, Mental Health and Patients’ Rights in Ontario: Yesterday, Today and Tomorrow” (Toronto: Queen’s Printer for Ontario, 2003), 9-11.

[835] PPAO, Annual Report, note 204, 9.

[836] Note 204, 10.

[837] Psychiatric Patient Advocate Office, “About the PPAO”. Online: http://www.sse.gov.on.ca/mohltc/ppao/en/Pages/AboutthePPAO.aspx.

[838] MHA, note 6, s. 59.

[839] MHA, note 6; R.R.O. 1990, Reg. 741, s. 16(1).

[840] MHA, note 6, s. 1.

[841] MHA, note 6; R.R.O. 1990, Reg. 741, s. 14.2.

[842] Lisa Romano, Judith A. Wahl & Jane Meadus (Advocacy Centre for the Elderly), Submission to the Law Commission of Ontario Concerning: The Law as it Affects Older Adults (July 23, 2008), 14-15.

[843] Joffe & Montigny, note 301, 93-94.

[844] Note 301, 95.

[845] Note 301, 94.

[846] A brief review of systemic advocacy by the PPAO can be found in David Simpson, “Systemic Advocacy: A Catalyst for Change” in Psychiatric Patient Advocate Office, Honouring the Past, Shaping the Future: 25 Years of Progress in Mental Health Advocacy and Rights Protection (Toronto: Queen’s Printer for Ontario, 2008), 43-45.

[847] Legal Aid Services Act, 1998, S.O. 1998, c. 26, s. 13.

[848] Legal Aid Ontario, Mental Health Strategy Consultation Paper (November 2013).

[849] Cuthbertson, note 765.

[850] Zheng v. Zheng, [2012] O.J. No. 2957, 2012 ONSC 3045 (Div Ct).

[851] Guardianship and Administration Act 1986 (Vic), s. 15.

[852] Guardianship and Administration Act 1986 (Vic), s. 16.

[853] VLRC, note 107, 447.

[854] For context, the population of the state of Victoria in 2013 was 5.7 million, compared to Ontario’s population of 13.5 million.

[855] OPA, Annual Report, note 455, 10.

[856] Note 455, 19.

[857] VLRC, note 107, 452.

[858] Note 107, 461.

[859] Agnes Samler, “An Independent Voice for Children and Youth: the Ontario Provincial Advocate” in Psychiatric Patient Advocate Office, Honouring the Past, Shaping the Future: 25 Years of Progress in Mental Health Advocacy and Rights Protection (Toronto: Queen’s Printer for Ontario, 2008), 46-48.

[860] Provincial Advocate for Children and Youth Act, 2007, S.O. 2007, c. 9, ss. 3, 6.

[861] Note 860, s. 15.

[862] Office of the Provincial Advocate for Children and Youth, “About Us”. Online: http://provincialadvocate.on.ca/main/en/about/aboutus.cfm.

[863] Provincial Advocate for Children and Youth Act, 2007, note 860, s. 16.

[864] Provincial Advocate for Children and Youth, 2011/2012 Annual Report to the Legislature, 9.

[865] Provincial Advocate for Children and Youth Act, 2007, note 860, s. 18.

[866] Note 860, ss. 19-20.

[867] Note 860, s. 2(3).

[868] COP, note 167, 178.

[869] Mental Capacity Act 2005, note 126, s. 39.

[870] The Mental Capacity Act 2005 (Independent Mental Capacity Advocates) (Expansion of Role) Regulations 2006 (UK), SI 2006 No. 2883.

[871] COP, note 167, 180.

[872] Note 167, 188.

[873] Note 167, 184.

[874] Note 167, 183-84.

[875] AGTA, note 153, s. 81.

[876] Alta Reg 219/2009, ss. 38, 45, 49, 51, 57.

[877] Alta Reg 219/2009, ss. 38, 46, 51, 58.

[878] AGTA, note 153, ss. 26(7), 46(7).

[879] Note 153, ss. 27, 48.

[880] Alta Reg 219/2009, s. 34.

[881] Alta Reg 219/2009, s. 36.

[882] Ministry of Community and Social Services, Policy Guidelines for the Adult Protective Service Worker Program 2012 (Revised October 2012), 11.

[883] Note 882, 14.

[884] Note 882, 10, 14.

[885] LCO, Framework for the Law as It Affects Persons with Disabilities, note 2, 54.

[886] LCO, Framework for the Law as It Affects Older Adults, note 1, 159; LCO, Framework for the Law as It Affects Persons with Disabilities, note 2, 54.

[887] Bach & Kerzner, A New Paradigm, note 109, 6. 

[888] Advocacy Centre for the Elderly, note 83, 45.

[889] Romano, Wahl & Meadus, note 842, 24.

[890] Wahl, Dykeman & Gray, note 489, 243-44.

[891] Advocacy Centre for the Elderly, note 83, 43.

[892] Note 83, 40.

[893] See, for example, note 83, 19.

[894] College of Nurses of Ontario, Consent, note 224.

[895] CSPO, Consent to Treatment, note 224.

[896] College of Occupational Therapists of Ontario, Consent, note 224.

[897] Regulated Health Professions Act, 1991, note 221, Schedule 2, s. 3.

[898] Wahl, Dykeman & Gray, note 489, 250-53.

[899] Note 489, 237-38.

[900] Note 489, 228-29.

[901] Note 489, 235.

[902] O Reg 460/05, ss. 2(1)(b), 4.

[903] O Reg 460/05, ss. 2(1)(c), 5(1).

[904] O Reg 460/05, ss. 2(1)(c), 5(2).

[905] O Reg 460/05, ss. 2(1)(d), 6.

[906] Bill 2013, note 463, s. 56(2).

[907] VLRC, note 107, 444.

[908] Guardianship and Administration Act 1986 (Vic), s. 15.

[909] Joffe & Montigny, note 301, 103.

[910] An Act to amend the Human Rights Code, S.O. 2006, c. 30, s. 57.

[911] Pinto, note 784.

[912] AODA, note 33, s. 41.

 

 

 

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