Perpetrators of crime can be found to be not criminally responsible (NCR) when their criminal behaviour is due to a diagnosed mental illness. The crime committed becomes known as the "index offence". They are then managed by the Ontario Review Board (ORB). Their release is determined by the ORB based upon an assessment of whether the individual constitutes a "significant threat to the safety of the public". The options for disposition include an absolute discharge, a discharge subject to conditions, or continued confinement in a hospital. Throughout the process, the offender is to be treated with dignity and afforded the maximum liberties compatible with the goals of public protection and fairness to the NCR accused found in Part. XX.1 of the Criminal Code (the "Code").
Section 672.54(a) of the Code directs that where an NCR accused is “not a significant threat to the safety of the public” he or she must be discharged absolutely. Section 672.5401 defines a “significant threat to the safety of the public” as “a risk of serious physical or psychological harm to members of the public – including any victim of or witness to the offence, or any person under the age of 18 years – resulting from conduct that is criminal in nature but not necessarily violent".
The Code does not create a presumption of dangerousness. It does not impose a burden on the NCR individual seeking release to prove a lack of dangerousness. The court or Review Board must make a disposition “that is the least onerous and least restrictive to the accused”. It becomes clear then that unless it makes a positive finding on the evidence that the NCR accused poses a significant threat to the safety of the public, the court or Review Board must order an absolute discharge.
The authority for these statements of the law came from the Supreme Court of Canada (SCC) in Winko v. British Columbia (Forensic Psychiatric Institute). The steps and process were set out by the SCC in some detail as follows:
An appeal from the decision of the ORB is made under Part XX.1 of the Code to the Ontario Court of Appeal (ONCA). The appeals are most often made by the NCR person seeking a release. The standard of the review on such an appeal is found in s. 672.78(1) of the Code. An ORB decision is to be accorded deference, but the ONCA has the power to set aside the decision if it is unreasonable, is not supported by the evidence, it is based on a wrong decision on a question of law, or there was a miscarriage of justice. The reasonableness of the ORB decision must be evaluated by considering the reasons in the context in which the decision was made. As stated by the ONCA in Re Wall:
The reasons for the Board’s decision and the substantive decision reached by the Board must be considered together in determining whether an acceptable and defensible outcome has been reached, keeping in mind the need to protect the liberty of the NCR accused as much as possible, while also protecting society.
Further, as the ONCA stated in Re Carrick,
he “significant threat” standard is an onerous one. An NCR accused is not to be detained on the basis of mere speculation. The Board must be satisfied as to both the existence and gravity of the risk of physical or psychological harm posed by the appellant in order to deny him an absolute discharge.
Input from a lawyer can assist health professionals in giving evidence at assessment or capacity hearings. At Wise Health Law, we also have an established network of criminal lawyers with whom we work. For the convenience of our clients, we have offices in both Toronto and Oakville, Ontario, and are easily accessible. Contact us online, or at 416-915-4234 for a consultation.
The Chief Medical Officer of Health for Ontario has issued an updated Directive #2 (dated May 26, 2020) for Regulated Health Professionals in the province.
Pursuant to the updated Directive #2, all deferred non-essential and elective services by health care providers may be gradually restarted – subject to the rest of the requirements set out in the Directive.
The updated Directive #2 does not provide particularly detailed guidance to health professionals on how to proceed, likely because it applies to such a broad spectrum of health care and health professionals. It does, however, provide some principles to assist health care providers in making decisions as we enter this transitional period.
In addition to the mask and hand sanitizer shortages, Ontario’s response to COVID-19 highlights the need for more frontline health care workers. Each regulated health profession’s college responded differently, and we have discussed some of those changes in other posts to keep you apprised.
Today, we focus on the College of Physicians and Surgeons of Ontario (CPSO), who set out to increase the number of available and licenced physicians out on the frontlines through certificates of registration that authorize supervised practice of short duration. The temporary licences authorize practice for 30 days.
Undoubtedly, COVID-19 has affected how health professionals practice. Pharmacists across the country are not only experiencing changes in how they practice (for example, accepting emailed prescriptions, where appropriate) but the scope of their practice as well. The latter change is not permanent, although the disruptions in practice may be felt long after the COVID-19 emergency subsides.
On March 19, 2020, Health Canada issued a short-term section 56(1) exemption under the Controlled Drugs and Substances Act (CDSA) that would authorize pharmacists to prescribe, sell, or provide controlled substances in limited circumstances, or transfer prescriptions for controlled substances (the CDSA Exemption).