Court: Supreme Court of Canada
Judgment Date: 6 June 2003
Where Reported: [2003] SCC 32
Legal Issues in Starson v Swayze
The legal issue in Starson v Swayze centred on the determination of the patient’s capacity to make medical decisions under the Health Care Consent Act.
Starson v Swayze raised the question of whether the Consent and Capacity Board correctly assessed the patient’s capacity to understand the information relevant to treatment and to appreciate the consequences of a decision or lack of decision, without erroneously applying a “best interests” standard.
The central focus was on the Board’s adherence to the legal tests for capacity and whether its decision was based on the patient’s capacity rather than his best interests.
Material Facts in Starson v Swayze
The case involved Professor Starson’s capacity to make medical decisions regarding his mental health treatment.
The Consent and Capacity Board determined that Professor Starson lacked the capacity to understand the information relevant to treatment and to appreciate the consequences of his decisions.
The Board’s decision was based on evidence indicating that Professor Starson was in “almost total” denial of his mental disorder and failed to appreciate the consequences of his decision, particularly in relation to medication.
The Board’s conclusion was challenged on the grounds that it was influenced by a belief that medication was in Professor Starson’s best interest, rather than being solely based on his capacity to make medical decisions.
Judgment in Starson v Swayze
The Court of Appeal upheld the Board’s decision, affirming that Professor Starson lacked the capacity to make medical decisions within the meaning of the Health Care Consent Act.
The Court emphasised that the evidence supported the Board’s findings regarding Professor Starson’s inability to understand the information relevant to treatment and to appreciate the consequences of his decisions.
The judgment highlighted that the Board’s decision was firmly anchored in the evidence and was not based on a “best interests” standard, but rather on the question of capacity throughout the assessment process.
The Reason for the Decision in Starson v Swayze
The reason for the decision was grounded in the Court’s assessment of the evidence and the Board’s application of the correct legal tests for capacity.
The Court found that there was ample evidence to support the Board’s findings of Professor Starson’s inability to understand the information relevant to treatment and to appreciate the consequences of his decisions.
The judgment emphasised that the Board remained focused on the question of capacity throughout its assessment and did not erroneously apply a “best interests” standard.
The Court concluded that the Board’s decision was reasonable and that it correctly applied the law in determining Professor Starson’s lack of capacity under the Health Care Consent Act.
Legal Principles in Starson v Swayze
The case of Starson v Swayze established important legal principles regarding the assessment of capacity under the Ontario Health Care Consent Act.
The decision in Starson v Swayze underscored the necessity for a careful review of the evidence to support findings of incapacity, particularly in cases where the patient’s understanding of treatment and appreciation of consequences are at issue.
The judgment also emphasised the importance of distinguishing between assessments of capacity and determinations based on the patient’s best interests, ensuring that decisions are firmly anchored in the evidence and the correct legal tests for capacity.
This principle has significant implications for the assessment of capacity in medical decision-making, highlighting the need for a rigorous and evidence-based approach to determining a patient’s capacity under the law.
