ABSTRACT
This chapter considers the problem of treatment refusal amongst involuntarily hospitalised psychiatric patients in the Canadian context. It describes mental health legislation in the provincial jurisdictions of Canada, followed by an examination of some of the important jurisprudence that shaped laws. The chapter identifies and examines some of the conceptual issues arising from the criteria for involuntary admission and treatment decision-making incapacity. It argues that legal provisions allowing the detention of psychiatric patients regardless of their treatment decision-making capacity are discriminatory against those with mental illnesses and undermines effective mental health service delivery. The manner in which clinicians make decisions about involuntary interventions in the face of competing clinical, legal, and ethical demands will be discussed. The chapter investigates various potential solutions to this difficult problem. It also examines some of the key concepts underlying involuntary hospitalisation criteria, highlighting the issues that are encountered by psychiatrists. A physician must assess the involuntary patient's capacity to consent to treatment.
