Clinical Ethics: Consent and Capacity

People can make their own decisions about health care and treatment when they are capable of doing so. A capable person will understand the information he/she needs to give consent and what might or might not happen as a result of making a decision. This is called informed consent.  A person is assumed to be capable unless there is reason to believe otherwise. Consent must be voluntary; the person has a right to make the decision freely, without force, coercion or manipulation.

According to Ontario law, a health practitioner who proposes a treatment for a person shall not give the treatment, and shall take reasonable steps to ensure that it is not given, unless,
(a) he/she is of the opinion that the person is capable with respect to the treatment, and the person has given consent; or
(b) he/she is of the opinion that the person is incapable with respect to the treatment, and the person’s Substitute Decision Maker has given consent on the person’s behalf in accordance with the Health Care Consent Act (1996).

For those patients who are not capable of making their own health care decisions, the legal Substitute Decision Maker will be identified and asked if he/she gives consent for treatment.

The Consent and Capacity Board

The Consent and Capacity Board (CCB) is created to assure the rights of patients. The CCB can hold hearings about diverse matters. It can review the capacity to consent to treatment. It can consider the appointment of a representative to make decisions for an incapable person. It can review the involuntary status of a patient. It can review the decisions of a Substitute Decision Maker; whether the decisions are made in the best interest of the patient.

Hearings can be requested by patients, families and health care professionals.

The CCB conducts hearings under the Mental Health Act, the Health Care Consent Act, the Personal Health Information Protection Act, the Substitute Decisions Act and the Mandatory Blood Testing Act. CCB members are psychiatrists, lawyers and members of the general public.

For more information about when, why and how to consult the Consent and Capacity Board:


Last updated: Tue, 2015-09-22 15:40