Medical Treatment Without Consent

There are a few situations where health care professionals do not need your consent before treating you. These include:

• emergency situations where you are unable to consent
• situations where you cannot consent due to mental illness
• situations where certain infectious diseases are involved

In normal cases, health care providers are not allowed to treat you against your will. If that does happen, you may want to file a complaint. You may also be able to sue the health care provider in court. In extreme circumstances, treating you against your will can be viewed as a criminal act.

There may be a time where you need immediate treatment, but you are unable to consent. You could be unconscious, for example. In this case, the law implies that you consent to treatment. This allows a health care provider to give you treatment to save your life even without your express consent.

However, if you expressly refuse to give consent, health care providers should not give that treatment, even in an emergency. For example, some people carry a card indicating that they do not want to receive certain medical treatments, even if it would save their life.

There are also times when a relative can provide consent for you. If you are not able to consent to treatment and have not prepared a health care directive, your nearest relative may consent on your behalf. Your nearest relative is determined in the following order and includes relatives by adoption:

• your spouse or person you live with as a spouse
• your adult son or daughter
• your parent or legal guardian
• your adult brother or sister
• your grandparent
• your adult grandchild
• your adult uncle or aunt
• your adult nephew or niece

When it comes to mental health, health care professionals still require your consent before treating you in most cases. People who are suffering from a mental illness are sometimes unable or unwilling to ask for help.

In exceptional circumstances, the law allows for people to receive mental health treatment without their consent. In these cases, The Mental Health Services Act provides a number of safeguards. These ensure that the individual's rights are protected while still protecting their safety and wellbeing.

In some cases, the law allows a person to be examined against their will by a psychiatrist. This can happen, for example, if:

• a doctor has examined you and believes you have a mental disorder and need treatment
• a police officer believes you have a mental disorder and are likely to harm yourself or others
• you are charged with an offence or are being held under the Criminal Code and a judge orders an examination
• someone believes that you have a mental disorder and requests that a judge make an order requiring a psychiatric examination

If you are required to have a psychiatric examination, you must immediately be:

• told the reason for the examination
• told that you have the right to contact a lawyer
• given a copy of any certificate, warrant or order requiring the examination

It is also possible to have an individual admitted to a special mental health unit and held there against their will. This can happen if:

• you have been charged or convicted of a criminal offence and the court orders it
• there is a long-term detention order and the court orders it
• a medical certificate authorizes it

To obtain a medical certificate, at least one psychiatrist and one other doctor must certify that:

• you have a mental disorder
• you require treatment
• you require supervision that can only be provided in a hospital or mental health centre
• the mental disorder is preventing you from making an informed decision and understanding the need for treatment and supervision
• the mental disorder will likely get much worse if left untreated or cause you to harm yourself or others

If it is not possible to have two doctors sign, then one doctor can sign it. In this case, the medical certificate can only last for up to 3 days. Otherwise, the person can be held for up to 21 days on a certificate. These certificates may be renewed for further 21-day periods as needed.

If your mental illness prevents you from understanding that you require treatment, and you will not give your consent, you may be treated without your consent. This can only be done if you are:

• being held under a medical certificate in a mental health centre
• being held under a court order for long-term detention
• placed under a community treatment order

Community treatment orders are used when someone needs treatment and will not consent but does not need to be hospitalized for the treatment.

Certain diseases are a threat to public safety because they can spread from person to person and can cause serious health problems or even death. The law requires certain action to be taken when someone is diagnosed with one of these diseases.

Under the federal Quarantine Act, people entering or leaving Canada may be detained. Quarantine officers can do this if they believe the person may have been exposed to an infectious disease. The traveller will then be required to undergo a medical examination. After this, the officer may order the traveller to follow treatment measures.

In Saskatchewan, The Public Health Act, 1994 deals with infectious diseases. It treats them differently depending on whether they are classified as a category I or II disease.

Category I includes diseases such as:

• meningitis
• influenza
• chickenpox
• COVID-19
• food poisoning
• mumps
• hepatitis A
• West Nile virus
• Lyme disease

The following people must report suspected cases of these diseases to Public Health within 48 hours:

• doctors or nurses treating a patient who is infected
• teachers or principals who believe a student is infected
• medical laboratory personnel finding cases in a specimen they are studying
• anyone operator a place where food is prepared or packaged who suspects someone who was in the place is infected

Parents who think their children may have one of these diseases should contact Public Health to ensure proper follow-up and help control the spread of disease.

Category II includes diseases such as:

• hepatitis B, C and D
• tuberculosis
• syphilis
• human immunodeficiency virus infection (HIV), including acquired immune deficiency syndrome (AIDS)

Anyone who suspects that they have been exposed or infected with a category II disease must consult a health care provider without delay.

If you are diagnosed with a category II disease, you must:

• take treatment and remain under treatment as long as necessary to control the spread of the disease
• if no treatment is available, take all reasonable steps to reduce the risk of infecting others
• answer any questions that the doctor or nurse who diagnosed you may have for you
• provide the names and contact details of anyone who you were in contact with that may also have been exposed to the doctor or nurse
• tell, or ask the doctor or nurse to tell, all your contacts that they may have been exposed

In most cases, public health officers cannot name the source of the exposure.

Public health officers may order people to do or not do certain things to decrease or eliminate the health risks infectious diseases pose. A person may be required to:

• isolate themselves from other persons
• undergo testing
• attend counselling to learn about effective measures for dealing with the disease, reducing risk behaviours and reducing the spread of the disease
• not behave in any manner that would expose another person to infection
• receive treatment or counselling until the person no longer poses a public health risk
• do anything necessary to give effect to an order under the Act