Psychiatric Law and Preventive Confinement

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Questions and Answers

What is the maximum duration that a person can be placed under preventative confinement without a court order?

12 hours

72 hours (correct)

24 hours

48 hours

What must a health care facility do if a patient does not consent to a psychiatric evaluation?

Proceed with the evaluation regardless.

Inform the patient about potential consequences.

Release the patient immediately.

File a motion for temporary confinement. (correct)

What obligation does a physician have regarding informing a patient about a psychiatric evaluation?

They must provide limited information to prevent panic.

They must only inform the patient if they believe the patient is a danger.

They have no obligation if the patient is unconscious.

They must fully inform the patient of their right to refuse. (correct)

What is required for a court to authorize an extension of preventative confinement beyond 72 hours?

Detailed evidence of the danger posed by the patient. Signup and view all the answers

Which of the following statements about consent and preventive confinement is true?

Confinement against a person's will requires interpretative restriction of the law. Signup and view all the answers

What is required for a court to mandate provisional confinement?

Serious reasons to believe the person is dangerous due to mental state Signup and view all the answers

What is the maximum timeframe for the first psychiatric assessment after arrival for a person under preventive confinement?

24 hours Signup and view all the answers

Under what condition can an application for provisional confinement not be resubmitted?

If the application is refused initially Signup and view all the answers

What is the second psychiatric assessment timeframe if the person has refused an examination?

Within 48 hours after the court order Signup and view all the answers

Who can apply to the court for provisional confinement?

A physician or an interested person Signup and view all the answers

What additional examinations may the court authorize during provisional confinement?

Any necessary medical examination Signup and view all the answers

When does the 96-hour time limit for the second psychiatric evaluation apply?

If the person was under preventive confinement without prior evaluation Signup and view all the answers

Who is responsible for conducting the psychiatric evaluations during provisional confinement?

Any licensed psychiatrist Signup and view all the answers

What is the maximum duration for an initial setting of confinement without requiring periodic examination?

21 days Signup and view all the answers

At what intervals must a person under confinement be examined after the initial 21 days?

Every three months Signup and view all the answers

Which of the following statements accurately reflects the rights of a person under confinement?

A patient can appeal decisions both to Tribunal Administratif du Québec and the Court of Appeal. Signup and view all the answers

What must be true for a person not to be served the application for confinement?

They have fled or cannot be found. Signup and view all the answers

In what situation must the information regarding care programs be provided to a person under confinement?

At any important change in the program or living conditions. Signup and view all the answers

What is required for a health establishment to treat a confined person against their will?

Court approval. Signup and view all the answers

Under what circumstances may restraints be used on a confined person?

Only if it is an emergency or ordered. Signup and view all the answers

Who can receive information about the care program for a child under 14 years of age in confinement?

The child’s guardian. Signup and view all the answers

What must a professional do if they have reasonable grounds to believe a child's security or development is in danger?

Report the situation to the Director of Youth Protection without delay. Signup and view all the answers

Which of the following conditions indicates that a child's security and development are considered to be in danger?

The child exhibits serious behavioral disturbances. Signup and view all the answers

At what age can a minor give consent alone to care required by the state of health?

14 years old and over. Signup and view all the answers

In which circumstance can a minor aged 14 or over be treated without their consent?

In an emergency situation where their life is in danger. Signup and view all the answers

If a child leaves a care facility without authorization, how is their situation classified?

It may be classified as a potential risk to their security and development. Signup and view all the answers

Which of the following professionals does NOT have the duty to report potential danger to a child?

Family members of the child. Signup and view all the answers

What is the required action if a minor's health condition necessitates a stay in a health services establishment for over 12 hours?

Parental authority must always be informed. Signup and view all the answers

Which of the following is NOT an example of when a child's security and development are in danger?

The child is achieving good grades in school. Signup and view all the answers

What is the maximum duration for which a motion for authorized confinement can be granted?

30 days Signup and view all the answers

Under what circumstance can the Public Curator act as the Mise-en-cause?

If there are no reasonable family members or friends available Signup and view all the answers

What must be confirmed in a psychiatric examination report for confinement to be deemed necessary?

The patient poses a danger to themselves or others due to their mental state Signup and view all the answers

What criterion must the court confirm before authorizing confinement based on psychiatric reports?

Both psychiatric reports must agree on confinement necessity Signup and view all the answers

What is one of the significant considerations for judges in granting motions for authorized confinement?

The judge’s discretion based on evidence presented Signup and view all the answers

What is the purpose of the 'Mise-en-cause' in the confinement process?

To serve the motion for confinement on a reasonable person Signup and view all the answers

When can delays in serving a motion for confinement be abridged?

When time constraints are pressing Signup and view all the answers

What is the primary focus of Art 29 CCQ in terms of a psychiatric examination report?

The necessity for confinement based on mental state dangers Signup and view all the answers

What is the key aspect of the rights outlined in the Act Respecting Health Services and Social Services (LSSSS)?

Patients are entitled to receive health services in a personalized and safe manner. Signup and view all the answers

Which article of the LSSSS allows patients to choose their medical professional?

Article 6 Signup and view all the answers

What challenge arises from limited health sector budgets and an aging population according to the provided content?

Increased patient dissatisfaction due to service availability. Signup and view all the answers

Which of the following is NOT a right guaranteed by the LSSSS?

To receive free healthcare services Signup and view all the answers

In cases where patient rights are in conflict, what is one legal case referenced that provides insight?

Jasmin c Cité de la santé de Laval Signup and view all the answers

What does Article 15 of the LSSSS specifically guarantee for patients?

The right to bilingual services Signup and view all the answers

What is a central obligation of health institutions concerning patient rights under LSSSS?

Institutions are required to respect or promote patient rights as defined by the act. Signup and view all the answers

What primary goal does LSSSS aim to address within the healthcare system?

To mediate between health sector demands and resource limitations. Signup and view all the answers

Study Notes

Law 2 - Confinement, Privacy & Confidentiality, and Resources

Course: NUR1 424 – Fall 2024
Lecturer: Daria Kapnik

Plan

Authorization for Treatment:
- Recap of Court Orders under CCQ
- Treatment order
Confinement Law:
- General Principles
- Parameters
- Types of Confinement (Preventive, Provisional, Authorized)
- Rights of the person under confinement
- Potential issues in confinement
Privacy, Confidentiality and Resources:
- Patient access and medical records (General, Deceased patients, Privacy, confidentiality and care issues regarding minors)
- Management of Limited Resources and Patient Rights (Key Provisions, Caselaw)

Outline

Authorization for Treatment:
- Recap of Court Orders under CCQ (situations for obtaining court orders)
- Art. 16 CCQ: person of full age incapable of giving consent refuses care
- Art. 16 CCQ: no delegate for consent or refuses without justification
- Art. 16 CCQ: Minor over 14 refuses care
- Arts. 17/18 CCQ: Care entails serious risk for minor's health
Confinement in an Institution:
- General Principles (Confinement is exceptional; person is a serious and imminent danger to themselves or others)
- Types of Confinement (Voluntary, Forced - Preventive, Provisional, Authorized)
- Locations for confinement (local community service centre, hospital)
- Preventive Confinement (no court order, ordered by physician, dangerous to oneself or others; immediate and grave danger)
- Prevenitive Confinement - further process (72-hour period, physicians conclusion of danger, court order for extension, provisional confinement, psychiatric examination, ideally within 24 hours)
- Section 8 Act P-38 (peace officer action)
- Section 23 Act P-38 and more pressing medical emergencies, hospital responsibilities
Confinement in an Institution - Types of Confinement (cont'd):
- No one may be confined without consent or authorization by law (CCQ 26 par 1) or by a court
- Specifics for 'Grave or important danger' to ensure it's detailed, specific and precise
Confinement in an Institution - Types of Confinement (cont'd):
- (Preventive Confinement cont'd)
- Assessment and authorization within 72 hours
Confinement in an Institution - Provisional Confinement:
- Person must present a danger (grave or serious potential danger) to themselves or others
- Court order required
- Obtained for evaluation if patient refuses evaluation
Confinement in an Institution - Provisional Confinement (cont'd):
- For situations outside of a hospital
- Court action to force psychiatric examination - required (Art. 28 CCQ)
- Court Order if immediate danger
Confinement in an Institution - Provisional Confinement (cont'd):
- Procedures for the initial process
- Timing for completion of 1st/2nd examination/
Confinement in an Institution- types of confinement (cont'd) :
- Initial 48-hour limits (review and renewal)
- 96-hour review after initial confinement
Confinement in an Institution - Motion for Authorized Confinement - Process: -Physician's conclusion about the need for confinement -Court presentation within 48 hours
Confinement in an Institution - Motion for Authorized Confinement - Process (cont'd):
- Court procedures (2 days for service of the motion)
- Patient’s family, close friend, or Public Curator if needed
Confinement in an Institution - Motion for Authorized Confinement - Duration:
- Maximum 30 days
- Other time frames if necessary -Release as soon as not dangerous to self or others
Confinement in an Institution - Motion for Authorized Confinement - PSY content:
- Psychiatric examination report specifics
- Necessity for confinement, ability to care for themselves/administer property, need for protective supervision
Confinement in an Institution - Motion for Authorized Confinement - Court order criteria: -Confinement only if both reports conclude it's necessary -Court needs serious reason to believe in danger
Confinement in an Institution - Motion for Authorized Confinement - Court order criteria (cont'd): -Judge’s discretion in these matters -Detailed reports needed
Confinement in an Institution - Motion for Authorized Confinement - Renewal:
- Extension possible, up to 90 days more -New psychiatric examination required
Confinement in an Institution - Motion for Confinement - End of Confinement: -Confinement ends without formality -Conditions for ending confinement: physician's certificate, time expiration, court decision on confinement (order)
Confinement in an Institution - Motion for Confinement - Longer Confinement (Section 10 of Act P-38): -Examination required every 21 days if longer than 21 days, every 3 months.
Confinement in an Institution - Rights of the person under confinement: -Review of rights (Schedule of P-38) , need for service of application ,exception for clinical
- Testimony needed unless otherwise not possible
- Right to communication with outside, counsel (at all stages)
Confinement in an Institution - Rights of the person under confinement (cont'd):
- Information about the program of care
- Right to appeal (Tribunal Administratif, Court of Appeal)
Confinement in an Institution - Potential issues in confinement:
- Consent to care during confinement still needed (through the Superior Court)
- Restraints (only if ordered or emergency)
- AWOL (lack of communication with DPS office which could result in forced return to hospital)
Caselaw:
- Charles Le Moyne v. E(F) (CQ)
- CSSS Côte-de-Gaspé, P(C) (CQ)
- Hôpital Maisonneuve-Rosemont c. H(M) (CQ)
- J.M. c. Hôpital Jean-Talon du (CIUSSS) du Nord-de-l'Île-de-Montréal (2018 QCCA 378)
Privacy - Patient Access and Medical Records:
- Patient's right to access health information. -limitations
- Rights for Deceased Patients. – legal representatives of a deceased person may access the record.
Privacy, Confidentiality and Care Issues Regarding Minors:
- Parental Access
- Access by other bodies, Statutory duties of disclosure
Management of Limited Resources and Patient Rights:
- Rights and obligations (LSSSS)
- Conflicts and Caselaw (Jasmin v Cité de la santé de Laval (AZ-90021046), Noël-Voizard, JO v. Hôpital Royal Victoria) (related to access or denial of certain services, and possible discriminatory practices)

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Description

This quiz covers essential questions regarding psychiatric law, specifically focusing on preventative confinement. It addresses consent, court orders, and the obligations of healthcare providers and physicians in these scenarios. Test your knowledge on the regulations surrounding psychiatric evaluations and confinement durations.