Legal developments in end-of-life issues.

Canadians have craved certainty as to the process to be followed when intervention is demanded that physicians are not prepared to offer or to continue to offer, even if it prolongs life, because it is considered to be otherwise non-beneficial. The Supreme Court of Canada (SCC), in its October 2013 judgment in Cuthbertson v. Rasouli, provided a narrow answer based on only Ontario's statutory regime and a specific set of facts. Or did it? The SCC's rationale, as well as decisions emanating from Ontario's unique Consent and Capacity Board, can arguably be relied on anywhere in Canada to defeat efforts to mandate the provision of interventions considered to be of no medical benefit and that cause harm.

The Ontario experience of involuntary treatment of pediatric patients with eating disorders.

In this paper, the authors (two clinicians with specialized practices in child and adolescent eating disorders and a lawyer who practices health law in Ontario, Canada) review pertinent aspects of clinical capacity assessment, with elaboration of the specific unique and complex issues which shape that assessment in children and adolescents with eating disorders. The relevant Ontario legislation and institutional framework governing consent and capacity in children and adolescents are reviewed. The literature on involuntary treatment and consent and capacity in patients with eating disorders is reviewed. Specific cases involving child and adolescent patients with eating disorders that have been heard by the Ontario Consent and Capacity Board (OCCB) in the past decade are discussed in order to elucidate the Board's views of consent and capacity in this vulnerable and challenging patient population. Strategies to support clinicians' therapeutic alliances with their patients while both are going through what can be a lengthy and potentially adversarial-seeming legal process are also discussed.