All About Estates

Dr. Richard Shulman

Total 22 Posts Website
Dr. Shulman is a Geriatric Psychiatrist, and is the Service Medical Director for Seniors Mental Health Services at Trillium Health Partners (Mississauga Hospital, Credit Valley Hospital and Queensway Health Centre). He is available for independent medical-legal capacity assessments. He is an assistant professor at the University of Toronto. Email: Richard.Shulman@thp.ca

Medical Assistance in Dying (MAiD) and Undue Influence

In 2015, the Supreme Court of Canada held that the ban on Medical Assistance in Dying (MAiD) was unconstitutional (for a summary of the decision, click here). However, MAiD is not available to all persons; to qualify, a person requesting MAiD must have a grievous and irremediable medical condition including…

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LTCHA Fails to Meet its Mandate for Seniors with Dementia and Responsive Behaviours

All long-term care homes in Ontario are governed by one piece of legislation: the Long-Term Care Homes Act, 2007 (LTCHA) designed to help ensure that residents of long-term care homes receive safe, consistent, high-quality resident-centred care. The Ontario Regulation 79/10 (Regulation) is made under the LTCHA and provides additional requirements….

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Assisting Detection of Hospital Acquired Delirium by Informal Caregivers – The Sour Seven

In the March 2018 edition of Reader’s Digest, I came across an article called “State of Confusion”[i] about hospital acquired delirium and the negative consequences that can arise from it. (The author’s original article can be found online.)[ii] The editor’s letter “Decoding Delirium”[iii] in the same issue recounts her mother’s…

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Consent to Medical Assistance in Dying vs. Withdrawal of Life-Sustaining Treatment

The cases before the court of Shalom Ouanounou and Taquisha McKitty[i] focus on the declaration of brain death and the withdrawal of life-sustaining treatment without consent. I will not address the issue of declaration of brain death as that lies outside my scope of practice, but rather will comment on…

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Capacity Evaluation of an Expressed Choice

In law, expressed choices are not necessarily a reflection of capable decision making. For example, regarding testamentary capacity, the Ontario Court of Appeal in Hall v. Bennett Estate (2003)[i] stated in paragraphs 15 and 16 that it is not sufficient simply to show that a testator had the capacity to…

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The SDA and Incapacity to Manage Personal Care – Additional Commentary on Limitations in Legislation

Pursuant to Section 45 of the Substitute Decisions Act (SDA),[i] incapacity for personal care is defined as – A person is incapable of personal care if the person is not able to understand information that is relevant to making a decision concerning his or her own health care, nutrition, shelter,…

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The SDA and Incapacity to Manage Personal Care – Another Example of a Limitation In Legislation

A frequent clinical challenge for doctors caring for seniors in hospitals is assessing decision making capacity and discharge planning. The following question arises; “Doctor, is the patient ‘capable’ to return home?” The problem with this question is the doctor has no authority in determining the answer. As per Section 45…

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The HCCA and Presumption of Capacity to Consent to Treatment; Principled but Flawed

Capacity to make treatment decisions in the Health Care Consent Act (HCCA)[i] refers to an intact ability to understand information that is relevant to making a decision to a proposed intervention and equally important the ability to appreciate the reasonably foreseeable consequences of a decision or a lack of decision….

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Schizophrenia in Late Life and Impact on Decision-Making Capacity

Schizophrenia in adults is the most common illness causing psychosis (a loss of contact with reality, a lack of ability to tell what is real from what is not real in some way). Schizophrenia generally commences in late adolescence or less commonly after age 40 referred to as late onset…

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Capacity Assessments and Biases to Beware of

Capacity assessments regarding capacity to manage property, testamentary capacity or capacity to appoint a power of attorney for property (POA), whether conducted contemporaneously or retrospectively, rely upon whatever materials/information that is provided to an assessor to review. Materials may include relevant medical records, previous wills and POA documents, interview of…

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