- JAG (Re), 2014 CanLII 32619 (ON CCB): http://canlii.ca/t/g7kbm
And that’s what happened here. JAG (also know as RAG) has been diagnosed by his treating physician, a Dr. Arthur Keith, as delusional, and requiring treatment by anti-psychotic medication. Alternatively, Dr. Keith commented there is a “small but definite prospect” the JAG is not delusional but instead is subject to “oppositional defiant disorder”. The latter activity would not benefit from anti-psychotic medication.
So what are we talking about here?
Oh yeah, we’re familiar with that.It seemed clear to Dr. Keith that the beliefs JAG held, which were similar to beliefs of Freeman on the Land, had been an important factor in JAG’s behaviour which had caused him to come in contact with the criminal justice system. Sometime prior to his hospitalization JAG had been charged with cannabis offences, driving without a licence or insurance, causing a disturbance, and failure to attend court. The doctor recounted in second or third hand fashion an encounter between the police and JAG relating to auto insurance. JAG apparently indicated that he was exempt from the insurance requirement. His reported explanation, bizarre to most ears, had something to do with $1 billion in silver bullion being sent to an Ontario Minister of the Crown, which protected JAG from all liability.
Dr. Keith had acquainted himself with OPCA-type beliefs (here identified as “Freeman on the Land” ideas) via Meads v. Meads, 2012 ABQB 571, and concluded JAG had analogous beliefs even though he did not self-identify as a Freeman-on-the-Land.
The decision also provides some context. JAG is in involuntary psychiatric treatment following “a criminal justice process.” He’d been held in that state for six months, and showed no sign of improvement. His detention was reviewed on March 20, 2014 by the Ontario Review Board which confirmed that JAG should be held in hospital involuntarily. The reason for detention was clearly a typical ‘Freeman travelling’ scenario. The Review Board appears to have classified JAG as a threat to the public.
JAG is 50 years old, a former school teacher and principal with a masters degree level education. He is currently on long-term disability via government support. This probably relates to chronic pain or injury, since Dr. Keith identifies JAG as having “Cannabis Dependence, Nicotine Dependence, and a Pain Disorder.”
It seems JAG and Dr. Keith (and other facility) staff did not get along. JAG rejected the therapy because of its side effects: “a chemical lobotomy.” JAG preferred treatment by Naturopathy (naturally!) and Psychotherapy. JAG preferred to stay in hospital than have his mental state affected by drugs.
The test on whether a patient can reject therapy is from a Supreme Court of Canada judgment called Starson v. Swayze, 2003 SCC 32, [2003] 1 SCR 722 (http://canlii.ca/t/1g6p9), which in essence indicates that if a patient understands the consequences of a proposed treatment (or non-treatment) then the patient decides whether or not that treatment should occur. Only in very limited cases can treatment therefore be imposed on a patient. It doesn’t matter if the patient’s choice is an obviously poor one, he or she is in control of their therapy unless the patient’s choice is irrational.
[As a brief aside, this is a classic Canadian Charter of Rights and Freedoms type case where state intervention is subordinated to personal rights and integrity. I could go on at length on the wisdom of this approach – but I suspect that would get a little annoying.]
In the case of JAG he clearly had OPCA-type beliefs. However, the hearing officer did not evaluate whether those beliefs were “delusional”:
Instead, the hearing officer concluded that JAG was aware of the risks and benefits of the proposed drug treatment. It was therefore his choice to choose or reject that therapy:… On a few occasions his statements (both at the hearing and reported at the hearing about incidents in the community) match theoretical constructs espoused by Freeman of the Land types. Whether it is appropriate to label the beliefs underlying those statements as “delusional” in a psychiatric sense, I cannot say.
.The evidence of JAG established that he had a clear appreciation on one possible consequence of refusing the recommended treatment. When the patient testified that “having an undrugged brain is worth giving up my bodily freedom” it demonstrated that JAG was alert to the prospect that refusing anti-psychotic medication might mean he would languish in the hospital involuntarily for a longer period than otherwise. This brings to mind another comment from the Starson case by Justice Major at paragraph 62:
In any event, Professor Starson made it clear that he would rather remain in custody and take his chances with the Review Board than take the proposed medication. While the Board may not agree with the wisdom of that position, it is not one that is so irrational that it can reasonably be said to be evidence of incapacity.
This is an interesting little decision for a number of reasons. First, it confirms that persons with OPCA beliefs are being diverted into the mental health apparatus. That has been previously documented in an professional psychiatric journal article from a pair of Canadian doctors:
- Jennifer Pytyck and Gary A. Chaimowitz, “The Sovereign Citizen Movement and Fitness to Stand Trial” (2013) International Journal of Forensic Mental Health, 12:2, p 149-153
Second, JAG shows a classic OPCA-type personal profile: educated person, on state support, marijuana user, in conflict with authorities. It’s pretty unusual for someone to be institutionalized for this length of time so JAG must have engaged in some pretty over-the-top conduct. I’m going to try to track down the Ontario Review Board decision mentioned to see what occurred that led to this individual as being classified as a public threat who required detention.
And there’s that interesting, perhaps philosophical question: at what point does irrational or extreme belief become insanity that requires treatment? In many senses OPCA-type beliefs could be re-framed as analogous to religion, they require absolute belief in the primacy of certain texts, continued conduct in the face of public rejection and personal failure, these concepts are propagated by persons of elevated status whose personal failings are secondary to their perceived importance to the cause – the list goes on.
I suppose in a certain sense that is all secondary to the simple fact that if these beliefs lead to illegal conduct then state and court response is to intervene to halt and control that misconduct. Whatever the OPCA litigant believes is immaterial. Except where it leads to a harsher sentencing response due to continued rejection of government authority.
SMS Möwe