Cognitive Neuroscience and the Solicitor's Approach to Mental Incapacity

• Author: Arthur I. Fish
• Pages: 133-165



CognitiveNeuroscienceandthe

SolicitorsApproachtoMental

Incapacity

Arthur I. Fish*

Theonlypartoftheconductofanyoneforwhichheisamenabletoso-

cietyisthatwhichconcernsothe rsInthepartwhichmerelyconcern s

himselfh isindependenceisofr ightabsoluteOverhimsel foverhis

ownbodyandmindt heindividualissovereignItisp erhapshardly

necessarytosaythatthisdoct rineismeanttoapplyonlytohumanbe-

ingsinthematu rityoftheirfacultie s

JohnStuartMillOnLibert y

MightI respec tfully suggest thathad any oft hepar ties reallyc ared

aboutthe allegedly incapableper sonswel lbeing theywould have

movedheavenandearthtohavehadthismaeradjudicatedyesterday

Insteadeachinhisorherownwayhasbickeredanddelayedleading

metobelievethattheallegedlyincapablepersonsbestinterestshave

beenshovedtothebackseatwhilstotherproblem samongstthesebat-

tlingfamilymemb ershavebeenbroughttothefore

BrownJinAbramsvAbrams

 BALLBBCLOxonSJDTorontoDirectorWealthManageme ntPractice

GroupBordenLadnerGervaisLLPToronto

 ONSCatparaCanLII

AIF

 

Thispaperwhich arguest hatthelaw ofmentalcapacity isincomplete

ifit doesnot properlyincorporate medicalex pertise andpractice was

inspiredbythemeetingsofthePlanningCommieefortheLawSociety

SpecialLectur esTheCommieewascomprisedofphysiciansand

lawyersandourdiscussions highlightedareasofcommoni nterestand

thepossibilitiesforlearningf romoneanotherAlthoughorperhapsbe

causephysicians approachmental capacity muchdierently than law-

yersdo itbe camec leart hatlawyers especially solicitors couldmore

eectivelyserveclientsbyadoptingsomeofthephysiciansapproaches

Italsoseemedthatthelawofmentalcapacitycouldbeimprovedbytak-

ingintoaccountsomeofthendingsofthedisciplinecalledcognitive

or behavioural neuroscience As a practical maer lawyers require

theassist anceof medicalprofessionals inaddressing dicult issuesof

mentalcapacityandinhelpingusdealeectivelywithclientswhomay

lackcapacityMoreimportantlylawasadisciplineisunabletodeneor

describementalincapacity ina practicallyuseful waywithoutdraw-

ing on brain science.

Thispaperisaimedprimarilyatlawyerswhopracticeasplannersor

counselorsadvisorsnotascourtro omadvocatesTherei sconsider-

ableoverlapbetweentheissuesthatconfrontmedicalprofessionalsand

advisorsin servingp eoplewhomaylack mentalcapacityForthisrea-

sonadvisors probablyhavemore tolear nfrom medical professionals

than docourtroom advocatesFurthermore advisorsworkw ithcourt-

roomlawyersonmentalcapacityissuesinmuchthesamewayashealth

careprofessional sdoThe quality ofthe workdonei nthe advisorsor

thephysiciansocewilloendeterminewhichcasesgiveri setolegal

disputes and in whose favour those disputes are resolved Byt aking

judicious account of medical practice and brain science advisors can

beerequipt hemselvestospare atleastsome clientsthekindof intra

familylitigationthatisbecomingmorecommoninOntarioscourtsand

thatsoarousedJusticeBrownsireintheAbrams cas e.

There is nothing new in lawyerphysician collaboration Indeed

OntariosSubstituteDecisionsActSDA emergedfrom twopolicy

docume ntsthatcon sideredtherespectiverolesoflawa ndmedicalsci-

 Ibid.

 SOcasamendedSDA].

 OntarioFinalRepor toftheAdvisoryCommieeonSubstituteDeci sionMakingforMen

tallyIncapablePersonsTorontoTheAdvisoryComm ieeFramReportand

OntarioEnquiryonMentalComp etencyFinalReportTorontoTheEnquir y

CognitiveNeuroscienceandtheSolicitorsApproachtoMentalIncapac ity

enceinformulatinga ndadministeringt helawofmentalcapacityBoth

the FramReport and the WeisstubReport considered whethermenta l

capacityisamedicaloralegalconceptanddecidedinfavourofthelat-

terpositionInadditionWeisstubgavelengthyanddetailedaentionto

themedicalliterature oncapacityandcapacityas sessmenttothepoint

ofincorporating inhis reporta scholarlyresponse tocertai nviewsad-

vancedbyoneofthemedicalexpertswhohadbeenretainedtoassistthe

en qu i r yEachdocumentrecognizedthepossibilityt hatthelawofmen-

talcapacitycou ldbecomeavehicle fordrawingvu lnerablepeopleinto

protracteda ndunnece ssary litigationand assumed thatt hisoutcome

couldbeavoidedbymeansofproceduralrights FramReportorbyof-

fering an intermediate form of substitute decision ma king the Con-

tinuingPowerofAorneyforPropertyandthePowerofAorneyfor

PersonalCa rethat inst antiated the principleof the least restrictive

alternativeWeisstub ReportTheideai sthat aperson whoisincap-

ableofmakingdecisionsregarding his ownpropert yor personalca re

maystillbecapableofappointingadecisionma kertodosoonhisown

behalf. Abramsandahostofsimi larcasescertai nlysuggestiftheydo

notdecisivelyestablishthattheseexpectationsa ndthemodelorpara-

digmofthoughtfromwhichtheyemergedweremisplacedandmustbe

correctedinthelightofexperiencea ndnewresearch

Threepointsemergewithpa rticularforceinconsideri ngwhymen-

talcapacitylitigationtoooenbecomesnastybrutishandlengthyeach

ofwhichwill beconsideredinthe secondandthird partsofthis paper

Thesethreepointscanbestatedsummarily

Firstmentalcapacityis notjustastandardto protectindividuallib-

ertyfromunwarrantedinterventionratheritisanunfortunatecondition

orstate thata ictssome humanb eingsAn assessment ofmental cap-

acitydoesnotmakeapersonincapablebutonlyconrmsorrefutesth ee xi st-

enceofaparticular stateofbeingMoresimplyincapacityissomethi ng

WeisstubReportForfurthere laborationofthisapproac htomentalcapacitysee

alsoAllenEBuch ananDanWBrockDecidingforOthersT heEthicsofSurrogate

Decision MakingCambridgeCambr idgeUniversityPressandArthurFish

MichelSilberfeldW hentheMindFailsAGuidetoDealingwithIncompetencyTo-

rontoUniversityofTorontoPress

 SeeFramReportibidatandandWeisstubReportibidat

 SeeFramReportibidat andandWeisstubReportibidat

andandespecially

 SDAabovenotessandandcompareFramReportibidatandWeisstub

Reportibidatespeciallyat

 Banton vBantonCanLIIOntSCFeng vSungEstateCanLII

OntSCChu vChangCanLIIOntSC