Inquest focuses on issues of consent and capability under Mental Health Act

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Complex issues around consent and capability took the focus at a coroner's inquest into the police-involved shooting of a Windsor man.

During Day 4 of a coroner's inquest looking into the death of 33-year-old Matthew Mahoney, who was diagnosed with schizophrenia, questions were raised about what was done to get him help before his death and his capability to consent to his treatment.

His mother Brenda Mahoney told the inquest that in the months leading up to the March 2018 shooting, Matthew had stopped taking his medication, appeared to not be taking care of himself and was making strange calls to family members.

She recounted times when he was taken to the hospital to receive care but that the family was not allowed to speak with the psychiatrists and healthcare providers treating him, stating he was over the age of 18 and did not provide consent to release information about his treatment.

After his release from the hospital, she says her son stopped taking his medication because he didn't like the side effects which included vertigo and throwing up after eating.

She described him as being "intelligent and kind-hearted" when he was on his medication.

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Michael Mahoney (left) with his mother and brother, Matthew (Photo courtesy of Michael Mahoney)

The inquest also heard from Mercedes Perez with PBP Lawyers, who practices in the fields of mental health and capacity law, and is also an adjunct professor instructing the Law and Psychiatry course at Osgoode Hall Law School in Toronto. She provided a detailed explanation of the various levels of options under the Mental Health Act to seek or force treatment for a person suffering from mental illness and the process for assessment.

Perez explained to the inquest, "there's no automatic assumptions that a person diagnosed with a mental illness is incapable of making a treatment decision."

She pointed out that a doctor would have to assess capacity, and if the person is able to understand the situation and the consequences. 

"There are people diagnosed with psychotic illness who are capable of making decisions on psychotic medications," she says. "If they don't like and and don't want to take it, they don't have to."

Perez also testified you can only force the incapable to take medications, but if they're capable, you can't force them, the same as someone when it comes to cancer treatments.

"There is a threshold on ability, not on wisdom when it comes to assessing capability," she says. "Refusal does not equate with incapacity, not agreeing with the doctor is not incapacity."

When it came to questions around the Personal Health Information Protection Act, Perez told the inquest that a person detained in a hospital may be capable about who they want their personal medical information shared with, an issue she noted she deals with in a number of cases involving family members.

"If the doctor agrees they are capable, the doctor can not share with family members," she says.

Brenda Mahoney was asked if anyone ever declared him mentally incompetent or asked her to act as a substitute decision maker, to which she replied, "no."

She also speculated that he didn't want his information shared with his family because he didn't want to take his medication.

On March 21, 2018, Matthew Mahoney was shot and killed following a confrontation with police in the Dufferin Place alley, behind the McDonalds at Goyeau Street and Wyandotte Street.

Officers had been called for a report of a man carrying a butcher block with knives. Police asked him to stop but he attacked the officers instead.  Police tasered the man, but it didn't stop him and then shots were fired.

One officer was stabbed during the altercation.

Ontario's Special Investigations Unit cleared police of any wrongdoing in the case, concluding the shots fired by the officers, which struck and killed Mahoney, 'were justified'.

The inquest is scheduled to hear from 18 witnesses over 10 days.

Once all parties with standing have the opportunity to present their information and ask questions of the witnesses, the jury may make recommendations aimed at preventing future deaths from occurring in similar circumstances.