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435Weighing
Public Health and Mental Health Responses to Non-Compliance…
The outbreak of COVID-19 has highlighted and reinforced the
vulnerability of multiple populations, including people who live
with mental illness. Among the many challenges are the requirements
for physical distancing, and in the case of symptomatic persons or
suspected or positive cases, self-isolation. Mental illness does not
automatically render a person incapable of adopting such measures
or their decisions not to do so suspect. People with mental illnesses
may decide not to follow public health directives related to physical
distancing, hygiene, and self-isolation, just as other people without
mental illness may choose to do, and public health enforcement mea-
sures would apply. Here we consider how best to respond in those
cases where the symptoms of mental illness do affect a person’s
adherence to public health directives by undermining the abilities to
understand, to exercise appropriate judgment, and to evaluate risk,
among other things. Should a person whose ability to follow direc-
tives is compromised by mental illness face the sanctions and enforce-
ment procedures under public health laws? Or should a mental health
intervention such as involuntary hospitalization be pursued to protect
both the person concerned and others, as well as the community in
general? At the same time, involuntary hospitalization is an excep-
tional measure that may come with its own risks of infection, and it is
evidently a much greater deprivation of liberty than a monetary fine
for refusing to follow public health orders in the community. In this
chapter, we consider the interplay of these two legislative regimes,
recognizing that the balance may change with the evolution of the
pandemic, shifting information, risk trade-offs, and social attitudes.
Mental health legislation varies among the provinces, although
the basic underlying objectives are similar. We base our analysis on
the Ontario Mental Health Act.1 The objectives of Ontario’s law are to
protect the person with mental illness from serious bodily harm or
physical impairment; to protect others where a person poses a risk of
serious bodily harm to other people; and to facilitate treatment where
a person is incapable and is at risk of deterioration.2 Public health leg-
islation, on the other hand, aims to protect the collective health and
safety of the community as a whole. Both laws embody a trade-off
between the legislative objectives and the liberty interests of those sub-
ject to the rules and restrictions adopted to promote these objectives.
1. Mental Health Act, RSO 1990 c M.7 [MHA].
2. Thompson v Ontario (Attorney General), 2016 ONCA 676 [Thompson].
VULNERABLE
The Law, Policy and Ethics of COVID-19
- Titel
- VULNERABLE
- Untertitel
- The Law, Policy and Ethics of COVID-19
- Autoren
- Vanessa MacDonnell
- Jane Philpott
- Sophie Thériault
- Sridhar Venkatapuram
- Verlag
- Ottawa Press
- Datum
- 2020
- Sprache
- englisch
- Lizenz
- CC BY-NC-ND 4.0
- ISBN
- 9780776636429
- Abmessungen
- 15.2 x 22.8 cm
- Seiten
- 648
- Kategorien
- Coronavirus
- International