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On February 4, 1992, Bill C-30, an Act to Amend the Criminal Code of Canada (Mental Disorder), the National Defence Act and the Young Offenders Act, was officially proclaimed. The authors provide an overview of this legislation and raise some concerns regarding certain sections of the Criminal Code.
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The law which, to some extent at least, reflects contemporary mores, has not kept pace with the recent scientific advances in genetics. Because of the rate of advance in the science of genetics there is a real risk that we shall know how to change the traditional nature of man before we possess the knowledge necessary to enable us to use the new knowledge for humane purposes. Clonal reproduction may produce a creature who, for the purposes of the law, especially the criminal law, which defines when a child becomes a human being in terms of "old-fashioned" motherhood, may not be a human being, so that putting him to death may not be homicide. Similarly, in vitro fertilization and development in an artificial uterus may result in the "birth" of one who, though having human attributes, may not, in law, be a human being. While cloning and in vitro fertilization may not have immediate legal implications because of the state of the art, genetic manipulation in the form of amniocentesis has very real legal implications now because it is a matter of current practice. The assumption that detection of genetic abnormality in the foetus is a beneficial development because it enables parents to have the option of terminating the pregnancy, though valid in the United Kingdom and the United States, is invalid in Canada. Abortion on demand is not part of the law in Canada and the liberalization of the abortion provisions of the Criminal Code of Canada in 1969 expressly avoided including as a criterion for therapeutic abortion the risk that the child, if born, would be likely to suffer from such physical or mental abnormalities as to be seriously handicapped. Beyond the more technical issues raised by scientific advances, however, lies the fundamental question whether a handicapped life is a life not worth living.
Since their adoption in 1892, the insanity laws in the Criminal Code of Canada have utilized a modified M'Naughton rule. The Department of Justice began work in the 1970s to update these laws. In 1983, soon after the Canadian Charter of Rights and Freedoms was proclaimed, the case of Regina v. Swain provided the impetus for this change. In 1990 the Supreme Court of Canada struck down the old law, giving parliament a specific time to pass new legislation. Bill C-30 modernized the language of the Criminal Code and introduced a number of procedural safeguards to protect the rights of the accused.
OBJECTIVE: To evaluate the impact in British Columbia of the 1992 Criminal Code of Canada amendments dealing with remands for fitness to stand trial and not criminally responsible on account of mental disorder (NCRMD) assessments. METHOD: Information on 620 remands for evaluation of fitness to stand trial and/or NCRMD were collected from a sample obtained in British Columbia from 1992 to 1994. The data collected included length of remand order, length of evaluation, criminal charges, psychiatric diagnoses, and the decisions about fitness or NCRMD. RESULTS: Remands increased by about 20% in a 1993-1994 fiscal year compared with the previous year. The majority of evaluations continue to be conducted in an inpatient facility. The goal of a 5-day evaluation period is rarely met: only 12.5% of inpatients were released within 5 days of admission, and the average length of evaluation was about 3 weeks. The use and success of the NCRMD defence appears to be on the rise. In addition, there were some striking differences in remands from metropolitan and nonmetropolitan areas in terms of rates of referral and recommendations of unfitness or NCRMD. CONCLUSION: Results indicated that Bill C-30 has not yet had the anticipated impact on remands as inpatient evaluations continue to be the norm and evaluations typically take several weeks. Suggestions for policy reform and future research are presented.
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OBJECTIVE: Until recently, the Criminal Code of Canada, enacted in 1892, stood stalwart to social, political and technological changes, particularly with respect to the regulations pertaining to the management of the mentally ill offender. This became more definitely so with the enactment of the Canadian Charter of Rights and Freedoms (1984) as many regulations in the Code about mentally ill offenders contravened the mandates contained in the Charter. The Supreme Court of Canada's decision on Regina v. Swain spurred the Federal Government to bring the regulations on the mentally ill offender into line with the Charter. The result was the enactment of Bill C-30 which was intended to dramatically change the way in which forensic psychiatry was practised in Canada. This paper presents the Alberta findings from a multi-site evaluation commissioned by the Federal Department of Justice to judge the effects of Bill C-30 on forensic health care practices. METHODS: Health records data were used to compare utilization patterns from the year prior to the enactment of Bill C-30 with the year following. In addition, qualitative data were obtained from key clinical and legal informants outlining implementation difficulties that they had experienced. RESULTS: Results support the judgement that Bill C-30 has not achieved its desired effects with respect to the length of the remand, and has resulted in an increased burden on hospitals and health care providers. In addition, an unanticipated finding was the increased use of the Mental Health Act which was considered to place forensic patients in a position of double jeopardy.
So how do we deal with biting dogs? To start with, we must remind ourselves that biting is a natural activity of all dogs, and that there is potential for injury. All dog owners must understand this and must be made aware that they are fully responsible for the actions of their dogs. I am not convinced that this is universally understood by dog owners, nor am I satisfied that every dog owner takes the necessary steps to train and socialize their dog. Owners need to be encouraged to actively work at inhibiting biting behaviour when dogs are young. As well, all dogs should be socialized to accept children, regardless of whether or not there are children living with the dog. Adults without dogs need to learn that dogs don't understand "people's rights," and that dogs should not be expected to act differently with different people. Adults also need to understand that young children should never be left alone with a dog (or a cat) without supervision, and that all children should be taught how to behave around dogs, particulary around dogs they don't know. So long as we have dogs living with us there will be people who get bitten. The most effective way to prevent bites is to encourage dog owners to become knowledgeable about their animals and to train and socialize them so that they can become good dog neighbours. Many municipalities already have by-laws that deal with animal bites, and in Ontario the Dog Owners Liability Act has proven to be effective in confining, restraining or disposing of biting or attacking dogs judged to be a definite threat to public health and safety, and when evidence warrants, there is always Section #221 of the Criminal Code of Canada. Most legislation deals with bites after the fact. If we want to prevent all bites, there is only one sure way and that is to ban all dogs. That is of course as unrealistic as trying to prevent bites by enacting breed specific legislation.
The mistreatment and consequences of mistreatment involving medical students have only recently been recognized and studied. This article reports on the nature, frequency, and sequelae of "abuse" that is prohibited by the Criminal Code of Canada, as experienced by fourth year medical students. A 160-item, multiple choice questionnaire, the Medical Student Abuse Survey (MSAS), was administered on a voluntary and anonymous basis in February 1992 and 1993 at the University of Toronto (Canada) Faculty of Medicine. All students enrolled in their fourth year (n = 500) were eligible. Of those present when the survey was administered (n = 415), 72.5 percent (301 of 415) responded. Of all respondents, 8.3 percent (25 of 301) experienced either threats of bodily harm, assault, or assault with a weapon; 12.6 percent (38 of 301) experienced physical sexual advances; four students experienced both. Perpetrators were most often clinicians in a surgical setting. Only about one-third of these students (21 of 59) complained to someone in a position of authority within the medical school, and no one reported these incidents to the police. There is a need within medical training programs to disseminate a "code of conduct" to all parties, familiarize students with complaint procedures, and improve the identification and rehabilitation of perpetrators. The lack of objective measures for verifying students' experiences of abuse remains a limitation of this study.
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The confidentiality of patient records, particularly in cases where sexual assault is alleged, has been called into question by two recent Supreme Court decisions. Toronto lawyer Marilou McPhedran discusses the recent Beharriell and O'Connor decisions and how they affect physicians.
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