The risks of treatment versus no treatment should be examined. The measure of competency should be whether the individual to receive care understands and appreciates the implications of the issues above. Criteria for measuring competency should be explained to the individual. Refusal to consent should not be deemed evidence of an inability to understand or a part of symptomatology. Rather it may be an act of self determination and freedom, particularly in the context of a potentially coercive institutional environment.
All individuals have the right to a second opinion.
Steps should be taken to determine whether a type of advance health care directive exists, and, if so, every effort made to honour it. The opportunity to develop an advance health care directive should be made available to all people across Canada. All individuals should have the right to appoint a person who should make fully informed decisions on their behalf in case of the individual's incompetency. In the instance of incompetency the decision - maker appointed by the individual should be the first person approached for a fully informed consent. If such a person has not been appointed, legal processes shall be used to obtain consent.