Introduction to Ontario's Health Care Laws

Ontario's Mental Health Act (MHA) and Health Care Consent Act (HCCA) are two pieces of legislation that guide mental health care and health care in the province of Ontario, Canada. The Mental Health Act (MHA) applies to psychiatric care, and provides rules and a legal process for voluntary, informal, and involuntary admissions. The Health Care Consent Act (HCCA) applies to all aspects of health care (both medical and psychiatric) and provides rules for obtaining informed, voluntary consent for treatment, and involvement from substitute decision makers.

Health Laws and Acts in Ontario

Act/Law What It Does
Mental Health Act (MHA) • Mental health/illness-related admissions (voluntary, involuntary, and informal), and rights advice, plus Consent and Capacity Board hearings.
Community Treatment Orders
Health Care Consent Act (HCCA) • Capacity determinations regarding treatment decisions, care facility admissions and personal service decisions
• HCCA presumes capacity for all ages; no age of consent in Ontario
• Rules for informed consent from capable person or SDM
• SDM hierarchy
• Emergency decisions
Substitute Decisions Act (SDA) • Legal framework for POA for personal care and property decisions and challenges to same
• Considered a piece of companion legislation to the MHA and HCCA
Patient Restraints Minimization Act (PRMA) • Minimization of patients restraints
• Clarification of legal use of restraints
Long-term Care Homes Act (LTCHA) • Applications/admission and care in long-term care homes
• Includes provisions for decision-making, secure units procedures, standard-of-care expectations, restraint use, and advanced care planning
Personal Health Information Protection Act (PHIPA) • Collection, disclosure, and utilization of personal health information
• Among persons providing health care (also known as health custodian), such as a social worker, RN, or MD, consent for release of personal health information by the patient is implied if information is used for the purposes of providing care
• Among non-health care custodians (e.g. parents, family, school, police), you need expressed consent from the patient
• Need expressed consent among health care custodians if information is used for non-health care purposes
• Capacity to consent is presumed
• For example, per PHIPA, informing a family doctor about a 14 year old who visited the ED with suicidal ideation is permitted without explicit consent, whereas, informing a parent is not.