Case information

Charter of rights — Health law — Consent to care — Patient in vegetative state unable to consent to care — Patient’s sister refusing care plan proposed for patient by respondent institution — Respondent applying for and obtaining authorization to cease life-sustaining treatment and administer only palliative care to patient — Whether the ensuing death of the patient was unlawful and a violation of his Charter rights —Whether the courts had jurisdiction to order an authorization to cease life-sustaining treatment when the patient had previously expressed his wish to receive life-sustaining treatment — Whether the appeal proceedings were unfair — Whether the Court of Appeal erred in dismissing the motion for stay of execution — Whether the application for leave to appeal raises an issue of public importance.

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The applicant, N.G., held a notarial protection mandate which authorized her to consent to any care required by the state of health of her brother (“patient”) in the event of his incapacity to consent to such care. In early 2024, the patient was hospitalized in the intensive care unit at the respondent Montreal University Health Center (MUHC). In early May 2024, the MUHC applied for an order of authorization of care with respect to the patient as both he and the applicant were refusing to consent to the care plan proposed by his treatment team. The Superior Court granted the order and the proposed care plan was implemented. The patient’s condition improved, but in late May 2024 he suffered a cardiac arrest which resulted in an anoxic brain injury. He was readmitted to intensive care but never regained consciousness. Given his vegetative state and his doctors’ opinion that he would not recover, it was recommended that life-sustaining treatment be discontinued and palliative care provided for his comfort. The applicant refused to consent to any change in care.

In September 2024, the MUHC applied for an authorization to implement the new recommended care plan, notwithstanding the applicant’s refusal. The Superior Court determined that the patient was incapable of giving consent and that the applicant’s refusal of the care plan was unreasonable and unjustified. The judge concluded that the proposed care plan was in the patient’s interests because it offered more advantages than disadvantages and would allow him to live out the remainder of his life with dignity and minimal suffering. He authorized the implementation of the care plan until the patient’s passing.

The applicant appealed. The Court of Appeal found that the judge had not committed any reviewable error and dismissed the appeal. An application to the Court of Appeal for a stay of execution of the judgment pending an application for leave to appeal to the Supreme Court of Canada was also dismissed.

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