A brilliant physicist who has spent four years in a pyschiatric institution rather than submit to forcible medication has won his bid to refuse drug treatment.
The Supreme Court of Canada ruled 6-3 on Friday that an Ontario board that determines the capacity of mentally ill people overstepped its powers when it ordered that Scott Starson be treated without his consent.
The court said the board strayed into forbidden terrain by substituting its own view of what was best for Mr. Starson. It said Mr. Starson was clearly aware that he was ill when he refused treatment.
"The board's reasons indicate that it strayed from its legislative mandate, which was to adjudicate solely upon the patient's capacity," Mr. Justice Jack Major wrote for the majority.
"The wisdom of the respondent's treatment decision is irrelevant to that determination. The Board improperly allowed its conception of the respondent's best interests to influence its finding on capacity."
The court largely confined itself to the facts of Mr. Starson's case, making no reverberating pronouncements on issues such as whether the case involved any unconstitutional elements.
Mr. Starson was transferred several weeks ago from the Pentetanguishene Mental Health Centre to the Royal Ottawa Hospital. While psychiatrists cannot forcibly medicate him, they can continue to hold him indefinitely under the Mental Health Act.
Mr. Starson's mother, Jeannie Stevens, said she is "devastated" by a ruling that will keep her son trapped forever.
"He has always fooled the greatest minds and he has done it again," she said in an interview. "I'm devastated because I've lost my son, and my son has lost his dreams.
"How can the Supreme Court hope to rule on a human being without having seen the person himself; without really and truly understanding the effects of his illness on his family and his society? It's beyond me."
In an interview several weeks ago, Mr. Starson moved from one topic to another in an unconnected manner.
"Your Supreme Court — and I mean no disrespect by this — is Little League," he said at one point. "The Supreme Court does not have solutions. They report to me."
Mr. Starson's life reads like a blended plot summary from the films A Beautiful Mind and One Flew Over the Cuckoo's Nest. While he concedes a history of mental troubles, he had remained adamant that being locked up for life is preferable to being medicated by psychiatrists intent on "improving" his life.
He contends that the medication he has been given in the past to combat his bipolar condition slows his thinking, dulls his inspiration and makes him appear disoriented.
A co-author of several articles on physics published in scholarly journals, he is accepted as a peer by many physicists who have written endorsements of his abilities and corresponded with him.
Mr. Starson earned degrees in engineering and computer programming, but his passion for physics led him into regular contact with professors in Toronto and the United States.
Several physicists have also written testimonials to Mr. Starson's ability.
"Our species is making every effort possible to communicate with your species and explain a situation to you," Mr. Starson said in the interview. "The Supreme Court of Canada certainly has no choice. They have been operating illegally. These are not my appeals. They are your appeals."
Anita Szigeti, a lawyer appointed to give arguments as a "friend of the court," said recently that an adverse ruling would likely have made it impossible for anyone to refuse treatment.
On the other hand, she said, a positive ruling "would be a victory for all patients — past and future — who may want to retain control over their bodies."
Mr. Starson's mother does not agree. She views her son as a man with a marvellous future that can never be realized unless he is medicated.
"He has absolutely no insight into his situation," she said recently. "He can rationalize anything. He always insists that he isn't crazy, you are."
While Mr. Starson has been in and out of psychiatric hospitals for years, this stint is by far the longest. It commenced after his arrest for threatening a neighbour in 1998.
(While Mr. Starson has issued threats regularly over the years, his only act of violence was when he unsuccessfully fought off psychiatric nurses injecting him with antipsychotic medication after his arrest.)
After a judge ruled at his 1998 trial that he was not criminally responsible for uttering death threats, Mr. Starson was declared incapable of consenting to treatment and was sent to Penetanguishene.
He appealed unsuccessfully to the Ontario Consent and Capacity Board a year later. The board asserted that Mr. Starson's life had been devastated by his disorder: "The patient's denial is almost total."
When Mr. Starson appealed again, the tide turned in his favour. Madam Justice Anne Molloy of the Ontario Superior Court overturned the board's decision, ruling that it had been based on unacceptable conjecture and subjectivity.
The Ontario Court of Appeal upheld her ruling.
The pivotal question for the Supreme Court was whether Mr. Starson understands his disorder enough to make rational decisions concerning treatment.
To Mr. Starson, it presented a classic Catch-22. By admitting to a serious illness, he left himself open to being treated against his will. But denying it allowed psychiatrists to conclude that he lacked insight — enabling them to treat him forcibly.
"Being 'normal' would be worse than death for me, because I have always considered normal to be a term so boring it would be like death," he remarked bitterly during one hearing.