The Starson Case

[HA]

Mentally ill genius who took case to top court was starving himself
The Ottawa Citizen Ottawa, Ont.: May 18, 2005. pg. A.1.Fro
Juliet O'Neill

Mentally ill genius who took case to top court was starving himself

Scott Starson is being nursed back from death's door with anti- psychotic drugs that the Supreme Court ruled he had the right to refuse two years ago.

Authorities at the Royal Ottawa Hospital quietly went back to legal bodies for authorization to treat him for mental illness after he refused to eat or drink for many weeks. "He was dying, losing all capacity to carry on, and we could not, as a hospital, stand by and watch," said hospital spokeswoman Kathryn Hendrick yesterday.

Jeanne Stevens, mother of the 49-year-old man who has been described in court documents as "extraordinarily intelligent," and been likened to John Nash of A Beautiful Mind fame, is absolutely thrilled.

"They felt that this was not what the Supreme Court wanted, that Scott should die," Mrs. Stevens said yesterday. "The nurse says he looks like a stick."

Mr. Starson, a once-strapping 6-foot-one man who weighed 175 pounds, is down to 118 pounds.

Mrs. Stevens, who lives in Toronto, said that after more than a week on medication, her son is said to be eating, bathing daily, responding to others and is less indecisive and paranoid. The last time she saw him four months ago, "I was devastated. He didn't even know where he was."

Jim Allin, director of forensic programs for the Royal Ottawa Health Care Group, said the Ontario Consent and Capacity Board agreed with psychiatrists that Mr. Starson was incapable of making treatment decisions and an Ontario court subsequently rejected Mr. Starson's appeal of that decision. He said treatment began a few days ago.

"He could appeal to a higher court but in the interim the appeal gives us the right to go ahead and treat legally," Mr. Allin said.

"I'm really glad, really pleased to see he's undergoing treatment now. We were concerned. Somebody who has stopped eating and taking in enough fluid, it's not a very long period of time before your fluid and electrolyte balance can be impacted and then of course your mental condition deteriorates worse and your physical condition can put your life at risk.

"He was in very bad shape for a while," Mr. Allin added. "We were actually having to take him out to other hospitals because we were concerned about his physical condition and had that assessed."

Mr. Starson is detained at the Royal Ottawa's forensic facility in Brockville, the third facility in which he has lived since he was declared not criminally responsible for uttering death threats in 1998. He suffers from shizo-affective disorder, a combination of schizophrenia and manic depression and he has not taken medication for nearly a decade.

Although he has no formal training, he has been lauded by some scholars for his physics writing. In the case that went to the Supreme Court he told a lower court that he did not want to take medication because it made his mind too foggy to work. In June 2003, the Supreme Court, in a 6-3 decision, upheld his right to refuse medical treatment for his mental illness.

John Gray, head of the Schizophrenia Society of Canada, hailed the treatment of Mr. Starson now as "good news."

[HA]

Court decision saves life of mentally ill man; [Final Edition]
Juliet O'Neill. Standard - Freeholder. Cornwall, Ont.: May 18, 2005. pg. 19

OTTAWA - Scott Starson is being nursed back from death's door with anti-psychotic drugs that the Supreme Court ruled he had the right to refuse two years ago.

Authorities at the Royal Ottawa Hospital quietly went back to legal bodies for authorization to treat Starson for mental illness after he refused to eat or drink for many weeks.

"He was dying, losing all capacity to carry on and we could not, as a hospital, stand by and watch," hospital spokeswoman Kathryn Hendrick said Tuesday.

Jeanne Stevens, mother of the 49-year-old man who has been likened to John Nash of "A Beautiful Mind" fame, is relieved.

"They felt that this was not what the Supreme Court wanted, that Scott should die," Stevens said Tuesday. "The nurse says he looks like a stick."

Starson, a once-strapping six-foot-one man who weighed 175 pounds, is down to 118 pounds.

Starson is detained at the Royal Ottawa's forensic facility in Brockville, the third facility in which he has lived since he was declared not criminally responsible for uttering death threats in 1998. He suffers from &*@^&*)-affective disorder, a combination of schizophrenia and manic depression and he has not taken medication for nearly a decade.

Although he has no formal training in physics, he was lauded by some scholars for his scientific writing. In the case that went to the Supreme Court, he told a lower court that he did not want to take medication because it made his mind too foggy to work.

Jim Allin, director of forensic programs for the Royal Ottawa Health Care Group, said the Ontario Consent and Capacity Board agreed with psychiatrists that Starson was incapable of making treatment decisions and an Ontario court subsequently rejected Starson's appeal of that decision. He said treatment began a few days ago.

"He could appeal to a higher court but in the interim the appeal gives us the right to go ahead and treat legally," Allin said. "I'm really glad, really pleased to see he's undergoing treatment now. We were concerned. Somebody who has stopped eating and taking in enough fluid, it's not a very long period of time before your fluid and electrolyte balance can be impacted and then of course your mental condition deteriorates worse and your physical condition can put your life at risk.

"He was in very bad shape for a while," he said. "We were actually having to take him out to other hospitals because we were concerned about his physical condition and had that assessed."

Stevens' mother, who lives in Toronto, said that after more than a week on medication her son is said to be eating, bathing daily, responding to others and he is less indecisive and paranoid.

[HA]

Treatment of Starson worries his lawyer: [Final Edition]
Juliet O'Neill. The Ottawa Citizen. Ottawa, Ont.: May 19, 2005. p. C.1.Fro

Lawyer Anita Szigeti said this week she is concerned Mr. [Scott Starson] did not have proper legal counsel at a hearing by the Consent and Capacity Board, and she questioned whether doctors needed to treat his mental illness in order to save him from hunger and dehydration. "There's always the ability to intervene in an emergency," she said.

Hospital officials revealed this week that they had been treating Mr. Starson with anti-psychotic drugs for a week, after quietly securing a ruling from the Consent and Capacity Board that Mr. Starson was not capable of consenting to or refusing treatment. It was a similar ruling in 1998 that Mr. Starson successfully appealed to the highest court.

The new board ruling contains medical testimony that Mr. Starson stopped eating and drinking because of paranoid delusions that hospital staff were trying to poison him. It says Mr. Starson also suffers from competing auditory hallucinations, one in which a harsh father-like voice tells him that doctors and nurses are trying to poison him and the other a soft, appealing voice that tells him to co-operate.

She believes there were other ways to deal with his refusal to eat than forcing him to take medication, writes Juliet O'Neill.

A lawyer who has long helped in Scott Starson's fight against forced medication says she is troubled by some of the procedures that have led Royal Ottawa Hospital authorities to treat him with anti-psychotic drugs on grounds he might otherwise starve to death.

Lawyer Anita Szigeti said this week she is concerned Mr. Starson did not have proper legal counsel at a hearing by the Consent and Capacity Board, and she questioned whether doctors needed to treat his mental illness in order to save him from hunger and dehydration. "There's always the ability to intervene in an emergency," she said.

However, Ms. Szigeti had not consulted Mr. Starson, so she declined to say whether he will, as some hospital staff fear, try to re-fight the case in the Supreme Court, which upheld his right to refuse treatment two years ago.

Mr. Starson, 49, has been described in court documents as "extraordinarily intelligent" and been likened to John Nash of A Beautiful Mind fame. But the latest ruling in his case quotes psychiatrist Neil McFeely saying he has not written any scientific papers since the middle 1980s, "and was now totally incapable of doing so."

Hospital officials revealed this week that they had been treating Mr. Starson with anti-psychotic drugs for a week, after quietly securing a ruling from the Consent and Capacity Board that Mr. Starson was not capable of consenting to or refusing treatment. It was a similar ruling in 1998 that Mr. Starson successfully appealed to the highest court.

The new board ruling contains medical testimony that Mr. Starson stopped eating and drinking because of paranoid delusions that hospital staff were trying to poison him. It says Mr. Starson also suffers from competing auditory hallucinations, one in which a harsh father-like voice tells him that doctors and nurses are trying to poison him and the other a soft, appealing voice that tells him to co-operate.

"Between these two voices the harsh, dismissive one always wins out," said testimony from Dr. McFeely.

An appeal of the Feb. 19 board ruling was dismissed by the Ontario Superior Court in Brockville on May 10 and treatment was immediately started with permission of his substitute decision- maker, Mr. Starson's mother, Jeanne Stevens, said hospital lawyer Greg Kelly.

Mr. Kelly said this is not an attempt to overrule the Supreme Court.

"It's a different diagnosis than before and, as I understand it, it entails different treatments," he said. "It's on its own merits. When I went before the Consent and Capacity board, he was dying. The anticipation was that he had maybe days, very short days."

Dr. John Bradford, chief forensic psychiatrist for Royal Ottawa Hospital, said in an interview that "in general terms, people that have severe psychiatric illness go into emergency situations where they stop eating and drinking, and unless you treat the mental illness, there can be mortality involved in it."

The board ruling, written by vice-chairman Mark Handelman, said he is generally opposed to going ahead with a hearing when a patient is representing himself.

"The right to counsel is integral to our system of justice. However, the right to counsel is not absolute."

He had balanced that right against Mr. Starson's right to, and need of, medical intervention. It was clear his "physical health had reached a state of crisis."

Mr. Starson, who lives at the Royal Ottawa's Brockville facility, was ordered into psychiatric detention six years ago after he was found not criminally responsible for uttering death threats.

[David Baxter]

Honestly, I have to question whether "Lawyer Anita Szigeti" is acting in Mr. Starson's best interests or in her own.

The physicians have intervened to save the life of a man with a serious mental illness who was not capable of making informed decisions on his own. Ms. Szigeti intervenes on a matter of legal principle (I'm being generous) to prolong a case in which she is earning a fee for every phone call made and interview granted.

I think I know who I trust to make the better decision...

[HA]

Since I'm speaking in public, I won't say what my thoughts are about Ms Szigeti. I did attend a panel presentation with her, a rights advisor, a lawyer who is pro involuntary treatment and a psychiatrist, at the recent Family Matters conference. This panel talked about both sides of this very political issue. Szigeti publically degraded psychiatrists. She is very invovled with Consent and Capacity Baords and will keep psychiatrists tied up for 3 days at times with these hearings. She is very adversarial in her practice of the law!

Th Starson case was a precedent setting case based on errors in technicalities as related to law and procedure. This man was too ill and a risk to society to be let free but could not be treated against his will. This meant a lifetime of hospitalization for this man. Szigeti and other rights activists hailed this as the greastest step forward for those with mental illness. Family members including myself saw it as the next thing to a death sentence for those with a severe and persistent psychotic illness. Being imprisoned by psychosis is a life of suffering.
The outcome of this case is an example of that very suffering.

This case was publicized world wide when it first happened. These articles here about this outcome, are the only 3 articles published anywhere including Canada.

The way I see it......schizophrenia is no longer an illness of health. It is an illness of politics.

Makes me sad.

[David Baxter]

It makes me sad too. I watched the patient advocacy movement in the 70s and 80s emasculate psychiatry and medicine in the name of protecting civil rights, giving us our current revolving door version of mental health treatment.

I just can't see how the patients have benefitted from this. I can see how people like Szigeti benefit, but I think it gross hypocrisy for them to claim they are helping anyone but themselves.

[Cat Dancer]

At what point does one lose the right to make decisions like this for oneself?

[David Baxter]

At the point where one is too ill to be able to make rational informed decisions. There is a protocol to be followed before anyone can be designated "involuntary" and then such a decision must be reviewed at set intervals, the first one being after 72 hours usually.

[HA]

BPH patient gets transfer

A Brockville Psychiatric Hospital patient, known for winning the right not to be medicated only to suffer a severe regression in his psychosis, has been granted a transfer to Toronto.

The Ontario Review Board on Thursday said Scott Schutzman, also known by the last name of Starson, will be transferred to the provincial capital, though a date was not specified.

Schutzman, a former physicist from Toronto, asked for the transfer at a hearing held August 16.
He will initially be sent to the Centre for Addiction and Mental Health in Toronto. However, he will be allowed to live in the general community in Toronto if approved to do so by psychiatric staff responsible for him there.

Schutzman has said he wants to restart his career. He has said he will take medication to battle his problems with schizophrenia and bipolar disorder, even though the medication slows his thinking process.

In the community, Schutzman would need to report to a supervisor at least once every two weeks, abstain from non-medical drugs, alcohol and other intoxicants, and be subject to urine testing.

Until he is transferred to Toronto, Schutzman can obtain 24-hour passes for supervised visits within a 350-kilomtre radius of Brockville. Police are to be advised when he is at large.
Schutzman has been in psychiatric institutions for eight years after being held not criminally responsible for uttering death threats.

He was seen as a hero in some circles after winning the right not to be medicated from the Supreme Court of Canada in 2003.

However, in late 2004 he became so delusional he nearly starved himself to death. He refused all food and drink out of fear he was being poisoneded.

[foghlaim]

"She is very adversarial in her practice of the law!" sounds to me like she may also be delusional\psychotic... just like her client Starson. Wonder if she is on any meds to keep it\herself under control..

does it really matter whether the docs intervened to save his life because he was delusional or because he was starving himself... the end result of his behaviour was going to be his dying.. This lawyer i think needs to re-evaluate her priorities and maybe see a therapist.

nsa