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148 MANITOBA LAW JOURNAL |VOLUME 35 NUMBER 1
defence, as set out in the Code, if he was to commit a crime in that
condition.
ii) The person afflicted is aware of his condition and has been
successfully medicated such that adhering to the medication
schedule as prescribed will put him into a “stable phase”. 16 The
stable phase renders him lucid and competent so as to negate the
relevant effects of the disease of the mind and able to appreciate the
nature and quality of his acts and know when they are wrong. He
would, therefore, not have the NCR defence available to him if he
were to commit a crime at this stage. This point is critical because if
the person, despite proper adherence to medication, was still left
with significant aspects of the “diseased mind” such that he never
ceased to be NCR, then any exacerbation of his condition can still
be attributed to the condition itself, and thus all of his actions
would remain under the protection of the NCR defence.
iii) While the person is lucid and competent in his stable state, he fails
to take his medication, which he knows, either from experience or
from being told by a health care professional, is likely to result in a
worsening of his mental condition. Specifically, he must know that
he may lose the ability to tell right from wrong, that he may suffer
from serious hallucinations, lose touch with reality, etc.
iv) Subsequently, as a result of discontinuing the medication, he
returns to a disordered state such that he again has a disease of the
mind and would again potentially qualify for the NCR defence.
v) The person commits a crime at this stage while he has a disease of
the mind and cannot appreciate the nature or quality of the act nor
does he know the act is wrong.
It would be useful at this stage to outline the standard treatment process
which a mentally disordered person might face. This information pertains
specifically to people with schizophrenia, as this paper deals primarily with cases
concerning that mental disorder. Other mental disorders with similar
symptomologies and treatment structures would fall under the proposal of this
paper as well.
First, there is the “acute phase”, wherein psychotic symptoms begin to
manifest themselves. Patients may seek treatment at this point and emphasis is
16
Pharmacotherapy, “Clinical Practice Guidelines for Treatment of Schizophrenia” (2005) 50:S1
Can J Psychiatry, 19S at 20S. Schizophrenia is broken down into three stages: acute, stabilizing,
and stable. At the stable phase, the person is as stable as their medication can make them.
Although the term applies to schizophrenia somewhat uniquely, for convenience, I will use the
term “stable phase” to denote all analogous periods in other mental disorders, wherein the
person is similarly and effectively medicated so as to leave them legally competent.