AAPL Practice Guideline for the Forensic Psychiatric Evaluation of Competence to Stand Trial: a Canadian legal perspective.

Canadian legal tests of fitness to stand trial, while similar to tests in the United States, place less emphasis on rational understanding of the complexities of the trial process and greater emphasis on communicating with legal counsel. The limited cognitive capacity test has gained wide acceptance in Canadian jurisprudence as a balance between ensuring that an accused person can provide the necessary information to allow his legal counsel to defend him adequately while also minimizing the potential delay in a speedy trial. The tests have been criticized by organized psychiatry and legal scholars but have been supported by advocacy groups for the mentally ill. Canadian research on accused persons committed to hospitals for fitness evaluations suggests that this process may be used or, arguably, misused by psychiatrists to provide treatment to persons who would otherwise be inaccessible to psychiatric intervention. This raises complex ethics-related questions not yet fully addressed.