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ecause it was futile and of no medical value. The Ontario Court of Appeal held that withdrawalof life support is a ‘treatment’, and that the matter should be decided by the Consent andCapacity Board. There are serious questions to be addressed here as to whether or not anadministrative tribunal is the appropriate forum for the resolution of disputes between physiciansand families at the end of life; the decision will also have important ramifications for incapablepatients generally who depend on a substitute decision-maker to safeguard their health andautonomy. A corollary issue in this case is the interpretation of the ‘best interests’ test, raisingimportant questions about quality of life. Ordinarily, an individual’s choice to refuse treatmentwould be respected, but those who suffer from depression or a similar diagnosis of mental illnessmay not have the same freedom, being more likely to be found to be incapable.Off-label Uses of Drugs: Knowledge Deficits and the Standard of CarePatricia Peppin, Queen’s University (peppinp@queensu.ca)Drugs are approved for use in certain populations and for certain purposes. These limits on usesreflect the testing conducted prior to regulatory approval. Physicians, though, may prescribebeyond these approved uses for other uses, populations, combinations and delivery systems.Such discretion provides a means of introducing further innovation into treatment in a situationwhere safety and efficacy data have been produced and approval granted. What are the risks ofsuch off-label uses? The central risk rests on the inadequacies of knowledge in the fullpopulation for which the product will be used. For example, use of antidepressants in adolescentswas such an unapproved use. Regulatory bodies limit promotion of off-label uses due to itspotential to provide a sense of certainty where unknowns exist and to expand the range ofadverse effects. How should physicians determine their legal obligations in this situation? Inparticular, the standard of care for treatment must be met, as must disclosure of risks andbenefits. The paper will examine this question in relation to the standard of care in other relatedsituations, such as research participation and end-of-life decision-making where the prognosis ishopeless.18. Building a Bio-Psycho-Social Response to Intimate PartnerViolenceViolence and the Brain: Biological Mechanisms that Underlie Violent andAggressive BehaviorKatherine Wyper, University of Alberta (kwyper@ualberta.ca)One of the important factors underlying violent, impulsive, and aggressive behaviour is brainfunctioning. A neuroscientific perspective may be taken to understand and possibly even predict49