The aim of this chapter is to go back to the basics on consent to treatment, starting with the right to refuse and building from there. Part II addresses the leading judicial statements on the value of medical self-determination, and in light of these statements, considers what is at stake in psychiatric treatment choice. Part III explores the three core elements of valid consent to treatment -- namely that consent be voluntary, informed and capable -- with attention to variation in the law amongst provinces and territories, and some lines of analysis and critique specifically applicable to mental health care contexts. Part IV considers new directions in law and policy clustering around the concept of supported decision-making – a concept forged through domestic and international disability rights advocacy, which urges fundamental re-examination of the interrelationship of legal capacity, autonomy and distributive justice.