Supreme Court of Canada
Coulombe v. Watier, [1973] S.C.R. 673
Date: 1972-11-22
Maurice Coulombe (Defendant) Appellant;
and
Armand Watier (Plaintiff) Respondent.
1972: November 3; 1972: November 22.
Present: Fauteux C.J. and Abbott, Martland, Hall and Pigeon JJ.
ON APPEAL FROM THE COURT OF QUEEN’S BENCH, APPEAL SIDE, PROVINCE OF QUEBEC
Damages—Detention in mental institution—Physician’s responsibility—Mental Patients Institutions Act, R.S.Q. 1964, c. 166, s. 10.
Respondent had been under the care of the appellant who is a psychiatrist and had been hospitalized on several occasions. Following a visit by respondent’s wife and daughter, informing the appellant that he was having seizures and was threatening to kill his wife and children and commit suicide, appellant prepared and signed a document recommending respondent’s hospitalization in a mental institution. After a medical certificate had been signed before witness by a doctor in the institution attesting that respondent was suffering from psychopathy and recommending his admission, the superintendent signed a form attesting to the necessity for the respondent to be hospitalized. A municipal judge issued an order for conveyance and constables took respondent to the hospital. He was provisionally released the next day and, following certain tests, was given his final discharge. He is claiming damages from the appellant for having unjustifiably caused him to be detained. On appeal a majority judgment held that the appellant was not justified in writing the document in question without making some further inquiry and quoting the opinion expressed in a judgment of separation, reversed the judgment of the Superior Court and condemned appellant to pay damages to the respondent. Hence the appeal to this Court by special leave.
Held: The appeal should be allowed.
The document signed by the appellant was not the certificate required by law for respondent’s hospitalization. This further certificate was signed by another doctor, who did not do so merely on seeing appellant’s opinion, but after carrying out his own investigation. It was he who took the responsibility for officially requiring hospitalization.
As to the opinion expressed in the judgment on the separation action, appellant was not a party to those
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proceedings. To invoke against him an opinion expressed on his conduct by a judge who did not have to judge it, in preference to that of the judge who heard the evidence submitted in the present case, is in conflict with fundamental rules of justice.
APPEAL from a judgment of the Court of Queen’s Bench, Appeal Side, Province of Quebec, reversing a judgment of the Superior Court dismissing the action. Appeal allowed.
Hunter Wilson, Q.C., for the defendant, appellant.
Jules Bernatchez, for the plaintiff, respondent.
The judgment of the Court was delivered by
PIGEON J.—This appeal, brought with leave of this Court, is against a decision of the Court of Appeal of Quebec, which, with Casey J. dissenting, reversed a judgment of the Superior Court dismissing respondent’s action, and ordered Maurice Coulombe, a psychiatrist, the appellant in this Court, to pay the sum of $1,500 in damages for having unjustifiably caused him to be detained for twenty-four hours in a mental institution.
Respondent is a judo instructor. In 1956 he was hospitalized for several days at the Neurological Institute with a history of cephalalgia and fainting spells since 1954. Bitemporal epilepsy was diagnosed and medicine prescribed, to be used indefinitely. In March 1959 he placed himself under the care of appellant. In 1960 his condition had deteriorated. He was hospitalized on two occasions in 1961, for about a week each time. Towards the end of 1963 he told the psychiatrist he was looking for an excuse to kill himself. In July 1964 the psychiatrist noted: [TRANSLATION] “Visit by husband and wife. She doesn’t want him to do any more judo. He teaches women as well, she admitted she was jealous…” The next months there were two more visits in which matrimonial difficulties were the main concern. On the latter the doctor wrote: [TRANSLATION] “Impossible to say defi-
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nitely what is the husband’s fault and what is his wife’s fault. Each has his own version…” On April 10, 1965, respondent’s wife went to see Dr. Coulombe with one of her daughters, to tell him that respondent was having seizures, that he was threatening to kill his wife and children and commit suicide, and that he had tried to choke his wife. On June 23, 1965, appellant prepared and signed a document reading as follows:
[TRANSLATION] Mr. Armand Watier is under my care in the outpatients’ clinic of the Enfant-Jésus Hospital. He suffers from temporal cephalalgia (losses-blackouts). Previously examined at the Montreal Neurological Institute. Spoke of suicide on several occasions during interviews—I have not seen him again for several months, but his wife and daughter came several times and even telephoned me to say they feared the worst. He apparently becomes delirious, at times deluded and very jealous. Refuses to come and see me at the outpatients’ clinic, as he thinks I am deceiving him with his wife. I feel it is urgent to hospitalize this patient whom I have every reason to believe to be dangerous at the present time.
N.B. Precautions necessary in apprehending him: he is a Black Belt, 2nd dan.
(signed) Maurice Coulombe
At the Saint-Michel-Archange Hospital Dr. Laurent Tremblay examined this document, received the information supplied to him by respondent’s wife and daughter, and completed and signed before a witness a medical certificate on the form prescribed under the Mental Patients Institutions Act, R.S.Q. 1964, c. 166, s. 10, of which provides:
10. No hospital shall receive a patient unless there be lodged with the superintendent:
(a) a certificate, signed before a witness, by a physician having the right to practice in the Province and who is neither related nor allied to the patient, attesting that the latter is suffering from psychopathy and recommending his admission to an institution for the mentally ill;…
The patient shall not be brought to the hospital nor may he be received therein without the authorization of the superintendent.
Dr. Tremblay concluded his medical certificate as follows: [TRANSLATION] “In view of these statements and of these symptoms which I
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attribute to psychopathy, I recommend that this patient be placed under observation in a specialized institution”. The medical superintendent thereupon signed a form attesting that it was necessary for respondent to be hospitalized as soon as possible, a judge of the municipal court issued an order for conveyance and constables went to apprehend respondent at the school where he was teaching and took him to the hospital. He was provisionally released the next day, and on June 28, following certain tests, was given his final discharge.
After citing s. 10 of the aforementioned Act, the trial judge stated:
[TRANSLATION] The question is therefore whether defendant was justified in attesting, according to the words of Exhibit P-4, that plaintiff was suffering from psychopathy, and in recommending his admission to an institution for the mentally ill.
Defendant is a psychiatrist and holds certificates from the Province of Quebec and the Royal College of Physicians. He is head of the psychiatric department at the Enfant‑Jésus Hospital. Dr. Coulombe stated that plaintiff’s subjective symptoms corresponded to the clinical symptoms, i.e. that the behavioural disorders which plaintiff complained of to Dr. Rabinovitch and himself could be related to the left temporal epileptic irregularities revealed by tests. In cross-examination Dr. Coulombe stated that epilepsy is a serious illness, with or without convulsions, and its effects could in certain cases be controlled by suitable medication; on the other hand, he stated that while he was treating the plaintiff his condition fluctuated, but he had not recovered. Defendant diagnosed paranoid behaviour in the plaintiff, particularly noticeable with regard to his family.
It is interesting to note that in 1966, at the time of the medical examination carried out by Dr. Libman, the tracing of the electro-encephalogram still showed a left temporal irregularity, and that in the words of this doctor:
“In comparison with the tracing of 1958, there is no significant improvement.”
This means that at the time Mrs. Watier and her daughter told Dr. Coulombe about plaintiff’s aggressive behaviour and the threats he was making,
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defendant knew that he was dealing with a patient whose cerebral disorders were not cured, as such could have been the case with a mere nervous breakdown, after treatment. It was in fact an illness which could at most be controlled by the proper medication (to the extent that the patient followed the orders of the doctor).
Knowing plaintiff’s medical history, did defendant commit a fault in accepting the statements of Mrs. Watier and her daughter? The Court does not think so. It is true that plaintiff’s wife is a nervous and excitable person, but the Court has no reason to reject her testimony, or that of her daughter, who is now married and lives away from the family surroundings.
…
It is true that husbands are often driven to attacks on the person of their wives or children, without however being subject to mental illness: these are simply cases of brutality or uncontrolled acts in anger. It is equally true that such misconduct is often caused by impairment of the mental faculties. For his part, Dr. Coulombe stated in all good faith that he felt there was danger in doing nothing: “I acted for his (Watier’s) sake, and for his family.”
…
It should be noted that all the facts stated in certificate P-4 are substantially correct, and that the Superintendent of the Saint-Michel-Archange Hospital himself found them sufficiently serious to order that plaintiff be hospitalized. While it is true that plaintiff was finally discharged from the hospital on June 28, it does not follow, in view of the aforementioned evidence, that defendant was at fault in requesting that he be hospitalized.
On appeal Montgomery J., with whom Turgeon J. concurred, said:
Before us, Appellant reproaches Respondent principally for his readiness to accept the statements made by Mrs. Watier without making any attempt to verify them. Respondent’s professional competence is unquestioned, and there is no suggestion of bad faith on his part. On the other hand, I find it difficult to understand his failure to make any independent verification of the statements made by Mrs. Watier or as to the necessity for Appellant’s forcible confinement. It is true that Appellant’s medical history was such as to make it possible that his condition might
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deteriorate to the point where he could become dangerous, although there was no record of his malady having induced any violent conduct in the past. On the other hand, Respondent knew Mrs. Watier to be neurotic and should have allowed for the possibility of exaggeration on her part. His statement in the first sentence of his letter that Appellant “est suivi par moi” appears misleading when we consider that Respondent had seen him for the last time in November 1963, nearly two years before, apart from the visits with his wife in the summer of 1964, nearly a year before.
In the past Appellant had been generally cooperative as a patient, yet Respondent made no direct attempt to communicate with him, contenting himself with sending messages to him through Mrs. Watier. In view of the deteriorating relations between husband and wife, it is perhaps not surprising that these messages did not produce any positive result. I therefore doubt that Respondent was justified in declaring in his letter that Appellant was refusing to see him. I agree with the judge who heard the separation action, who commented on Respondent’s conduct as follows (at p. 434):
[TRANSLATION] He stated he had every reason to regard him as dangerous, on the basis, he said, of interviews he had had with him in previous years. This statement is, to say the least, astonishing, for is it reasonable, even for a psychiatrist, to authorize the confinement of a person whom he has not seen for two years?
There is no evidence of any change in the situation that took place in June to justify Respondent’s sudden decision. It is possible that an explanation of his precipitate action may be found in the fact that he was about to take a holiday. (V. his examination on discovery, at p. 26.) Whatever the cause, I am of the opinion that he was not justified in writing the above letter without making some further inquiry and that he is therefore responsible for the damages caused by Appellant’s confinement, which was the direct and predictable result of the delivery of this letter to Mrs. Watier.
With respect, it seems to me that this conclusion does not take into account the fact that the document signed by Dr. Coulombe was not the certificate required by law for the respondent to be hospitalized. For that another certificate was needed, signed by a doctor on the prescribed
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form. This further certificate was signed by Dr. Tremblay, who did not do so merely on seeing Dr. Coulombe’s opinion, but after carrying out his own investigation. By not completing the official form Dr. Coulombe was ensuring that another doctor would have to give an opinion. This other doctor’s action cannot be treated as a mere formality. It was he who took the responsibility for officially requiring hospitalization. It is true that this other doctor was not called to testify, but the document signed by him was included in the record, and counsel for the parties agreed at the start of evidence to admit that if the doctors were summoned, they would say what is contained in their reports.
As to the opinion expressed in the judgment delivered on the separation action, I would say with respect that it was an error to rely on it in the present case. In that case the husband’s complaint against his wife was precisely of having had him committed. She, on the other hand, alleged grievous insults and her cross-demand was for that reason allowed with costs. The principal action was equally allowed, but without costs because [TRANSLATION] “defendant could have some justification for acting in this manner”. The learned judge obviously formed these conclusions on the basis of the evidence presented before him in that case, to which Dr. Coulombe was not a party. Consequently, nothing said there can be evidence against him. His counsel correctly objected to the judgment given in the other case being produced, and to invoke against him an opinion expressed on his conduct by a judge who did not have to judge it, in preference to that of the judge who heard the evidence submitted in the present case, is in conflict with fundamental rules of justice.
For these reasons I would allow the appeal, reverse the decision of the Court of Appeal and restore the judgment of the Superior Court dis-
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missing the action, with costs in all Courts against the respondent.
Appeal allowed with costs.
Solicitors for the defendant, appellant: Lafleur & Brown, Montreal.
Solicitors for the plaintiff, respondent: Lazorovitch, Bernatchez, McNicoll & Levasseur, Quebec.