Date: 20101220
Docket: T-973-09
Citation: 2010 FC 1312
[UNREVISED ENGLISH
CERTIFIED TRANSLATION]
Ottawa, Ontario, December 20, 2010
PRESENT: The
Honourable Mr. Justice Boivin
BETWEEN:
RICHARD
HARNOIS
Applicant
and
ATTORNEY
GENERAL OF CANADA
Respondent
REASONS FOR JUDGMENT AND
JUDGMENT
[1]
This
is an application for judicial review under section 18.1 of the Federal
Courts Act, RSC 1985, c F-7, of two decisions by the Director of the
Correctional Service of Canada. The first decision, dated June 10, 2009, was to
assign to the applicant the Correctional Service of Canada’s institutional
clinician. The second decision, dated June 11, 2009, was to cancel a visit
by members of the applicant’s family.
[2]
In
this application, the applicant is asking this Court to declare that he had a
right to see his attending physician during his incarceration and that
cancellation of the visit was unreasonable.
Facts
[3]
The
applicant has a number of medical conditions, including HIV/AIDS and Hepatitis C.
[4]
On
December 2, 2009, the applicant finished serving a sentence of three years and
nine months for a series of robberies to which he pleaded guilty.
[5]
He
served most of his sentence at the La Macaza Institution where Dr. Jean
Robert provided his care.
[6]
On
August 29, 2008, the applicant was given statutory release.
[7]
Dr. Robert
continued to treat the applicant during his release.
[8]
On
April 29, 2009, the applicant’s statutory release was suspended by the Correctional
Service of Canada (CSC). He was then reincarcerated at the Leclerc Institution
in the Postsuspension Unit for breaching the conditions of his release.
[9]
Leclerc
Institution is a medium-security federal correctional institution located in Laval, Quebec. Leclerc
Institution provides a number of programs, including living skills, substance
abuse treatment, violent offender treatment and educational programs.
[10]
When
the applicant was reincarcerated he was receiving treatment for
Hepatitis C under a payment authorization from the Régie de l’assurance maladie
du Québec for an initial phase from September 8, 2008, to April 22, 2009, which
was to be extended for a total of 48 to 72 weeks, in the circumstances.
[11]
When
the applicant arrived at Leclerc Institution on April 29, 2009, he was
interviewed by a nurse, Johanne Gagnon, who checked the medication the
applicant was taking while he was in the community.
[12]
The
institutional clinician at Leclerc Institution is Dr. Michel Breton, and
on occasion Dr. Jacques Bélanger.
[13]
On
June 10, 2009, the applicant was taken to the Centre hospitalier Cité de la Santé
in Laval for
exploratory neurological testing. That decision was made by Dr. Michel Breton.
It was based on the fact that the applicant seemed to be experiencing
neurological complications with symptoms resembling Gilles de la Tourette Syndrome, but with an
unknown medical diagnosis.
[14]
There
is a contractual agreement between the CSC and the Centre hospitalier Cité de
la Santé in Laval to provide
incarcerated inmates with a continuum of health care, when necessary. A secure
room at the Centre hospitalier Cité de la Santé in Laval is therefore
made available to the CSC in the event that inmates must remain in hospital, as
was the case for the applicant.
[15]
On
June 11, 2009, while the applicant was a patient at the Centre hospitalier
Cité de la Santé in Laval, he received permission for a visit from
members of his family: Isabelle Harnois and Stéphane Deslandes. However, before
the visit took place, Geneviève Thibault, Deputy Warden of Leclerc Institution,
read an observation report written by a correctional officer who was doing
surveillance of the secure room where the applicant was hospitalized. The
report stated that the correctional officer heard the applicant on June 10,
2009, speaking with a member of his family on the telephone about having
tobacco brought into the institution during the scheduled visit to the hospital.
[16]
When
she read the report, on the afternoon of June 11, 2009, Ms. Thibault cancelled
the special visit on June 11, 2009, in view of the risk of
tobacco (unauthorized item) being introduced that the visit presented.
[17]
On
July 8, 2009, the applicant was released as a result of a decision of the National
Parole Board.
Relevant
statutory provisions
[18]
The
relevant statutory provisions are set out in the Annex.
Issues
[19]
In
the opinion of the Court, the application for judicial review raises the
following issues:
1.
Is the
decision of the CSC dated June 10, 2009, and reiterated in the letter of
June 11, 2009, providing that Dr. Jean Robert could not be the
applicant’s clinician during his incarceration at Leclerc Institution
reasonable?
2.
Does
that decision violate the applicant’s rights under sections 7, 12 and 15 of
the Charter?
3.
Is the
decision of the CSC dated June 11, 2009, to cancel the special family visit
reasonable or does it violate the principles of procedural fairness?
4.
Does
that decision violate the applicant’s rights under sections 7, 12 and 15
of the Charter?
Standard of review
[20]
In
this case, both decisions were made in a penitentiary context and the
decision-maker has expertise in penitentiary management. The decision-maker
must protect the inmate while having regard to a paramount consideration, the
protection of society. The decision-maker must also comply with CSC directives.
A decision to cancel an inmate’s visit relates to the safety of inmates and
visitors. In both cases, it is essentially a question of fact, and the
applicable standard of review is reasonableness.
[21]
In Dunsmuir v New Brunswick, 2008 SCC 9, [2008] SCJ No 9, at paragraph 47,
the Supreme Court of Canada defined reasonableness as follows:
[47] Reasonableness is a deferential standard animated by the principle
that underlies the development of the two previous standards of reasonableness:
certain questions that come before administrative tribunals do not lend
themselves to one specific, particular result. Instead, they may give
rise to a number of possible, reasonable conclusions. … A court
conducting a review for reasonableness inquires into the qualities that make a
decision reasonable, referring both to the process of articulating the reasons
and to outcomes. In judicial review, reasonableness is concerned mostly
with the existence of justification, transparency and intelligibility within
the decision-making process. But it is also concerned with whether the
decision falls within a range of possible, acceptable outcomes which are
defensible in respect of the facts and law.
[22]
The
decision-maker’s decisions are essentially based on that person’s expertise and
involve a question of fact, or at most a question of mixed fact and law, and
the applicable standard of review is therefore reasonableness. In these
circumstances, the Court must show deference.
[23]
With respect to the procedural fairness issues
raised, it is now settled law that the applicable standard is correctness.
Analysis
(a) Section 302
of the Federal Courts Rules
[24]
At
the hearing before this Court, the respondent argued that the applicant’s
application for judicial review raises two issues rather than just one, and
therefore violates Rule 302 of the Federal Courts Rules. Rule 302
reads as follows:
GENERAL
…
Limited
to single Order
302. Unless the Court orders otherwise, an application for
judicial review shall be limited to a single order in respect of which relief
is sought.
|
DISPOSITIONS GÉNÉRALES
[…]
Limites
302. Sauf ordonnance contraire de la Cour, la demande de
contrôle judiciaire ne peut porter que sur une seule ordonnance pour laquelle
une réparation est demandée.
|
[25]
One
of the appropriate remedies for failure to comply with Rule 302 would be
for this Court to grant an extension of time to enable the applicant to file an
application for judicial review nunc pro tunc in relation to another
decision (Pfeiffer v Canada (The Superintendent of Bankruptcy), 2004 FCA
192, [2004] FCJ No 902). However, after reviewing the record and hearing the
parties, although the Court is of the opinion that the two decisions that are
part of this application for judicial review are separate, they are nonetheless
sufficiently related in the circumstances. Having regard to the facts in the
record, they are sufficiently part of a continuum that this Court may hear them
in a single judicial review proceeding.
(b) Is the decision of the CSC dated June 10, 2009, and
reiterated in the letter of June 11, 2009, providing that Dr. Jean
Robert could not be the applicant’s clinician during his incarceration at
Leclerc Institution reasonable?
[26]
It
should be noted at the outset that paragraph 2(c) of the Canada
Health Act provides that an inmate in a federal penitentiary is no longer
covered by the public health care plan. Accordingly, the CSC takes on
responsibility and has an obligation to provide every inmate with essential
health care and reasonable access to non-essential mental health care that will
contribute to the inmate’s rehabilitation and successful reintegration into the
community (ss. 85 and 86 of the Corrections and Conditional Release Act).
[27]
The
CSC therefore acts as a sort of insurer and to some extent as a hospital. To
provide inmates with health care, CSC penitentiaries have a health department. The
CSC employs doctors who provide health care to inmates in penitentiaries. The
doctors employed fall into two categories: those who are retained on contract
as consultants and those who are hired as attending physicians to treat inmates
in institutions (institutional clinician).
[28]
Under
Commissioner’s Directive 800 concerning health services (CD 800), the
institutional clinician is the physician responsible for prescribing treatment
and medication for inmates. A consultant makes recommendations to the attending
physician.
[29]
It
should also be noted that paragraph 4(e) of the Corrections and
Conditional Release Act (CCRA) provides that inmates retain the rights and
privileges of all members of society, except those rights and privileges that are necessarily removed or restricted as a consequence
of the sentence. Accordingly, the courts have held that certain Charter
rights of inmates are restricted because of incarceration, and this is the
case, in particular, for the expectation of privacy (Weatherhall v Canada (Attorney
General), [1993] 2 S.C.R. 872).
[30]
In
this case, the issue of health care in a penitentiary takes centre stage.
[31]
When
the applicant arrived at Leclerc Institution, he was interviewed by a nurse who
assessed his health needs. She checked the medication the applicant had been
taking while he was in the community. By checking prescriptions, the
institution can make sure that the doses prescribed are appropriate. This procedure
also ensures that doses are not being used to meet needs associated with drug
addiction or for trafficking within the penitentiary (CD 800 and Affidavit of
Martin Turcotte, Respondent’s Record at page 216).
[32]
Next,
Dr. Michel Breton, the institutional clinician, prescribed a substitute
for the applicant’s medication in accordance with the CSC’s pharmacological
formulary. As the respondent explained at the hearing, the CSC’s
pharmacological formulary is a national formulary that contains a list of medications
the CSC funds as part of the essential medical care provided to inmates. The
respondent also correctly observed that the national pharmacology committee
recommends following the prescriptions for medications included in that
formulary (Affidavit of Martin Turcotte, Respondent’s Record at pp. 216-217).
Some of the doses prescribed to the applicant before he was incarcerated at Leclerc
Institution are not included in the CSC’s pharmacological formulary.
[33]
The
CSC has adopted guidelines for treating the hepatitis from which the applicant
suffers. It appears that the guidelines are consistent with recognized Canadian
standards in this area and the CSC expects the health professionals who provide
these services to comply with the guidelines (Affidavit of Hélène Racicot, Respondent’s
Record at page 2).
[34]
The
applicant alleges that the institution refused to allow Dr. Jean Robert to
provide care to him. The correspondence in the record actually confirms that
there was no objection to Dr. Robert being given temporary privileges in
order to provide the applicant with care, by contacting Dr. Breton, the
institutional clinician, to discuss it and obtain the approval of the attending
institutional clinician, in this case Dr. Breton (Respondent’s Record at
pp. 343, 348, 351 and 353 and the letters of June 19 and June 29,
2009, from Eric Lafrenière to Isabelle Turgeon). The Court is of the opinion
that this procedure complied with the provisions in issue, and in particular
with paragraph 4(a) and section 86 of the CCRA and CD 800.
The evidence also shows that the CSC stopped using Dr. Robert’s services
because of failure to comply with the guidelines for treating viral hepatitis (Affidavit
of Hélène Racicot, Applicant’s Record at page 2).
[35]
The
applicant also argued that his treatment was interrupted by Dr. Breton while
he was incarcerated. The Court is of the opinion that there is no evidence that
the doses administered by Dr. Breton violated the standards of the
profession, as argued by the applicant. The evidence in the record actually
shows that Dr Breton and the physicians at the institution made consistent
decisions and occasionally expressed doubts as to the applicant’s medical
complaints. For example, Dr. Breton stopped the Statex on the basis that
the applicant seemed to be concealing his narcotic in his mouth. There were
therefore doubts as to whether the applicant was using the medication to
relieve the alleged pain or instead using it as contraband within the
institution (Applicant’s Record at pp. 16 and 18 and Affidavit of Martin
Turcotte, Respondent’s Record at page 217).
[36]
Accordingly,
the decision not to continue ribivarin-interferon treatment in the applicant’s
case, in light of the recommendations of a specialist consultant in that area, Dr. Marc-André
Gagné, was reasonable (Affidavit of Dr. Michel Breton, Respondent’s Record
at page 220 and document entitled “Management of Chronic Hepatitis C:
Consensus Guidelines,” Respondent’s Record at pp. 259, 265, 267, 268 and
270). In addition, the evidence shows unequivocally that the applicant accepted
the decision to interrupt his treatment for Hepatitis C (Applicant’s
Record at page 197; s. 88 CCRA).
[37]
In
fact, there is nothing in the record to show that Dr. Breton’s medical
opinion was incorrect, unreasonable or not consistent with the standards
recognized by medical practice, as the applicant attempted to show. Rather, it
is apparent that Dr. Breton exercised his professional clinical judgment
by ensuring that the applicant received essential care within the meaning of
section 86 of the CCRA (Powell v Canada (Attorney General), 2004 FC
1304, [2004] FCJ No 1566). The Court therefore does not accept the applicant’s
allegation that the treatment was [TRANSLATION] “botched”.
[38]
In
addition, the Court notes that the applicant filed no complaint or grievance
(s. 90 of the CCRA; Brian Raymond Stauffer v John Cosby, T-1677-09,
January 28, 2010, order of Prothonotary Roger F. Lafrenière).
[39]
The
applicant’s arguments lead to a central argument: essentially, that an inmate
is entitled to have access to a physician of his choice because there are no
provisions in the CCRA or the Corrections and Conditional Release
Regulations (Regulations) that restrict that right.
[40]
The
Court is of the opinion that if Parliament had intended to allow an inmate to
have access to a physician of his of her choice, it would have clearly said so.
In the circumstances, the analogies with provincial law proposed by the
applicant have limits. In general, although there is a right to universal
health care, that right is not an absolute right for the general public and
there is nothing in the CCRA that suggests otherwise for inmates. The scheme
put in place by Parliament through the CCRA, which applies to penitentiaries,
confirms that the institutional clinician is in fact the guardian of the
statutory mandate assigned to the CSC.
[41]
In
the circumstances, the Court concludes that the decision made by the
institution, to have the applicant treated by the institutional clinician, Dr. Breton,
is reasonable. The decision falls within a range of possible, acceptable
outcomes which are defensible in respect of the facts and law (Dunsmuir).
[42]
In
view of the answer to question 1, it is not necessary for the Court to
dispose of the second question.
(c) Is the decision of the
CSC dated June 11, 2009, to cancel the special family visit reasonable or does
it violate the principles of procedural fairness?
[43]
The
Court notes that while the applicant was incarcerated he was taken to the Centre
hospitalier Cité de la Santé in Laval for assessment, to
complete his file. At that time, neither Dr. Breton nor Dr. Robert seemed
to know the source of the applicant’s neurological problem (Respondent’s Record
at page 343).
[44]
While
he was at the Centre hospitalier Cité de la Santé in Laval, a visit was
scheduled for June 11, 2009. Before the visit on June 11, 2009, was
cancelled, it had been allowed on a special basis because the visitors were not
on the visiting list.
[45]
The
applicant submits that the decision to cancel the visit is unreasonable and
violates the principles of procedural fairness because it was made on the same
day as the scheduled visit. The applicant further submits that he was informed
of the decision to cancel the visit when his visitors had already left.
[46]
The
Court cannot agree with the applicant’s arguments.
[47]
First,
the decision by Ms. Thibault to cancel the visit was based on the
observation report by a correctional officer who heard the applicant in a
telephone conversation with his potential visitors discussing the possibility
of introducing unauthorized items, and specifically tobacco (Respondent’s
Record at page 208). She learned of that information on the afternoon of
June 11, at about 2:45 p.m. That was when the decision to cancel the
visit was made.
[48]
The
applicant submits that Ms Thibault had an obligation under section 91 of
the Regulations to inform him promptly of the reasons for her decision and give
him an opportunity to make representations with respect thereto. The applicant
also submits that Ms. Thibault failed to comply with the Regulations
because the applicant was informed of the decision at about 6:00 p.m.,
when his visitors had already left the hospital.
[49]
Having
regard to the circumstances and the context in which the decision to cancel the
visit was made, the Court is of the opinion that, given the safety concerns,
Ms. Thibault’s decision is reasonable, for the following reasons:
-
tobacco
is an unauthorized item and is a subject of safety concerns, given the
contraband problem in institutions (Directive 259);
-
it
is not possible to strip-search visitors and monitor inmates adequately in
hospital, and possible exchanges between inmates and their visitors, as can be
done in a penitentiary;
-
it
is not possible in this hospital to limit the visit to a window visit;
-
there
is no reason to doubt that operationally it was not possible at that precise
time to post a correctional officer who would sit between the visitors and the
applicant;
-
Ms. Thibault
had little time to manage the risk between the time when the correctional
officer’s report was communicated to her and the time of the visit.
[50]
In
light of the foregoing, the Court is also of the opinion that the facts in this
case do not support the applicant’s argument that there was a breach of
procedural fairness.
[51]
A
few days later, after a reassessment of the risk was done, Ms. Thibault authorized
a special family visit with the applicant. The visit took place on June 20,
2009.
[52]
Accordingly,
based on safety concerns and information relayed to her on the afternoon of
June 11, 2009, and having regard to the fact that the visit was scheduled
to take place in a hospital centre and not in a penitentiary, the Court
concludes that Ms. Thibault’s decision is reasonable, that it complies
with the Regulations and Directive 770 concerning visiting and that it
does not violate the principles of procedural fairness.
[53]
In
view of the answer to question 3, it is not necessary for the Court to
dispose of question 4.
[54]
For
all these reasons, the Court dismisses the application for judicial review.
JUDGMENT
THE COURT
ORDERS AND ADJUDGES that the application be
dismissed with costs.
“Richard
Boivin”
Certified
true translation
Susan
Deichert, Reviser