Ontario judge finds that psychiatric patients were tortured

An Ontario judge has found that psychiatric patients at the Oak Ridge division of the Penetanguishene Mental Health Centre (today the Waypoint Centre for Mental Health Care) endured gross violations of their human dignity and human rights and were tortured both mentally and physically while detained.

The case was a multi-plaintiff proceeding commenced in 2000 by a group of patients at Oak Ridge for incidents that occurred between 1966 and 1983 in the Social Therapy Unit.  The plaintiffs alleged that  “in the interests of research, [the defendants] engaged in degrading and abusive human experimentation that could not be justified on medical or scientific grounds and that had severely deleterious effects on the patients at Oak Ridge”.  The defendants plead that the Social Therapy Unit was a therapeutic community based on principles recognized in psychiatry at the material time.  They described the programs in the Social Therapy Unit as “predicated on the concepts that patients needed to undergo self-discovery and to take responsibility for their own behaviour”.

Three therapy programs were impugned in the case.  The first was called Defence Disruptive Therapy (DDT).  In this program, patients were administered combinations of hallucinogenic, delirium producing, psychosis producing, or mind-altering drugs including combinations of alcohol, dextroamphetamine, LSD, methedrine,  nozinan, ritalin, scopolamine, and sodium amytal.

The second program was titled the Motivation, Attitude, Participation Program (MAPP).  In this program, patients lived under strict rules and were required to study and write examinations on interpersonal communications.  A patient was prohibited from leaving the program unless he had completed 14 days without unauthorized talking or movement.  Disruptive Oak Ridge patients were forced to sit on a bare Terrazzo floor with their feet straight out in front of them.  Their hands were cuffed or placed in front.  They were confined to a space of approximately three square feet in which they could move only four times in a four-hour session.  Standing was not permitted.  Failure to comply with non-movement orders and other commands resulted in verbal confrontation, restraints, solitary confinement or heavy chemical sedation.

The third program was called the Capsule Program.   As described by Justice Perell in his reasons for decision, in the Capsule Program “the patient was placed in a specially constructed, soundproof, windowless, but continuously lighted room, eight feet by ten feet in size, furnished only with a soft rug over a foam floor. There were washing and toilet facilities, which consisted of an open toilet and wash basin, but no towels were provided. Beds were not provided, and the patients slept on the floor. A group of up to seven patients were confined in the room to remain for many days at a time. The patients were totally removed from contact with the outside world. They were stripped nude and often chained to one another. They were fed through liquid food dispensers – four straws through the wall – and received no solid foods. They were drugged with Dexamyl, Tofranil, LSD, and other hallucinogens. The room was continuously lit, and the patients were temporally disoriented and sleep deprived. The room was under constant observation, either through a one-way mirror in the ceiling or by closed circuit television with a high-quality audio amplifying system.”

Justice Perell found that “to experimentally administer drugs to patients in the manner of the DDT program or to punish them in the manner of the MAPP program or to strip them, drug them, chain them nude one to another, feed them only liquids through a straw through a wall, deprive them of sleep and confine them for extended periods of time in a crowded continually lit room with no privacy and with a humiliating location for their personal hygiene and health for the purpose of changing their personality and behaviour in the manner of the Capsule program is to grossly violate their human dignity and human rights and to torture them both mentally and physically.

Justice Perell found that the plaintiffs’ treatment constituted breach of fiduciary duty and an “obliteration” of the Hippocratic Oath.

He noted that regardless of the medical and professional standards at the material time “[w]hat happened at Oak Ridge from 1966 to 1983 was a situation in need of the special protection that equity affords. If the professional standards at the time justified patients being tortured as being humane treatment, this is precisely the circumstance where equity historically would be engaged because the common law is inadequate to respond to wrongdoing. As Justice McLachlin observed in Norberg v. Wynrib, equity is capable of protecting not only narrow legal and economic interests, but can also serve to defend fundamental human and personal interests. As Justice La Forest observed in McInerney, equity will intervene to protect the patient from an improper exercise of the physician’s discretion.”

The proceeding will now continue to address issues of harm, causation and damages.

The full decision can be accessed here.

Media coverage is available here.