Monday, October 27, 2008


Over the past eighteen months I have used this Blog to intensively report on developments relating to Dr. Charles Smith culminating with the recently concluded Goudge Inquiry.

I am now winding up this phase of the Blog - to be replaced eventually by periodic reporting of developments relating to Dr. Smith and related issues as they occur - with an examination of Justice Goudge's findings in the cases reviewed by the Inquiry.

I think it is important to take this closer look at the report in this Blog, because the mainstream media, which has done an admirable job in reporting the inquiry, have gone on to other stories.

Justice Goudge's findings relating to the various cases have been scattered throughout the report.

My approach is to weave together the findings relating to all of the principal actors - so we can get a fuller picture of Justice Goudge's findings as to their conduct;

--An overview report prepared by Commission staff tells us that Nicholas was born in Sudbury, Ontario on January 2, 1995.

Nicholas was the child of Lianne Gagnon and Steven Tolin.

Nicholas died on November 30, 1995, in Sudbury.

Nicholas was 11 months old at the time of his death.

Criminal proceedings were not initiated.

The local children's aid society initiated proceedings in respect of Ms. Gagnon's second child, born in 1968.

The proceedings concluded on March 25, 1999 when the society withdrew the protection application;


Justice Stephen Goudge ruled in his report that: "Mr. (Maurice) Gagnon was persistent. His letters were well researched and well reasoned. Given what is now known, many of his concerns about Dr. Smith, Dr. Cairns and the Chief Coroner's Office were legitimate. Unfortunately, those in the senior positions at the Chief Coroner's Office did not listen."


You are probably right.

According to Justice Goudge, the response to Maurice Gagnon's complaint about Dr. Cairns was drafted by none other than Chief Coroner Dr. James Young who also happened to bear the title of assistant deputy minister to David Tsubouchi.

Worse, Justice Goudge concluded that Tsubouchi's response to Gagnon - as drafted by Young - was "substantively inaccurate."

According to Goudge: "The reply set out that the Chief Coroner's Office had arranged for an independent review by Dr. Case and, after receiving this opinion, had concluded that no cause of death could be established and that the means of death was undetermined."The Chief Coroner's Office had reviewed Dr. Smith's involvement, the letter continued, and had concluded that the opinion Dr. Smith came to was within a reasonable range given the facts of the case." The Chief Coroner's Office therefore considered the complaint and the underlying matter "dormant."

But Justice Goudge goes on to say that, "The Solicitor General's response to Mr. Gagnon's complaint, drafted by Dr. Young, was substantively inaccurate."

"Dr. Case directly contradicted Dr. Smith's opinion," Goudge continued.

"The Chief Coroner's Office had accepted Dr. Case's opinion that there were "no findings" to support Dr. Smith's determination of asphyxia or head trauma. Dr. Young had met with Dr. Smith to talk to him about concerns that he was "out on a limb," not "hugging the tree."

"No independent expert ever suggested to the Chief Coroner's Office that Dr. Smith's opinion in the Nicholas case fell within a reasonable range," said Goudge.

"There was therefore no basis for Dr. Young to make that assertion."