Doctors fight scope of inquest into death of Ashley Smith

Ashley Smith is shown in this still image taken from a coroner's video.

TORONTO -- Doctors who treated a deeply troubled teenager are fighting the scope of a coroner's inquest into her death in an Ontario prison cell five years ago, The Canadian Press has learned.

Documents show the three doctors -- two psychiatrists and a general practitioner -- argue the presiding coroner's plans are unconstitutional because they include events that occurred outside Ontario.

The challenge threatens to further delay the already much-delayed proceedings and has infuriated the family of Ashley Smith, which argues medical professionals are trying to escape scrutiny of their role in the tragedy.

"It is a certainly a shock to the family that Ashley Smith's caregivers would be at the heart of a challenge to inquiring into her therapeutic care," said family lawyer Julian Falconer. "What a sad state of affairs."

Smith, 19, of Moncton, N.B., spent the past 11 months of her life being shuttled from one prison to another in various parts of the country -- much of it in solitary confinement.

She choked to death on a strip of cloth in her cell at the federal Grand Valley Institution for Women in Kitchener, Ont., in October 2007 after numerous episodes of self-harm.

Her family says her death was accidental.

In a lengthy decision on scope, presiding coroner Dr. John Carlisle said the effects of long-term solitary confinement and Smith's repeated transfers -- 17 times in under a year -- are among issues that must be explored.

Smith suffered severe mental illness, was classified as suicidal, and repeatedly used ligatures in near-fatal self-strangulation, Carlise said.

As a result, he said, the probe needed to look at areas including the role of her mental-health care and how authorities managed her.

"Where her custodians are unable to stop those behaviours or respond to them in a way which prevents death, it seems clear that the circumstances of the death give rise to the need for recommendations which might assist the system to avoid such a deaths in future," Carlisle said.

The decision made it clear the coroner was cognizant of the jurisdictional issues he faced.

However, the three Ontario doctors -- Loys Jane Ligate, Carolyn Jean Rogers and Dr. Sam Swaminath -- maintain Carlisle exceeded his constitutional authority "by purporting to investigate matters outside the borders of the province of Ontario."

Supported by the Correctional Service of Canada, they are pressing to narrow the scope of the inquest, something Ontario's child advocate Irwin Elman said makes no sense.

"All the people who were points of protection, points of care, including the medical profession around her -- we need to look at how they did or did not support her," Elman said.

"Every day now that passes without us actually getting to the heart of what happened in her short life -- and learning from it and doing her honour in that way -- extends the tragedy."

The doctors' lawyer did not immediately return a call seeking comment, while inquest counsel said she would have more to say late Friday when the challenge comes before Carlisle.

Falconer said various doctors -- including those outside Ontario -- signed off on transferring Smith "like so much cattle" and called the challenge "offensive."

"Obviously, those responsible for her treatment have very serious questions to answer," Falconer said.

"It is a shock to the family that caregivers, who should have an interest in having this fully dealt with, would intervene at this very late stage and threaten to derail this process."

This is the second inquest called into Smith's death. The first one collapsed last year amid legal wrangling and the abrupt resignation of the coroner.

Among previously contested issues was the release of videotapes from a Quebec prison showing Smith being given injections without her consent and medical staff apparently threatening her with further injections.

The new hearing was slated to begin formal hearings Jan. 13, 2013 and the doctors want Carlisle to delay issuing summonses to out-of-province witnesses until the jurisdictional issue is dealt with.

Inquests into deaths in federal institutions are common, and observers said the jurisdictional challenge appears to be unprecedented.