Croke v. Smith (No. 2)
In the matter of a reference pursuant to Article 40.4.3 of the Constitution
Sean Croke
Applicant
and
Charles Smith, Art O'Connor, Eastern Health Board, Ireland and The Attorney General, Respondents (No. 2)
[S.C. No. 272 of 1995]
Supreme Court
Constitution - Personal rights - Liberty - Person of unsound mind - Detention of person to whom chargeable patient reception order made - Discharge by proper authority - Whether administration of justice - Type of inquiry required - Mental Treatment Act, 1945 (No. 19), s. 172 - Mental Treatment Act, 1961 (No. 7) - Constitution of Ireland, 1937, Article 40.1, Article 40.3.1 and Article 40.4.
Statute - Validity - Presumption of Constitutionality - Whether statutory provision constitutional - Mental Treatment Act, 1945 (No. 19), s. 172.
Article 40.4.3 of the Constitution provides that:-
"3. Where the body of a person alleged to be unlawfully detained is produced before the High Court in pursuance of an order in that behalf made under this section and that Court is satisfied that such person is being detained in accordance with a law but that such law is invalid having regard to the provisions of this Constitution, the High Court shall refer the question of the validity of such law to the Supreme Court by way of case stated . . ."
Pursuant to s. 162 of the Mental Treatment Act, 1945, application may be made by designated persons to registered medical practitioners for recommendations for the reception and detention of persons of unsound mind in district mental hospitals.
Section 163 (2) sets out the contents of a recommendation for reception.
Section 71 of the Act of 1945 provides for the examination of the person by the resident medical superintendent of the hospital and the making or refusal of a chargeable patient reception order.
Section 172 of the Act of 1945 provides as follows:-
"(1) Where a chargeable patient reception order is made, any of the persons mentioned in subsection (2) of this section may receive and take charge of the person to whom the order relates and detain him until his removal or discharge by proper authority or his death and, in case of his escape, retake him within twenty-eight days thereafter and again detain him as aforesaid.
(2) The persons entitled to receive, take charge of, detain, and retake a person under this section shall be -
(a) the mental hospital authority maintaining the district mental hospital mentioned in the relevant chargeable patient reception order,
(b) the resident medical superintendent of such hospital,
(c) the other officers and the servants of such hospital."
Section 218 of the Act provides for the removal or discharge of chargeable patients who have recovered within 7 days of the giving of notice under the section.
Section 220 provides for the discharge of a chargeable patient upon the application of a relative or friend to take care of the patient.
Section 221 provides that a patient shall not be discharged where a written certificate has been given by the resident medical superintendent that the person is dangerous or otherwise unfit to be discharged. It further provides that where an objection is made to the certificate by or on behalf of the person to whom it relates, the Minister may require the Inspector of Mental Hospitals to examine the person and the Minister may, after consideration of the report of the Inspector of Mental Hospitals, direct the discharge of the person.
Section 222 of the Act provides that the Minister may, on application by any person, order the examination of a person detained in a mental institution by two registered medical practitioners and if they certify such person may be discharged without risk of injury to himself or others, the Minister may direct the discharge of such person.
Section 237 of the Act, as amended by s. 33 of the Act of 1961, provides, inter alia, that the Inspector of Mental Hospitals ". . . notify the person in charge of the institution that he has doubts as to the propriety of such patient's detention".
Section 239 provides that the Inspector of Mental Institutions shall notify the Minister if the detention requires further consideration and the Minister may require a further visit and report by the Inspector and may, after consideration of such report, direct the discharge of the patient.
Section 241 of the Act of 1945 provides:-
"The President of the High Court may by order require and authorise the Inspector of Mental Hospitals to visit and examine any person detained at any place as a person of unsound mind and to report to the President of the High Court on the condition of such person."
Section 266 of the Act of 1945 as amended by s. 36 of the Act of 1961 provides:-
"Any letter addressed by a patient in a mental institution to the Minister, the President of the High Court, the Registrar of Wards of Court, a mental hospital authority, a visiting committee of a district mental hospital, or the Inspector of Mental Hospitals shall be forwarded unopened."
Upon application for an inquiry pursuant to Article 40.4.2 of the Constitution as to the lawfulness of the applicant's detention in the Central Mental Hospital, the High Court (Budd J.) being satisfied that the applicant's detention was in accordance with the provisions of the Mental Treatment Act, 1945, as amended, and in particular s. 172 of that Act, but that such law was invalid having regard to the provisions of the Constitution, referred to the Supreme Court by way of case stated, pursuant to Article 40.4.3 of the Constitution the question of the validity of s. 172 of the Act of 1945 having regard to the provisions of the Constitution.
Held by the Supreme Court (Hamilton C.J., O'Flaherty, Blayney, Denham and Barrington JJ.), in answering the case stated, 1, that s. 172 of the Act of 1945 empowered the person set forth in sub-s. 2 thereof to deprive a person, in respect of whom a chargeable patient reception order had been made, of his liberty. The purpose of s. 172 of the Act of 1945 was to provide for the detention of persons of unsound mind who were certified to be proper persons for detention under care and treatment.
2. That in considering the constitutionality of a law passed by the Oireachtas, the Court must (i) grant to the impugned provision the presumption of constitutionality unless and until the contrary was clearly established; (ii) not declare the impugned provision to be invalid where it was possible to construe it in accordance with the Constitution; (iii) favour the validity of the provision in cases of doubt; and (iv) have regard to the fact that the presumption of constitutionality carried with it not only the presumption that the constitutional interpretation for construction was the one intended by the Oireachtas but also that the Oireachtas intended that proceedings, procedures, discretions and adjudications which were permitted, provided for or prescribed by an Act of the Oireachtas were to be conducted in accordance with the principles of constitutional justice.
In re Art. 26 of the Constitution and the Offences Against the State (Amendment) Bill, 1940 [1940] I.R. 470 and East Donegal Co-operative Livestock Mart Ltd. v. Attorney General[1970] I.R. 317 considered.
3. That there was a presumption that in the enactment of the Act of 1945 and, in particular s. 172 thereof, the Oireachtas was conscious of and had regard to the constitutional obligation on the courts to protect as best they may from unjust attack and in the case of injustice done, to vindicate the life, person, good name and property rights of every citizen, including in particular citizens suffering from mental disorders.
4. That, in considering whether or not the Oireachtas had failed in its obligation under Article 40.1 of the Constitution, the matters to be considered were: (i) the persons to whom s. 172 applied; (ii) the nature of the powers conferred by s. 172; and (iii) whether the constitutional rights of the persons affected were breached by the provisions of s. 172 of the Act of 1945 and by the alleged failure of the Oireachtas to provide adequate safeguards in the administration thereof which would ensure that a citizen was not, even for a short period unnecessarily deprived of his liberty.
5. That the State, including the Oireachtas, was obliged by virtue of the provisions of Article 40.3.1 in its laws to respect, and as far as practicable by its laws to defend and vindicate the personal rights of the citizen but was entitled to have due regard to differences of capacity and the particular requirements of particular citizens, particularly those suffering from incapacity including mental disorders.
6. That in considering whether powers of detention were invalid having regard to the constitution, the court must consider (i) the objectives of the Act and the other provisions thereof; (ii) the safeguards and other protections afforded by the Act; and (iii) the procedures regarding detention and release therefrom contained in the Act.
7. That the initial detention of a person considered to be of unsound mind and to be a proper person to be taken in charge and detained under care and treatment pursuant to a chargeable patient reception order made in accordance with s. 171 of the Act of 1945 was not part of the administration of justice and did not require a judicial inquiry or determination. The sections which permitted of such detention did not constitute an attack upon the personal rights of the citizen but rather vindicated and protected the rights of the citizens concerned by providing for their care and treatment and were not repugnant to the Constitution on this ground.
In re Philip Clarke [1950] I.R. 235approved.
8. That the decision to make a recommendation for a reception order or a chargeable patient reception order could be set aside in the appropriate circumstances by the court upon an application for judicial review or upon complaint made to the High Court in accordanceLegal citation with Article 40.4.2 of the Constitution.
9. That the sections of the Act which permitted the detention of a citizen who was of unsound mind and required care and treatment and who had been so certified after examination by two separate medical practitioners, satisfied every reasonable requirement and did not constitute an attack upon the personal rights of the citizen under Article 40.1.
10. That under Articles 40.3.1 and 40.4.2, the Oireachtas in permitting the detention of a citizen pursuant to s. 172 of the Act of 1945 was obliged to ensure that, not even for a short period, would a citizen be unnecessarily deprived of his liberty and the court must be vigilant to ensure no citizen could be unnecessarily deprived of his liberty and legislation which permitted the deprivation of such liberty contained adequate safeguards against abuse and error in the continued detention of such citizens.
R.T. v. Director of the Central Mental Hospital [1995] 2 I.R. 65approved.
11. That in the exercise of the powers conferred on them by the Act of 1945 both the resident medical superintendent and the Minister were obliged to inquire into the mental health of the patient and the necessity for his detention under care and treatment and the nature of that inquiry was a simple inquiry.
12. That there was a statutory and constitutional obligation on the resident medical superintendent and the Minister to discharge a person detained as a chargeable patient when they were satisfied that such patient had recovered.
13. That in exercising the powers conferred on them by the Act of 1945 the resident medical superintendent and the Minister were not engaged in the administration of justice and no judicial intervention was necessary or required unless they or either of them failed to comply with the requirements of fair procedures and constitutional justice or failed to have regard to the constitutional right to liberty of the patient.
Keady v. Commissioner of An Garda Síochána [1992] 2 I.R. 197followed.
14. That the detention of a patient did not require automatic review by an independent tribunal because of the obligation placed on a person in charge of a district mental hospital to discharge a patient who had recovered. There was an inherent obligation placed on the resident medical superintendent regularly and constantly to review a patient in order to ensure that he had not recovered and was still a person of unsound mind and was a proper person to be detained under care and treatment.
15. That under Article 40.4.2 complaint may be made to the High Court of unlawful detention and once such complaint was made the High Court was obliged to conduct an inquiry into the lawfulness of the applicant's detention.
In re The Midland Health Board [1988] I.L.R.M. 251approved.
16. That, in addition to the constitutional right to apply to the High Court, s. 266 of the Act of 1945 provided that a letter addressed to, inter alia, the President of the High Court and the Registrar of the Wards of Court should be forwarded unopened, was an acknowledgement of by the Oireachtas of the role of the President of the High Court in the exercise of the jurisdiction in lunacy matters. The President of the High Court upon receipt of a complaint had a jurisdiction and a duty to intervene and cause an inquiry to be made into the lawfulness of such a person's detention and to direct his release if he had recovered or was otherwise unlawfully detained.
In re Godfrey (1892) 29 L.R. Ir. 278 considered.
Obiter dictum: That if it were to be shown in some future case that there had been a systematic failure in the existing safeguards and that the absence of such a system of automatic review was a factor in such failure, that might cause the court to hold that a person affected by such failure was being deprived of his constitutional rights.
17. That, in view of the requirements set forth in ss. 163 and 171 of the Act of 1945 which did not of themselves constitute an unjust attack upon the personal rights of the citizen affected thereby or a failure to defend and vindicate such rights, the provisions of s. 172 of the Act of 1945, having regard to the citizen to whom it was applicable, did not constitute a failure by the Oireachtas to respect and, as far as practicable, to defend and vindicate the right of such citizens affected thereby.
Cases mentioned in this report:-
Addington v. Texas 418 U.S. 323.
In re Philip Clarke [1950] I.R. 235; (1949) 85 I.L.T.R. 119.
Croke v. Smith [1994] 3 I.R. 525.
E. v. E. [1982] I.L.R.M. 497.
East Donegal Co-operative Livestock Mart Ltd. v. Attorney General[1970] I.R. 317; (1970) 104 I.L.T.R. 81.
Application of Gallagher [1991] 1 I.R. 31; [1991] I.L.R.M. 339.
In re Godfrey (1892) 29 L.R. IR. 278.
In re Haughey [1971] I.R. 217.
K. v. An Bord Altranais [1990] 2 I.R. 396.
Keady v. Commissioner of An Garda Síochána [1992] 2 I.R. 197; [1992] I.L.R.M. 312.
Kiely v. Minister for Social Welfare (No. 2)[1977] I.R. 267.
King v. The Attorney General [1981] I.R. 233.
In re The Midland Health Board [1988] I.L.R.M. 251.
McDonald v. Bord na gCon (No. 2) [1965] I.R. 217.
Application of Neilan [1990] 2 I.R. 267; [1991] I.L.R.M. 184.
Norris v. The Attorney General [1984] I.R. 36.
O'Connor v. Donaldson 422 U.S. 396.
Ó Dómhnaill ó dómhnaill v. Merrick [1984] I.R. 151; [1985] I.L.R.M. 40.
O'Dowd v. The North Western Health Board [1983] I.L.R.M. 186.
In re Art. 26 of the Constitution and the Offences Against the State (Amendment) Bill, 1940 [1940] I.R. 470; (1940) 74 I.L.T.R. 61.
O'Keeffe v. An Bord Pleanála [1993] 1 I.R. 39; [1992] I.L.R.M. 237.
In re Solicitors Act, 1954 [1960] I.R. 239; 95 I.L.T.R. 167.
The State (Healy) v. Donoghue[1976] I.R. 325; (1975) 110 I.L.T.R. 9; (1977) 112 I.L.T.R. 37.
State (Lynch) v. Cooney [1982] I.R. 337; [1982] I.L.R.M. 190; [1983] I.L.R.M. 89.
The State (Power) v. Jones and Murray [1944] I.R. 68; (1942) 77 I.L.T.R. 111; (1943) 78 I.L.T.R. 91.
State (Royle) v. Kelly [1974] I.R. 259.
R.T. v. Director of the Central Mental Hospital [1995] 2 I.R. 65; [1995] 2 I.L.R.M. 354.
Winterwerp v. The Netherlands [1980] 2 E.H.R.R. 387.
X. v. The United Kingdom [1981] 4 E.H.R.R. 350.
Case stated.
The facts have been summarised in the headnote and are fully set out in the judgment of Hamilton C.J., infra.
By case stated dated the 4th August, 1995, the High Court (Budd J.) referred the question of the validity of s. 172 of the Mental Treatment Act, 1945, to the Supreme Court pursuant to the provisions of Article 40.4.3 of the Constitution of Ireland, 1937.
The case was heard by the Supreme Court (Hamilton, C.J. O'Flaherty, Blayney, Denham and Barrington JJ.) on the 16th, 17th and 18th April, 1996.
Cur. adv. vult.
Pursuant to the provisions of Article 34 of the Constitution the decision of the Court was pronounced by a single judge.
Hamilton C.J.
31st July, 1996
Article 40.4.3 of the Constitution of Ireland, 1937, provides that:-
"Where the body of a person alleged to be unlawfully detained is produced before the High Court in pursuance of an order in that behalf made under this section and that Court is satisfied that such person is being detained in accordance with a law but that such law is invalid having regard to the provisions of this Constitution, the High Court shall refer the question of the validity of such law to the Supreme Court by way of case stated . . ."
The High Court, Budd J., being satisfied that the applicant is being detained in the Central Mental Hospital in accordance with the provisions of the Mental Treatment Act, 1945, as amended and in particular s. 172 of the Act, but that such law is invalid having regard to the provisions of the Constitution, referred to the Supreme Court by way of case stated, pursuant to the aforesaid Article of the Constitution, the question of the validity of such law, being s. 172 of the Act having regard to the provisions of the Constitution.
Section 172 of the Act provides:-
"(1) Where a chargeable patient reception order is made, any of the persons mentioned in subsection (2) of this section may receive and take charge of the person to whom the order relates and detain him until his removal or discharge by proper authority or his death and, in case of his escape, retake him within twenty-eight days thereafter and again detain him as aforesaid.
(2) The persons entitled to receive, take charge of, detain, and retake a person under this section shall be -
(a) the mental hospital authority maintaining the district mental hospital mentioned in the relevant chargeable patient reception order,
(b) the resident medical superintendent of such hospital,
(c) the other officers and the servants of such hospital."
As the power to receive and take charge of a person in accordance with the provisions of the aforesaid section is based on a "chargeable patient reception order" having been made, it is necessary to refer to the particular provisions of the Act of 1945 which are set forth in Chapter 1 of Part XIV of the Act, providing for the making of the said chargeable patient reception order.
Before doing so, however, it is essential to state that the validity of such provisions having regard to the provisions of the Constitution is not an issue in this case. The jurisdiction of this Court is, and is only, to determine the question which was referred to it by the High Court in accordanceUnrelated / insufficient with the provisions of Article 40.4.3 of the Constitution viz. the question whether s. 172 of the Act is invalid having regard to the provisions of the Constitution.
These provisions enjoy the presumption of constitutionality, as indeed do the provisions of s. 172 of the Act, unless and until the Court, orders otherwise.
Section 162 of the Act as amended by s. 6 of the Mental Treatment Act, 1961, (hereinafter referred to as "the Act of 1961") provides,inter alia:-
"(1) Where it is desired to have a person received and detained as a person of unsound mind and as a chargeable patient in a district mental hospital for the mental hospital district in which he ordinarily resides, application in the prescribed form may be made to a registered medical practitioner (not being a registered medical practitioner disqualified in relation to such person) for a recommendation (in this Act referred to as a recommendation for reception) for the reception and detention of such person as a person of unsound mind in such district mental hospital."
Sub-section (2) designates, subject to ss. 3 and 4 the persons entitled to apply for such recommendation for reception.
Section 163, as amended by s. 7 of the Act of 1961, deals with the making, or refusal, of the application for recommendation by the registered medical practitioner and sub-s. (2) thereof provides that:-
"The following provisions shall have effect in relation to a recommendation for reception -
(a) the recommendation shall state the date of the examination by the registered medical practitioner of the person to whom the recommendation relates and shall be signed . . . on the date of such examination;
(b) the recommendation shall contain a certificate that such person is of unsound mind, is a proper person to be taken charge of and detained under care and treatment, and is unlikely to recover within six months from the date of such examination;
(c) the recommendation shall contain a statement of the facts upon which the registered medical practitioner has formed his opinion that such person is a person of unsound mind, distinguishing facts observed by himself and facts communicated by others."
Where a recommendation for reception is made, the applicant for the recommendation for reception or any person authorised by him may take the person to whom the recommendation relates and convey him to the district mental hospital mentioned in the recommendation (vide section 167).
Where such a person is removed to the district mental hospital, the resident medical superintendent or other medical officer of the hospital acting on his behalf, is obliged on the arrival of the person at the hospital and on presentation of the recommendation to examine the person. If, as a result of such examination, he is satisfied that the person is a person of unsound mind and is a proper person to be taken charge of and detained under care and treatment, he shall forthwith make an order in the prescribed form (in the Act and hereinafter referred to as "a chargeable patient reception order") for the reception and detention of the person as a person of unsound mind in the hospital. If he is not so satisfied he is obliged not to make such order (vide section 171).
As appears from the judgment of Budd J. it had been argued by counsel on behalf of the applicant that the foregoing provisions of the Act were unconstitutional due to the lack of judicial or quasi-judicial intervention prior to the reception and detention of a patient.
In view of his finding that s. 172 of the Act was repugnant to the Constitution the learned trial judge did not consider it necessary to form any conclusion on this issue or to refer any question with regard to the validity of such provisions having regard to the provisions of the Constitution to this Court. Consequently, this Court is only concerned with the validity of s. 172 of the Act of 1945 having regard to the provisions of the Constitution.
Presumption of constitutionality
The approach of the Court when considering the constitutionality of a law passed by the Oireachtas or any provision thereof is well established.
It was held by the former Supreme Court in In re Art. 26 of the Constitution and the Offences Against the State (Amendment) Bill, 1940 [1940] I.R. 470 at p. 478 that:-
"Where any particular law is not expressly prohibited and it is sought to establish that it is repugnant to the Constitution by reason of some implied prohibition or repugnancy, we are of opinion, as a matter of construction, that such repugnancy must be clearly established."
In delivering the judgment of the Court in East Donegal Co-operative Livestock Mart Ltd. v. Attorney General [1970] I.R. 317, Walsh J. stated at p. 341:-
". . . an Act of the Oireachtas, or any provision thereof, will not be declared to be invalid where it is possible to construe it in accordance with the Constitution; and it is not only a question of preferring a constitutional construction to one which would be unconstitutional where they both may appear to be open but it also means that an interpretation favouring the validity of an Act should be given in cases of doubt."
He further stated at p. 341:-
"At the same time . . . the presumption of constitutionality carries with it not only the presumption that the constitutional interpretation or construction is the one intended by the Oireachtas but also that the Oireachtas intended that proceedings, procedures, discretions and adjudications which are permitted, provided for, or prescribed by an Act of the Oireachtas are to be conducted in accordance with the principles of constitutional justice. In such a case any departure from those principles would be restrained and corrected by the Courts."
As a result of these and other decisions of this Court, the Court, approaching the consideration of the provisions of s. 172 of the Act of 1945 and its determination of the question as to whether the provisions thereof are invalid having regard to the provisions of the Constitution, must
(1) grant to the impugned provision the presumption of constitutionality unless and until the contrary is clearly established;
(2) not declare the impugned provision to be invalid where it is possible to construe it in accordance with the Constitution:
(3) favour the validity of the provision in cases of doubt; and
(4) must have regard to the fact that the presumption of constitutionality carries with it not only the presumption that the constitutional interpretation or construction is the one intended by the Oireachtas but also that the Oireachtas intended that proceedings, procedures, discretions and adjudications which are permitted, provided for or prescribed by an Act of the Oireachtas are to be conducted in accordance with the principles of constitutional justice.
As stated by O'Byrne J., in delivering the judgment of the court, in In re Philip Clarke [1950] I.R. 235 at p. 250 of the report:-
"This Act as shown in the title, was primarily intended to provide for the prevention and treatment of mental disorders and the care of persons suffering therefrom"
and at p. 247:-
". . . is of a paternal character, clearly intended for the care and custody of persons suspected to be suffering from mental infirmity and for the safety and well-being of the public generally."
Section 172 of the Act of 1945 cannot be construed solely in relation to the facts of one particular case: it must be construed in the light of its own language within the framework of the Act in its entirety and within a constitutional framework.
As appears from the judgment of the former Supreme Court in In re Philip Clarke it had been submitted to that Court that the provisions of Part XIV of the Act and in particular s. 165 thereof, were repugnant to the Constitution.
Section 165 empowered a member of the Garda Síochána, who was of the opinion that it was necessary that a person believed to be of unsound mind should, for the public safety or the safety of the person himself be placed forthwith under care and control, to take such person into custody and remove him to a garda station.
By virtue of the provisions of s. 165 (3) of the Act, the member of the Garda Síochána who had taken the person into custody was obliged to apply forthwith to a registered medical practitioner for a recommendation for the reception and detention of the person as a person of unsound mind in a district mental hospital.
Such medical practitioner is empowered to make the recommendation if he is satisfied that it is proper to do so and if such recommendation is made, the member of the Garda Síochána may take the person and convey him to the district mental hospital, whereupon the provisions of s. 171 of the Act become applicable.
The provisions of s. 171 are applicable in all cases where a recommendation for reception is made, whether in pursuance of the provisions of ss. 162, 165 or 166 of the Act and may result in the making of a "chargeable patient reception order" in respect of the person the subject of the application.
As appears from the judgment of the Court in In re Philip Clarke [1950] I.R. 235, the main argument against the validity of s. 165 of the Act of 1945 was based upon the absence of any judicial intervention or determination between the arrest of the person alleged to be of unsound mind and his subsequent detention under a reception order.
In rejecting this argument, the Court stated at p. 247:-
"The impugned legislation is of a paternal character, clearly intended for the care and custody of persons suspected to be suffering from mental infirmity and for the safety and well-being of the public generally. The existence of mental infirmity is too widespread to be overlooked and was, no doubt, present to the minds of the draughtsmen when it was proclaimed in Article 40.1 of the Constitution that, though all citizens, as human beings, are to be held equal before the law, the State may, nevertheless, in its enactments, have due regard to differences of capacity, physical and moral, and of social function. We do not see how the common good would be promoted or the dignity and freedom of the individual assured by allowing persons, alleged to be suffering from such infirmity, to remain at large to the possible danger of themselves and others.
The section is carefully drafted so as to ensure that the person, alleged to be of unsound mind, shall be brought before, and examined by, responsible medical officers with the leaset possible delay. This seems to us to satisfy every reasonable requirement, and we have not been satisfied, and do not consider that the Constitution requires, that there should be a judicial inquiry or determination before such a person can be placed and detained in a mental hospital.
The section cannot, in our opinion, be construed as an attack upon the personal rights of the citizen. On the contrary it seems to us to be designed for the protection of the citizen and for the promotion of the common good.
In our opinion the section in question is not repugnant to either the letter or spirit of the Constitution and, accordingly, we are of opinion that this ground of appeal fails."
The power to make a chargeable patient reception order is provided for in s. 171 and detention on foot thereof in section 172.
Though the decision made by the registered medical practitioner to make a recommendation for a reception order may, and the decision of the medical superintendent to make a chargeable patient reception order will, result in the deprivation of the liberty of the person to whom they relate, such decisions cannot be regarded as part of the administration of justice but are decisions entrusted to them by the Oireachtas in its role of providing treatment for those in need, caring for society and its citizens, particularly those suffering from disability, and the protection of the common good. These decisions can only be made when it is established that the person to whom they relate is a person of unsound mind and is a proper person to be taken in charge and detained under care and treatment. These decisions can be set aside in the appropriate circumstances by the court upon an application for judicial review or upon complaint made to the High Court in accordance with Article 40.4.2 of the Constitution but this does not mean that the decisions are part of the administration of justice.
In the course of his judgment inApplication of Neilan [1990] 2 I.R. 267, Keane J. stated at p. 286 that:-
"No doubt in any case where it could be shown to the satisfaction of the court that the executive has exercised the power purportedly given to them by the section in an unlawful manner, whether because their decision was arbitrary, capricious or unreasonable or was in some other sense vitiated by illegality, the decision could be set aside by the court as the result of an application for judicial review. But that is not a material consideration in determining whether the exercise of the function in question is properly regarded as part of the administration of justice."
The Court is satisfied that the original detention of a person considered to be of unsound mind and a proper person to be taken charge of and detained under care and treatment pursuant to a chargeable patient reception order made in accordance with the provisions of s. 171 of the Act is not part of the administration of justice and does not require a judicial inquiry or determination and that the sections which permit of such detention do not constitute an attack upon the personal rights of the citizen but rather vindicate and protect the rights of the citizens concerned by providing for their care and treatment and are not repugnant to the Constitution on this ground.
It was submitted however on behalf of the applicant that even if the original detention was lawful and not repugnant to the Constitution the power given to the mental hospital authority, to the resident medical superintendent of such hospital and the officers and servants of such hospital by s. 172 of the Act of 1945 to detain a person until his removal or discharge by proper authority or his death rendered the provisions of such section repugnant to and invalid having regard to the provisions of the Constitution: that in granting such powers of detention of an indefinite nature, without a judicial adjudication prior to detention that he was a person to whom the section applied, without an opportunity to challenge before a court or independent tribunal the reliability of the diagnosis of mental illness, the legality of the procedures used to commit him, the treatment proposed in respect of his alleged or actual illness and the necessity for compulsory treatment, and without a right of appeal against such decision to a court or other independent tribunal and without providing for an automatic independent judicial or other review of the justification for his continued detention, the Oireachtas failed to exercise its constitutional obligation to respect and so far as practicable to defend and vindicate his personal rights, including his right to liberty.
Article 40.1 of the Constitution provides that:-
"All citizens shall, as human persons, be held equal before the law.
This shall not be held to mean that the State shall not in its enactments have due regard to differences of capacity, physical and moral, and of social function."
In enacting the Act of 1945 and the provisions of s. 172, the Oireachtas was entitled to have due regard to the differences of capacity of the persons to whom the Act applied, the requirements of their welfare and its obligation to respect and, so far as practicable, to defend and vindicate their personal rights.
For the purpose of considering whether or not the Oireachtas has failed in its obligation in this regard it is necessary to consider
(a) the person to whom s. 172 applies;
(b) the nature of the powers conferred by s. 172, and
(c) whether the constitutional rights of the persons affected were breached by the provisions of s. 172 of the Act and by the alleged failure of the Oireachtas to provide adequate safeguards in the administration thereof which would ensure that, not even for a short period, is a citizen unnecessarily deprived of his liberty.
Persons to whom the provisions of s. 172 of the Act of 1945 apply
A person to whom the provisions of s. 172 of the Act applies is
(i) a person of unsound mind in respect of whom an application has been made, in accordance with the provisions of either s. 162 or s. 165 of the Act, to a registered medical practitioner for a recommendation for reception and detention as a person of unsound mind;
(ii) a person, who has been examined by the said registered medical practitioner before he granted the application for the recommendation for reception and detention and who has been certified, in accordance with the provisions of s. 163 (2) (b) of the Act, as being a person of unsound mind and being a proper person to be taken charge of and detained under care and treatment and unlikely to recover within six months from the date of such examination;
(iii) a person who, on arrival at a district mental hospital in pursuance of a recommendation for reception, is examined by the resident medical superintendent of the hospital, or by another medical officer of the hospital acting on his behalf, who before making an order, in accordance with the provisions of s. 171 of the Act, must be satisfied as a result of such examination that the person is a person of unsound mind and is a proper person to be taken charge of an detained under care and treatment and was so satisfied.
Before a "chargeable patient reception order" can be made in respect of any person, two doctors viz. the registered medical practitioner to whom the application, in accordance with the provisions of s. 162 of the Act, was made and the resident medical superintendent of the district mental hospital, to which he had been removed, must be satisfied that the person is a person of unsound mind and is a proper person to be taken charge of and detained under care and treatment.
The Court is satisfied that the sections of the Act of 1945 which permit the detention of a citizen, who is of unsound mind and requiring care and treatment and who has been so certified, after examination, by two separate medical practitioners, satisfy every reasonable requirement and do not constitute an attack upon the personal rights of the citizen.
Effect of s. 172 of the Act of 1945
Where a chargeable patient reception order has been made, the person to whom the order relates may be received and taken in charge and detained until his removal or discharge by proper authority or his death by the persons designated in sub-s. (2) of s. 172, i.e. the mental hospital authority, the resident medical superintendent and the other officers and servants of such hospital.
In the course of his judgement in O'Dowd v. The North Western Health Board [1983] I.L.R.M. 186, Henchy J. after setting fourth the provisions of Article 40.3.1 of the Constitution stated at p. 2 05:-
"It was the implementation of those constitutional guarantees that caused the Legislature to hedge around the making of a chargeable patient reception order with the formalities mandated by the Act and the regulations made under it. As Clarke's case shows, some of those formalities are only formalities; but others are clearly obligatory, designed to implement the constitutional guarantees I have quoted, and in particular to ensure that, not even for a short period, will a citizen be unnecessarily deprived of his liberty and condemned to the tragic and degrading status of a compulsory inmate of a mental hospital, with the dire social consequences that such a fate is likely to have on his future and on that of his relations."
By virtue of the aforesaid provisions of the Constitution, the Oireachtas was, in permitting the detention of a citizen pursuant to the provisions of s. 172 of the Act, obliged to ensure that, not even for a short period, would a citizen be unnecessarily deprived of his liberty and the court must be vigilant to ensure that no citizen can be unnecessarily deprived of his liberty.
In the course of his judgment in R.T. v. Director of the Central Mental Hospital[1995] 2 I.R. 65, which dealt with a detention pursuant to the provisions of s. 207 (2) (c) of the Act of 1945, Costello P. stated at p. 78:-
"The applicant's constitutional right to liberty is central to this case. It is to be found in Article 40, s. 4, sub-section 1. This article provides that no citizen shall be deprived of his personal liberty save in accordance with law. This does not mean that the Oireachtas is free to enact any legislation it wishes trenching on the guaranteed right. It is however well established that legislative restrictions on the citizen's liberty must be in accordance with the fundamental norms of the legal order postulated by the Constitution (see King v. Attorney General [1981] I.R. 233). These fundamental norms are manifold - that with which this case is concerned is the constitutional requirement that the State should defend and vindicate the citizen's personal rights, and these include the right to liberty. So, if it can be shown that a law fails to defend and vindicate the right to liberty, it infringes a fundamental norm of the legal order postulated by the Constitution and will be invalid as trenching on the rights guaranteed by Article 40, s. 4, sub-section 1.
The right to liberty is, of course, not an absolute right and its exercise is in fact and in many different ways restricted by perfectly valid laws, both common law and statutory. Adjudication on a challenge to restrictive laws will be helped by considering the object and justification advanced in support of the law. It is obvious that if the object of the law is to punish criminal behaviour different considerations will apply than when the impugned law has a totally different object, such as the welfare of the person whose liberty is restricted.
The reasons why the Act of 1945 deprives persons suffering from mental disorder of their liberty are perfectly clear. It does so for a number of different and perhaps overlapping reasons - in order to provide for their care and treatment, for their own safety, and for the safety of others. Its object is essentially benign. But this objective does not justify any restriction designed to further it. On the contrary, the State's duty to protect the citizens rights becomes more exacting in the case of weak and vulnerable citizens, such as those suffering from mental disorder. So, it seems to me that the constitutional imperative to which I have referred requires the Oireachtas to be particularly astute when depriving persons suffering from mental disorder of their liberty and that it should ensure that such legislation should contain adequate safeguards against abuse and error in the interests of those whose welfare the legislation is designed to support."
The obligation which rested and rests on the Oireachtas is to ensure that a citizen, who is of unsound mind and requiring treatment and care, is not unnecessarily deprived, even for a short period, of his liberty and to ensure that legislation which permits the deprivation of such liberty contains adequate safeguards against abuse and error in the continued detention of such citizens.
Section 172 of the Act permits the detention of a person to whom a chargeable patient reception order relates until
(a) his removal, or
(b) his discharge by proper authority, or
(c) his death.
The removal of such a patient is authorised by the provisions of s. 208 of the Act of 1945 which provides that:-
"(1) Where a mental hospital authority, acting on the advice of the resident medical superintendent of their district mental hospital, are of opinion that a person detained in such hospital or in any other institution maintained by them requires treatment (including surgical treatment) not available save pursuant to this section, the authority may direct and authorise the removal of such person to any hospital or other place where the treatment is obtainable and in which he may be received in pursuance of an arrangement under this section.
(2) Subject to the provisions ofsubsection (1) of this section, a mental hospital authority and the controlling authority of any hospital or other place where treatment is obtainable may make and carry out an arrangement for the purposes of that subsection.
(3) Where the medical attendant of a person detained in a mental institution not maintained by a mental hospital authority is of opinion that such person requires treatment (including surgical treatment) not available save pursuant to this section, he may direct and authorise the removal of such person to any hospital or other place where the treatment is obtainable and in which it has been agreed to receive him.
(5) A person removed under this section to a hospital or other place may be kept there so long as is necessary for the purpose of his treatment and shall then be taken back to the place from which he was removed unless it is certified by a registered medical practitioner that his detention is no longer necessary."
A patient is removed in accordance with the section only when he or she requires treatment, not available in the institution in which he or she is detained but is available in the institution to which he or she has been removed.
Sub-section (5) provides for the detention of a person in such institution only as long as is necessary for the purpose of treatment.
When the treatment is completed, the patient must be taken back to the place from which he was removed unless it is certified by a registered medical practitioner that his detention is no longer necessary.
The powers conferred on the resident medical superintendent by this section are for the benefit of the patient who requires treatment which is not available in the institution in which he is being detained and do not constitute in any way an attack on his personal rights. On the contrary by making provision for such treatment, when necessary, they amount to a vindication of such right. If the patient recovers as a result of such treatment he must be discharged if a registered medical practitioner certifies that his detention is no longer necessary.
Discharge by proper authority
Section 218 of the Act of 1945, as amended, provides that:-
"(1) Where the person in charge of a district mental hospital or other institution maintained by a mental hospital authority is satisfied that a person detained therein as a chargeable patient has recovered, he shall give notice to that effect to such relative (if aware of any) of the person detained as he thinks proper, and the notice shall contain an intimation that, unless the person detained is removed before a specified date not earlier than seven days after the date on which the notice is given, he will be discharged.
(2) If a person in respect of whom a notice under this section is given is not removed from the institution in which he is detained before the date specified in that behalf in the notice, he shall be discharged.
(3) A notice under this section in re lation to a person detained in a district mental hospital or other institution maintained by a mental hospital authority shall not be given save with the approval of the resident medical superintendent.
(4) Where, consequent upon a notice under thissection, a person detained in a district mental hospital or other institution maintained by a mental hospital authority is removed or discharged, the authority may, if they so think proper, pay to or in respect of him such sum as they consider reasonable towards his travelling expenses on his journey to his home."
It is clear from the provisions of ss. 208 and 218 of the Act of 1945 that the continued detention of a patient, the subject of a chargeable patient reception order, must be terminated on the recovery of the patient and that he must be discharged on recovery by the resident medical superintendent of the institution in which he is detained.
In addition the resident medical superintendent may on the application of any relative or friend of a chargeable patient willing to take care of him or her discharge the person detained if he thinks fit and provided he is satisfied that the person detained will be properly taken care of.
Section 220 of the Act of 1945, as amended, provides that:-
"(1) Any relative or friend of a person detained as a chargeable patient in a district mental hospital or other institution maintained by a mental hospital authority may apply to the person in charge of the institution to allow him to take care of the person detained and, upon such application, the person in charge of the institution may, if he so thinks fit and provided that he is satisfied that the person detained will be properly taken care of, discharge the person detained.
(2) A person detained in a district mental hospital or other institution maintained by a mental hospital authority shall not be discharged under this section save with the approval of the resident medical superintendent."
However, s. 221 of the Act provides:-
"(1) Notwithstanding anything contained in this Part of this Act, a person detained in a mental institution shall, save where the Minister directs the discharge of such person under this Act, not be discharged where (in the case of a district mental hospital or other institution maintained by a mental hospital authority) the resident medical superintendent, or (in any other case) his medical attendant, gives a written certificate, containing a statement of the grounds therefor, that he is dangerous or otherwise unfit to be discharged.
(2) Where a certificate is given under this section, the following provisions shall have effect:-
(a) notice in writing of objection to the certificate may be given to the Minister by or on behalf of the person to whom the certificate relates,
(b) on receipt of such notice, the Minister may, by notice in writing given to the person in charge of the relevant mental institution, require such person to give to the Minister a copy of the certificate and such person shall comply with such requisition forthwith,
(c) the Minister, on receipt of such copy of the certificate, may require the Inspector of Mental Hospitals to examine the person to whom the certificate relates,
(d) after consideration of the report of the Inspector of Mental Hospitals on his examination of the person to whom the certificate relates, the Minister, if he so thinks fit and provided that not more than fourteen days have elapsed since he received such copy of the certificate, may by order direct the discharge of the person to whom the certificate relates and, if the Minister so directs, such person shall be discharged accordingly."
By reason of the provisions of s. 221 of the Act, the power given to the resident medical superintendent to discharge a person is restricted when he or the patient's medical attendant gives a written certificate containing a statement of the grounds therefor that he is dangerous or otherwise unfit to be discharged.
When such a certificate is issued the provisions of subs. (2) come into operation and the matter becomes subject to review by the Minister.
In addition to the powers given to the Minister under subs. (2) of s. 221 of the Act of 1945, s. 222 of the Act provides that:-
"(1) Any person may apply to the Minister for an order for the examination, at the expense of the applicant, by two registered medical practitioners approved of by the Minister, of a person detained in a mental institution, and the Minister, if he so thinks fit, may make such order.
(2) Where the Minister makes an order under subsection (1) of thissection for the examination by two registered medical practitioners of a person detained in a mental institution, the practitioners shall, on presentation by them at the institution of the order, be admitted and allowed to examine such person on two occasions, at least seven days intervening between the first and second occasion, and if the practitioners certify that such person may be discharged without risk of injury to himself or others, the Minister may, if he so thinks fit, by order direct the discharge of such person and, if the Minister so directs, such person shall be discharged accordingly."
While there is no definition of "proper authority"contained in the Act, the persons vested by the Act with the power to discharge a person the subject of a chargeable patient reception order are the resident medical superintendent of the institution in which he or she is detained and in the circumstances set forth in ss. 221 and 222 of the Act, the Minister.
It had been decided in In re Philip Clarke [1950] I.R. 235, that the Constitution did not require that there should be a judicial inquiry or determination before a person to whom the Act applied can be placed and detained in a mental hospital.
It must be presumed however that the Oireachtas intended, when giving to the resident medical superintendent the power of detention, and to him and the Minister the power of discharge, that the permitted discretions and adjudications given to them are to be exercised in accordance with the principles of constitutional justice and that any departure therefrom would be restrained and corrected by the courts.
In the exercise of the powers conferred and the obligations imposed by the Act, the resident medical superintendent and the Minister are obliged to act in accordance with the principles of constitutional justice, are not entitled to act in an unlawful manner, are not entitled to act arbitrarily, capriciously, or unreasonably and must have regard to the personal rights of the patient, including the right to liberty which can be denied only if the patient is a person of unsound mind and in need of care and treatment who has not recovered and must be particularly astute when depriving or continuing to deprive a citizen, suffering from mental disorder of his or her liberty.
It is important that any person exercising any power or discretion under the Act, which touches on the rights of a patient, should be conscious, not only of the wording of the power or discretion which the statute appears to confer upon him or her but also of the constitutional rights of the patient which the statute presumes that he or she will respect when purporting to exercise that power or discretion.
There is a statutory and constitutional obligation on the resident medical superintendent and the Minister to discharge a person detained as a chargeable patient when he is satisfied that such patient has recovered.
In addition, it must be presumed that in the enactment of the Act and in particular s. 172 thereof and the provision therein providing for "discharge by proper authority", that the Oireachtas was conscious of and had regard to the constitutional obligation on the courts to protect as best they may from unjust attack and in the case of injustice done, to vindicate the life, person, good name and property rights of every citizen, including in particular citizens suffering from mental disorders and to the jurisdiction of the President of the High Court in lunacy matters and that "discharge by proper authority" included a power by the court and the President of the High Court to order the discharge of a patient detained who had recovered or who has been otherwise unlawfully detained and consequently was being detained other than in accordance with the provisions of the Act.
Article 40.4 provides that:-
"1 No citizen shall be deprived of his personal liberty save in accordance with law.
2 Upon complaint being made by or on behalf of any person to the High Court or any judge thereof alleging that such person is being unlawfully detained, the High Court and any and every judge thereof to whom such complaint is made shall forthwith enquire into the said complaint and may order the person in whose custody such person is detained to produce the body of such person before the High Court on a named day and to certify in writing the grounds of his detention, and the High Court shall, upon the body of such person being produced before that Court and after giving the person in whose custody he is detained an opportunity of justifying the detention, order the release of such person from such detention unless satisfied that he is being detained in accordance with the law."
In the course of his judgment in In Re The Midland Health Board, [1988] I.L.R.M. 251, Finlay C.J. stated at p. 258:-
"Though on my view of the case it does not arise for decision I feel I should express my view that on my understanding of the provisions of Article 40.4.2 of the Constitution the High Court, on the hearing of an application pursuant to that sub-article must reach a single decision, namely, whether the detention of the person concerned is or is not in accordance with law. If it is, then the application must be refused. If it is not, the person must be discharged from the custody in which he is. Such a procedure does not appear to me to admit of any supervision or monitoring of the interests of the person concerned, even allowing for a condition of mental retardation or other want of capacity."
By virtue of the provisions of Article 40.4.2 of the Constitution, the complaint may be made to the High Court by or on behalf of a patient detained pursuant to the provisions of the Mental Treatment Act, 1945, as amended, alleging that he is being unlawfully detained and once such a complaint is made, the High Court is obliged to conduct an inquiry into the lawfulness of the applicant's detention.
The onus is on the person in whose custody the applicant is to justify the detention and the High Court must be satisfied that such detention is in accordance with law before permitting the continued detention of the applicant.
Upon the hearing of the application the High Court must be satisfied that:-
(1) the person detained is a person of unsound mind and in need of care and treatment,
(2) that the procedures outlined in the Act have been complied with,
(3) the person detained has not recovered, and
(4) the person detained is not being unnecessarily deprived of his liberty.
Unless it is satisfied with regard to each of the foregoing, the High Court must order the discharge or release of the person detained.
In addition to the constitutional right of a patient to apply to the High Court pursuant to the provisions of Article 40 of the Constitution, s. 266 of the Act of 1945 provides that a letter addressed to, inter alia, the President of the High Court and the Registrar of Wards of Court shall be forwarded unopened.
This is an acknowledgement by the Oireachtas of the role of the President of the High Court in the exercise of the jurisdiction formerly exercised by the Lord Chancellor in lunacy matters.
This jurisdiction is very wide. In the course of his judgment in In re the Midland Health Board[1988] I.L.R.M. 251, Finlay C. J. at p. 257 quoted with approval the statement made by the Lord Chancellor in the course of his judgment in In Re Godfrey(1892) 29 L.R. IR. 278, where he stated:-
"The power given by the Queen's sign-manual creates a high and reasonable duty in the Lord Chancellor towards these afflicted persons, calling on him to act on their behalf whenever it may come to his notice that their liberty or happiness require his intervention, and this beneficent jurisdiction is not confined to those so found by process of law, or narrowed to any special class. The power and duty so given and created afford in this case an illustration of the most salutary and protective exercise of the prerogative of the Sovereign."
In this case, the Lord Chancellor made an order f reeing a person alleged to be of unsound mind from detention in an institution upon finding that she was no longer of unsound mind. The person had not at any time been a ward of court.
The President of the High Court upon receipt of a complaint from a person of unsound mind not only has jurisdiction but a duty to intervene on his or her behalf and cause an inquiry to be made into the lawfulness of such a person's detention and to direct his or her release if he or she has recovered or is otherwise being unlawfully detained.
Power of detention
Whilst the powers of detention conferred by s. 172 of the Act on the persons named in subs. (2) of that section are extensive, the Court, in considering whether or not the provisions of s. 172 of the Act of 1945 are invalid having regard to the provisions of the Constitution, must have regard to:-
(a) the objectives of the Act and the other provisions thereof;
(b) the safeguards and other protections afforded by the Act; and
(c) the fact that
(i) the powers of detention therein contained relate only to persons in respect of whom a chargeable patient reception order has been made;
(ii) before a chargeable patient reception order can be made in respect of any person, the formalities mandated by ss. 163 and 171 of the Act must be complied with;
(iii) these sub-sections require that before a chargeable patient reception order may be made, an application for such an order must be made in accordance with the provisions of s. 163 of the Act which requires that a registered medical practitioner must examine the patient and certify that he is a person of unsound mind, is a proper person to be taken in charge and detained under care and treatment and an examination of the patient by the resident medical superintendent or other medical officer of the hospital acting on his behalf who before making an order must be satisfied as a result of such examination that the person is of unsound mind and is a proper person to be taken in charge of and detained under care and treatment;
(iv) such person may only be detained while he remains a person of unsound mind and in need of care and treatment;
(v) he or she may be discharged by "proper authority";
(vi) such proper authority includes the resident medical superintendent of the institution in which the patient is being detained, the Minister for Health, the High Court upon an application in accordance with the provisions of Article 40.4.2 and the President of the High Court in the exercise of his jurisdiction in lunacy matters or by any other judge of the High Court designated by the President thereof to exercise such jurisdiction;
(vii) the resident medical superintendent is obliged by s. 218 of the Act to discharge a patient when he is satisfied that he has recovered and by virtue of the provisions of s. 220 of the Act is entitled to discharge the patient upon the application of any relative or friend of a person detained provided he is satisfied that the person detained will be properly taken care of;
(viii) in accordanceUnrelated / insufficient with the provisions of s. 222 of the Act the Minister may, if he so thinks fit, by order direct the discharge of a person;
(ix) the powers and discretions given to the resident medical superintendent and the Minister in regard to the discharge of patients must be exercised in accordance with the principles of constitutional justice and are subject to review by the courts in the event of failure to so act.
Inspector of Mental Hospitals
Section 12 of the Act provides for the office of an Inspector of Mental Hospitals ("the inspector").
The powers and duties of the inspector are set forth in Part XVIII of the Act of 1945.
The inspector is empowered by s. 235 to visit, whenever and so often as he thinks fit at any time during the day or night, any mental institution and may visit and examine any patient therein.
Section 237 of the Act of 1945, as amended by s. 33 of the Act of 1961, provides,inter alia, that:-
"When making a visit and inspection of a mental institution required by this Act, the Inspector of Mental Hospitals shall -
(a) see every patient -
(i) whom he has been requested to examine by the patient himself or by any other person or persons (including, in particular, the person in charge of the institution and in the case of a district mental hospital, the visiting committee), or
(ii) the propriety of whose detention he has reason to doubt,…
(g) with respect to any patient the propriety of whose detention he doubts, notify the person in charge of the institution that he has doubts as to the propriety of such patient's detention."
Section 239 provides that:-
"(1) Where the Inspector of Mental Hospitals becomes of opinion that the propriety of the detention of a patient detained in a district mental hospital or other institution maintained by a mental hospital authority requires further consideration, he shall report the matter to the Minister.
(2) After consideration of a report under subsection (1) of thissection, the Minister may, if he so thinks fit, require the Inspector of Mental Hospitals to visit the patient to whom the report relates and to make a report on his mental condition to the Minister.
(3) After consideration of a report undersubbsection (2) of this section, the Minister may, if he so thinks fit, by order direct the discharge of the patient to whom the report relates and, if the Minister so directs, the patient shall be discharged accordingly."
In addition, s. 241 provides that:-
"The President of the High Court may by order require and authorise the Inspector of Mental Hospitals to visit and examine any person detained at any place as a person of unsound mind and to report to the President of the High Court on the condition of such person."
Section 266 of the Act of 1945, as amended by s. 36 of the Act of 1961, provides that:-
"Any letter addressed by a patient in a mental institution to the Minister, the President of the High Court, the Registrar of Wards of Court, a mental hospital authority, a visiting committee of a district mental hospital, or the Inspector of Mental Hospitals shall be forwarded unopened."
By virtue of this section, a patient in a mental institution may by letter invoke the assistance of the bodies named in the said section, if he or she alleges that he or she is unlawfully detained.
It must be presumed that any complaint made to any of these authorities will be considered and appropriate action taken, if considered necessary.
It is submitted on behalf of the applicant that the safeguards outlined herein are inadequate and do not afford constitutional protection to a person being detained in a mental institution.
It is submitted that the protection afforded by ss. 218 and 220 do not adequately protect the rights of a person detained because the determination of the issue as to whether the patient has recovered rests on the medical superintendent.
It is further submitted that the safeguards contained in ss. 222, 237 and 239 are inadequate because the decisions in regard thereto are made by the Minister.
It was further submitted by the applicant that the right of a patient to send an unopened letter to the persons mentioned in s. 266 is inadequate because it does not help the illiterate, uneducated or inarticulate patient who may not be aware of his rights in this regard.
It was further submitted on behalf of the applicant that the Act of 1945 and in particular s. 172 thereof does not provide any mechanism whereby the legal and medical propriety of a patient's continued detention or treatment is automatically reviewed by a court or an independent tribunal and that the nature of mental illness itself requires that there be a periodic automatic and independent assessment of the necessity for further detaining or treating a patient and that s. 172 of the Act was unconstitutional because there were no safeguards to protect the applicant against error or abuse in the operation of the section and that in the absence of such automatic review by a court or independent tribunal of decisions made by the resident medical superintendent and/or the Minister, the Oireachtas failed to respect and, as far as practicable, defend and vindicate the personal rights of the patient particularly his right to liberty.
In the exercise of the powers conferred on them by the Act, both the resident medical superintendent in the first instance and the Minister, in the circumstances outlined in the Act, are obliged to inquire into the mental health of the patient and the necessity for his or her detention under care and treatment.
The nature of this inquiry is not "a contest between the parties" and does not involve a dispute or controversy as to the existence of the legal rights or a violation of the law. It is simply an inquiry.
In the course of his judgment in Keady v. Commissioner of An Garda Síochána [1992] 2 I.R. 197, O'Flaherty J. stated at p. 212:-
"The arguments advanced on behalf of the plaintiff had two prongs. In the first place, it was submitted that the inquiry held constituted an administration of justice and this should be reserved solely for the courts; and secondly, it was said that the powers capable of being exercised by the inquiry could not be regarded as 'limited functions and powers of a judicial nature' as provided for in Article 37 of the Constitution. The main question that must be confronted, therefore, is: did the operation of the inquiry constitute an administration of justice?
In McDonald v. Bord na gCon (No. 2) [1965] I.R. 217 at p. 231 the learned High Court Judge, Kenny J., in a passage which was accepted by this Court on appeal, identified the following as the characteristic features of the administration of justice, viz.,
1. A dispute or controversy as to the existence of legal rights or a violation of the law;
2. The determination or ascertainment of the rights of parties or the imposition of liabilities or the infliction of a penalty;
3. The final determination (subject to appeal) of legal rights or liabilities or the imposition of penalties;
4. The enforcement of those rights or liabilities or the imposition of a penalty by the Court or by the executive power of the State which is called in by the Court to enforce its judgment;
5. The making of an order by the Court which as a matter of history is an order characteristic of Courts in this country.
In turn it is possible to isolate two essential ingredients from these characteristics and they are that there has to be a contest between parties together with the infliction of some form of liability or penalty on one of the parties. Here while undoubtedly there was the infliction of a penalty - and a severe one - the other essential ingredient is not present. This was not a contest between parties; it was, as its name says, an inquiry.
I conclude with the learned trial judge, therefore, that the inquiry under the Regulations of 1971 (incidentally no longer extant: see, now: Garda Síochána (Discipline) Regulations, 1989 (S.I. No. 94 of 1989) had to be conducted in a fair and just manner but that it did not involve either any trespass on the judicial domain or the exercise of judicial functions. It is right to emphasise, too, that the correct operation of domestic tribunals and inquiries such as the one here impugned has been delineated in many cases such as McDonald v. Bord na gCon (No. 2) [1965] I.R. 217; East Donegal Co-operative Livestock Mart Ltd. v. The Attorney General [1970] I.R. 317; In re Haughey[1971] I.R. 217; Kiely v. Minister for Social Welfare (No. 2)[1977] I.R. 267 and O'Keeffe v. An Bord Pleanβla [1992] I.L.R.M. 237.
This line of authority establishes that there is now in place a well charted system of administrative law which requires decision-makers to render justice in the cases brought before them and sets out the procedures that should be followed, which procedures will vary from case to case and from one type of tribunal to another and which, of course, are subject to judicial review. Similarly, the rules of evidence may not necessarily be applied with the same strictness as in a court of law provided that the decision-making body keeps in the forefront of its deliberations the necessity to come to a correct and just verdict having regard to the complaints that have to be investigated; the determination to be made and the consequences such determination may have for the other party or parties appearing before it."
The Court is satisfied that, in exercising the powers conferred on them by the Act of 1945, the resident medical superintendent and the Minister are not engaged in the administration of justice and that no judicial intervention is necessary or required unless they or either of them fail to comply with the requirements of fair procedures and constitutional justice or fail to have regard to the constitutional right to liberty of the patient.
While it may be desirable that the necessity for the continued detention of the person, in respect of whom a chargeable patient reception order has been made, be subject to automatic review by an independent review board as provided for in the Mental Treatment Act, 1981, which has not, unfortunately, after fifteen years, been brought into force by the Minister, the failure to provide for such review in the Act has not been shown to render the provisions of the Act of 1945, and in particular s. 172 thereof, constitutionally flawed because of the safeguards contained in the Act, which have been outlined in the course of this judgment. If, however, it were to be shown in some future case, that there had been a systematic failure in the existing safeguards, and that the absence of such a system of automatic review was a factor in such failure, that might cause this Court to hold that a person affected by such failure was being deprived of his constitutional rights.
If they so fail, their decisions are subject to review by the High Court, whether by way of an application for judicial review or by way of a complaint made to the High Court in accordanceUnrelated / insufficient with the provisions of Article 40.4.2 of the Constitution.
The Court is further satisfied that the detention of a patient does not require automatic review by an independent tribunal because of the obligation placed on a person in charge of a district mental hospital to discharge a patient who has recovered. Inherent in this section is the obligation placed on the resident medical superintendent to regularly and constantly review a patient in order to ensure that he or she has not recovered and is still a person of unsound mind and is a proper person to be detained under care and treatment. If such review is not regularly carried out, in accordance with fair procedures and rendering justice to the patient then the intervention of the court can be sought because of the obligation placed on the resident medical superintendent to exercise the powers conferred on him by the Act in accordance with the principles of constitutional justice. There is no suggestion that such a review is not carried out.
There is no doubt that the provisions of s. 172 of the Act empowers the persons, set forth in sub-s. (2) thereof, to deprive a person, in respect of whom a chargeable patient reception order has been made, of his liberty.
By virtue of the provisions of Article 40 of the Constitution, the State, however, in its enactments is obliged to have due regard to differences of capacity, physical and moral, and of social function.
The Mental Treatment Act, 1945, was, as stated in the preamble thereto, "An Act to provide for the prevention and treatment of mental disorders and the care of persons suffering therefrom . . ."
As stated by the Supreme Court inIn re Philip Clarke [1950] I.R. 235, the legislation was "of a paternal character, clearly intended for the care and custody of persons suspected to be suffering from mental infirmity and for the safety and well-being of the public generally".
The purpose of s. 172 of the Act was to provide for the detention of persons of unsound mind and certified to be proper persons for detention under care and treatment.
The State, including the Oireachtas, is obliged by virtue of the provisions of Article 40.3.1 in its laws to respect, and as far as practicable by its laws to defend and vindicate the personal rights of the citizen but in its laws is entitled to have due regard to differences of capacity and the particular requirements of citizens, particularly those suffering from incapacity including mental disorders.
Do the provisions of s.172 of the Act, having regard to the citizen to whom it is applicable, constitute a failure by the Oireachtas to respect and, as far as practicable, defend and vindicate the personal rights of such citizens?
In view of the requirements set forth in ss. 163 and 171, which do not of themselves constitute an attack upon the personal rights of the citizen affected thereby or a failure to defend and vindicate such rights, the Court is satisfied that it has not been established that the provisions of s. 172 constitutes a failure by the Oireachtas to respect and, as far as practicable, to defend and vindicate the right of such citizens affected thereby.
In being so satisfied, the Court has had regard to the presumption of constitutionality which the Act is entitled to enjoy and in particular the presumption that the Oireachtas intended that the proceedings, procedures, discretions and adjudications by the resident medical superintendent, the Inspector of Mental Hospitals and the Minister permitted by the Act are to be conducted in accordance with the principles of constitutional justice and in particular with regard to the principle thereof that no person should be unnecessarily deprived of his liberty even for a short period.
This requirement places a heavy responsibility on these officers to ensure that no person detained pursuant to the provisions of s. 172 of the Act is detained for any period longer than is absolutely necessary for his proper care and treatment and that the safeguards provided for in the Act be stringently enforced. The necessity for the continued detention of a patient, to whom s. 172 of the Act applies must be regularly reviewed to ensure that he or she is not being unnecessarily detained.
Decisions made in this regard are not decisions made in the administration of justice but the decision makers are obliged to act in accordance with the principles of constitutional justice and to have regard to the constitutional right to liberty.
Consequently, the Court is satisfied that it has not been established that the provisions of s. 172 of the Mental Treatment Act, 1945, are invalid having regard to the provisions of the Constitution and will so answer the question referred to it by the High Court in accordanceUnrelated / insufficient with the provisions of Article 40.4.3 of Bunreacht na hÉireann héireann.