Ontario Review Board
Re: Maurice Lefebvre
ORB File No: 8164
Hearing held on: Wednesday, February 12, 2025
Place of Hearing: Royal Ottawa Mental Health Centre
Pursuant to: Sections 672.81(1) and 672.48(1) of the Criminal Code
Before: Alternate Chairperson: Mr. P. Capelle Members: Dr. G. Glancy Dr. G. Boulais Mr. P. Hageraats Mr. A. Bernardo
Parties Appearing: Accused: Maurice Lefebvre | Counsel: Mr. M. Davies Person in charge of hospital: | Representative Dr. F. Wood Attorney-General of Ontario: | Counsel: Ms. M. Dufort
REASONS FOR DISPOSITION
(Dated April 10, 2025)
Introduction
[1]. On September 29, 2022, the accused, Maurice Lefebvre, was found unfit to stand trial on account of mental disorder on seven charges of sexual assault, all contrary the Criminal Code of Canada (the Criminal Code). Mr. Lefebvre is currently subject to a disposition of the Ontario Review Board dated February 20th, 2024, which detains him at the secure forensic unit of the hospital with privileges up to and including to live in the community in a locked all-male accommodation approved by the person in charge.
[2]. On February 12th, 2025, a panel of the Ontario Review Board ("the ORB" or "the Board") convened a hearing at the Royal Ottawa Mental Health Centre ("ROMHC") pursuant to s. 672.81(1) of the Criminal Code of Canada. The annual review for Mr. Lefebvre was held in person. The hospital was represented by Dr. Floyd Wood, the Attorney-General by Ms. Marie Dufort and Mr. Lefebvre's counsel, Mr. Michael Davies.
Issues to be Determined
[3]. The issues to be determined by the Board was whether Mr. Lefebvre continues to be unfit to stand trial and, if so, what is the necessary and appropriate disposition taking into account the factors set out in section 672.54 of the Criminal Code. In addition, should the Board find that Mr. Lefebvre remains unfit, then the Board must determine whether to make a recommendation that the court hold an inquiry to ascertain whether a stay of proceedings should be ordered pursuant to section 672.851 of the Criminal Code.
Preliminary Issue
[4]. Mr. Lefebvre together with his daughter Monique, were permitted to participate via video conference from Mr. Lefebvre's long term care facility in Cornwall.
Without Prejudice Position of the Parties:
[5]. Dr. Wood, on behalf of the hospital, recommended no changes to the terms of the existing Detention Disposition. Ms. Dufort indicated that she was initially ad idem with the hospital's recommendation which she confirmed in her closing submissions. Mr. Davies indicated that a joint position was appropriate in this instance and subsequently conceded the ongoing presence of significant threat.
Index Offences
[6]. The circumstances giving rise to the charges on the index offences can be summarized as follows:
Mr. Lefebvre, who was 77 at the time of the index offences, was living in a mixed-gender long-term care home. He had been diagnosed with dementia in the mid-80s. Between April 13, 2021 and August 30, 2021, he sexually assaulted four female residents ranging in age between 65 and 89 by touching their breasts or other parts of their bodies. Two had been assaulted on more than one occasion. The assaults are described in the police synopsis.
Since the incidents, Mr. Lefebvre had been transferred to a locked all-male unit in another facility."
Current Diagnoses
[7]. Mr. Lefebvre is currently diagnosed with:
- Major Neurocognitive Disorder (dementia), vascular disease alcohol-induced, severe,
- Alcohol Use Disorder, severe, in a controlled environment.
Evidence at the Hearing
[8]. The Board admitted into evidence the Hospital Report dated January 10th, 2025, as Exhibit 1. The document provides a great deal of information concerning Mr. Lefebvre's personal history, mental health history as well as his course in hospital and in the community both prior to and subsequence to the index offences. As the Hospital Report was made an Exhibit, it is unnecessary to reproduce the information contained therein in these Reasons.
[9]. Dr. Wood testified that Mr. Lefebvre continues to do well at his long-term care facility although there have been a few behavioural incidents. Responding to questions from Ms. Dufort, Dr. Wood reported that there have been six or seven incidents of inappropriate sexual behaviours which is consistent to what was seen in the previous reporting year.
[10]. Dr. Wood would like Mr. Lefebvre to accept a low dose of Seroquel so as to reduce the frequency of the above noted incidents.
[11]. Overall, there has been no significant decline in Mr. Lefebvre's mental functioning, and he remains physically stable.
[12]. Dr. Wood opined that Mr. Lefebvre is likely permanently unfit due to challenges with his memory as he cannot recall what has been conveyed to him from one session to the next. The doctor testified that Mr. Lefebvre's nursing home employs a significant amount of night-time agency staff that are not necessarily adherent to the care plan posted on the wall of his room.
[13]. Asked if fitness capacity has been actively explored in the course of this reporting year, Dr. Wood replied that it has been on three occasions in the course of case conferences. Dr. Wood added that his patient displays some rudimentary knowledge of the court players but remains surprised when advised that there are outstanding charges against him. As previously noted, Mr. Lefebvre cannot recall what has been said to him from one day to the next and therefore cannot remember events that occurred in the past or provide ongoing assistance to defence counsel as he cannot remember what may have been said on a previous occasion.
[14]. Good channels of communication are maintained through social worker Mr. Robins who is in contact with Mr. Lefebvre's daughter, Monique. Dr. Wood's current involvement is relatively minimal, although he is considering a geriatric psychiatric referral so as to enable his patient's consistent compliance with Seroquel.
[15]. Responding to a question from a panel member, Dr. Wood confirmed that Mr. Lefebvre's current risk level with current housing and supports in place is "low to moderate" and that his violence is directed at health care staff. Were he not residing in a nursing home, that risk would increase to "moderate to high".
[16]. Dr. Wood opined that Mr. Lefebvre continues to represent a significant threat to public safety. The Risk Management Plan for 2025/2026, found at page 29 of the Hospital Report is reproduced below for ease of reference:
There are no disease-modifying therapies for Mr. Lefebvre's advanced dementia. The task of risk management thus becomes appropriate behavioural and pharmacological management of his Behavioural and Psychiatric Symptoms of Dementia (BPSD). He saw a Geriatric Psychiatrist on several occasions prior to his legal involvement.
The interventions of the psychiatrist and change of environment to a locked, all-male dementia unit appear to have successfully mitigated Mr. Lefebvre's sexually inappropriate behaviours. While this combination of interventions have largely mitigated his behaviours, there have still been incidents of inappropriate sexual activities towards female staff when the approved protocols were not followed at the home
Closing Observations
Dr. Wood submitted that Mr. Lefebvre is properly placed and but for the incidents of sexually inappropriate behaviour he continues to be better managed than before coming under the jurisdiction of this Board.
Mr. Davies referenced last year's Reasons for Decision as the Crown apparently is unaware if a prima facie case remains available. Mr. Davies reiterated that he takes no issue with regard to the fitness determination or the permanency of that determination.
Ms. Dufort undertook to contact the Crown's office in Cornwall and thereafter indicate at next year's hearing whether a prima facie case continues to exist pursuant to 672.33(1) of the Criminal Code.
Analysis
During the three instances that his fitness to stand trial was assessed by Dr. Wood this past reporting year , Mr. Lefebvre was unable to identity the key players in a court proceeding or their respective roles. He was unable to explain the difference between guilty and not guilty pleas or recognize the importance of telling the truth while giving evidence in court. Dr. Wood opined that Mr. Lefebvre is therefore unable to understand the consequences of a Court proceeding and also unable to advocate on his own behalf or to work effectively with his lawyer. Regrettably, as a result of Dementia, a major mental illness, Mr. Lefebvre cannot recall what has been said to him from one day to the next.
There has been no change in Mr. Lefebvre's presentation over the course of this reporting year and he continues to be permanently unfit to stand trial. The Board therefore accepts the joint position of the parties and Dr. Wood's uncontested opinion that since Mr. Lefebvre continues to represent a significant threat to public safety that a Detention Disposition, absent any changes is required to manage his risk.
In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Sandhu and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Lefebvre's mental condition, his reintegration into society and other needs.
DATED this 10th day of April 2025, at the City of Toronto, in the Toronto Region.
Mr. P. Capelle Legal Member
Office of the Registrar Ontario Review Board