Speech by:The Honourable Anne C. Cools

Gove Inquiry into Child Protection and the Child Abuse and Neglect Death of Matthew Vaudreuil

THE SENATE OF CANADA, Thursday, March 21, 1996

CHILD ABUSE AND NEGLECT
DEATH OF MATTHEW VAUDREUIL -- INQUIRY -- DEBATE ADJOURNED

Hon. Anne C. Cools rose pursuant to notice of Wednesday, February 28, 1996:

That she will call the attention of the Senate to the child abuse and neglect (CAN) death of 5 year old Matthew Vaudreuil at the hands of his mother, Verna Vaudreuil, in July 1992; and the inquiry by Judge Thomas J. Gove into child protection services in British Columbia as they relate to the terrible child abuse and neglect (CAN) death of Matthew Vaudreuil; and Judge Gove's report entitled, "The Report of the Gove Inquiry into Child Protection in British Columbia, November 1995."

She said: Honourable senators, I rise to call the attention of the Senate to the death of a 5-year-old boy, Matthew Vaudreuil, who was killed by his mother, Verna Vaudreuil on July 9, 1992, and the consequent 1995 Judge Gove Inquiry.

The history of child maltreatment and child abuse is long and terrible. It is a painful and deeply disturbing tragedy whose most severe forms cause us to shrink in horror. Our hearts, souls, and intellects are deeply troubled by these severe expressions of violence.

Judge Thomas Gove, Commissioner for the Inquiry into Child Protection in British Colombia, articulates our universal suffering in his report, saying:

... Matthew's story is very sad and will upset many readers, as it upsets me.

Despite 100 years of hard evidence on the well-known role of women and mothers in severe and lethal child abuse, many maintain a state of disbelief and denial. This disbelief must be suspended as evidence on feminine aggression enters our consciousness.

The Greek tragedy dramatist, Euripides, in 431 B.C. wrote "Medea," a play about Medea and Jason, and Medea's murder of their two sons. Medea, the Greek enchantress, had helped Jason obtain the Golden Fleece. When Jason deserted her for another woman, Medea, in revenge, planned and performed the murder of their two sons. Medea said:

Let no man think I am a feeble, frail-hearted woman who sits with folded hands: no, let them know me for the opposite of that - one who knows how to hurt her enemies ...

Medea mused that the cruelest way to hurt her husband Jason was to kill their children. In pledging her maid to silence about this deed, Medea revealed the essence of today's problem of detecting and addressing child abuse and neglect, saying:

Say nothing of the plans I have prepared; don't say a word, if you are loyal to your mistress and loyal to the race of woman!

Euripides articulated the modern problem of loyalty to the race of woman and its attendant silence on feminine aggression, particularly mothers' aggression towards their children. This terrible silence is murderous.

Honourable senators, abuse and neglect in the death of children is historical. In a work published in 1972 entitled Checks on Population Growth: 1750-1850, William Langer, professor emeritus of history at Harvard University, wrote on the widespread use of infant homicide as population control. One popular method of killing children was the use of Godfrey's Cordial, a poisonous mixture of opium, treacle and sassafras. Another was overlaying; that is, smothering the child as it nursed at its mother's breast. The perpetrators in most cases of child killing never reached the courts, and those who did, Langer informs, "...were usually let off with a light sentence; ..." Langer writes that a London coroner, Edwin Lankester, testified in the 1800s that he:

... had never known of a woman's being punished for killing her baby, no matter how flagrant the circumstances.

Langer also quotes Dr. William Ryan in 1862:

... that infanticide is not looked upon in the same light as other murders by the public generally... There is no crime that meets with so much sympathy, often of the most ill-judged kind.

Most literature on child abuse and the psycho-history of childhood informs that the perpetrators of this violence and neglect against children are their parents, most often their mothers.

Between 1880 and 1930, Canada imported from England our littlest immigrants. Some 80,000 children were imported from England to Canada. Of these, 30,000 were sent by Dr. Thomas John Barnardo, of Barnardo's homes for boys and girls. The expressions "Barnardo's boys" and "Barnardo's girls" were then part of the lexicon of emerging child welfare. These immigrants were abandoned children, taken from the streets, workhouses and pauper homes of England to be transported to Canada. The youngest were adopted, and the older ones were assigned to farms in Ontario, Quebec, and Nova Scotia. There were many success stories but there were some tragic ones. One tragic story is the death of the little immgrant George Green at the hands of his female caretaker Helen Findlay in 1895 in Owen Sound, Ontario where Coroner, Dr. Allan Cameron, testified that the 15 year old boy died of neglect, starvation and physical brutality. He testified that the state of George Green's body, and the condition of the room where he died would haunt his memory forever, and that in his 40 years in medicine, including his days in the slums of Glasgow, he had seen nothing as terrible. Helen Findlay was charged with murder, later reduced to manslaughter. Her justification was that little immigrant Green was a sickly child, disabled, defective from head to foot, cross-eyed, humpbacked, and quite useless. Helen Findlay went free and suffered no penalty in George Green's murder.

Honourable senators, I do not know how many of you know of these Barnardo's boys and girls, but the last of them were still alive up to about three or four years ago. The issue of child abuse neglect or CAN death, though insufficiently studied by governments, is well known to those who work in the field. In 1986 Dr. Cyril Greenland, professor emeritus, McMaster University, conducted a study of child abuse neglect deaths. He examined and analyzed records of 100 child abuse and child neglect deaths, from 1973 to 1982 here in Ontario. These records were from the Chief Coroner's Office. Dr. Greenland reported in his book, Preventing CAN Deaths: An international study of deaths due to child abuse and neglect, that:

Natural parents were the perpetrators in 63 per cent of cases. Mothers were involved in 38, fathers in 13 and both in 12 cases.

During Dr. Greenland's study of these 100 cases, three more cases of CAN deaths were uncovered in the Coroner's records. These three cases had been previously classified as Sudden Infant Death Syndrome or SIDS. In two of these cases, the parents later admitted to having deliberately suffocated their children.

Honourable senators, in 1994, the Toronto Institute for the Prevention of Child Abuse released a study entitled "The Ontario Incidence of Reported Child Abuse and Neglect." This study reviewed the 1993 child maltreatment investigations, 46,683 total, by all 54 Children's Aid Societies of Ontario. Child maltreatment is defined by this study as any one of physical abuse, sexual abuse, child neglect, or child emotional maltreatment. The findings were as follows: Of the total substantiated cases of child maltreatment, mothers were perpetrators in 49 per cent and fathers in 31 per cent of the cases. In the category of child neglect, mothers were perpetrators in 85 per cent of the substantiated cases. In the category of child physical abuse, biological mothers were perpetrators in 39 per cent of the substantiated cases, and biological fathers in 40 per cent of the cases. In the category of emotional maltreatment, mothers were perpetrators in 79 per cent. This study found that:

Boys were most strongly over-represented in the area of physical abuse, especially in the 0- to 3-year-old category where boys accounted for 59 percent of investigations.

Male children aged 4 to 11 years accounted for 55.5 per cent. The single largest number of investigated families, 35 per cent, was the single-mother family.

Honourable senators, child mortality is terrifying. The survival of male children has received little attention in recent times. Let us review the state of survival of male children. I just mentioned that 59 per cent of the investigations of child abuse are male children aged 0 to 3 years old. Male children are the recipients of most physical abuse from parents and mothers. Dr. Eleanor Maccoby, in her book Social Development: Psychological Growth and the Parent-Child Relationship, writes that this is so even in lower primates, such as monkeys. She said:

We should be aware, however, that even among monkey mothers, a certain amount of differential socialization takes place. For example, they administer more punishment to male than female young, just as human parents do.

Dr. Maccoby added:

... parents more often enter into mutually coercive cycles of interaction with their sons.

We know that male children of single-mother or father-absent homes are more likely to display aggression and behavioral disorders. We know that domestic discord affects children adversely, and is the major cause of behavioral and anti-social problems in male children. Dr. Eleanor Maccoby tells us that male fetuses are more vulnerable to the mishaps of pregnancy and childbirth, saying:

A higher proportion of males than females are spontaneously aborted; the approximately equal sex ratio at birth exists only because more males than females are conceived. The incidence of various congenital defects is greater among male infants, ... greater male vulnerability remains a fact, and a puzzling one.

The 1984 Vital Statistics published by the Registrar General of Ontario revealed that newly born male infants are more vulnerable in the post neo-natal period, accounting for 58 per cent of deaths of infants aged zero to 12 months. The 1984 statistics inform us that of 394 deaths of infants aged under 28 days, 230 were male.

Honourable senators, confronted with the grim realities contained in over a century of accounts of child misfortune and maltreatment, statistics, reports, studies, inquiries, victims and deaths, and in consideration of the significant revenues spent on child protection, it seems incomprehensible that in 1994 the number of homicides of infants under 1 year of age as reported by Statistics Canada homicide data was 27, representing a staggering increase from the previous 10-year average of 20. Infant homicide is increasing. Children continue to die at the hands of their caretakers and parents, and many deaths are not classified or detected as homicides. I welcome the news in recent days about the Ontario Coroner's initiatives investigating SIDS deaths, even exhuming bodies. Dr. Jim Cairns, Ontario's Deputy Coroner, in reviewing infant deaths from 1986, conservatively estimates that at least 10 such deaths per year were, in his words, "... due to foul play." These events are reported in The Toronto Sun article called "Getting away with murder," and The Toronto Star article "20 cases listed as crib deaths re-opened for police probe." These articles inform us that in the past decade in Ontario, at least 100 babies whose deaths were labelled SIDS deaths were likely murdered or abused.

Honourable Senators, the case in point today is the child abuse neglect death of 5 year-old Matthew Vaudreuil who was killed by his mother, Verna Vaudreuil. The cause of death was asphyxiation resulting from the mother's hand over Matthew's mouth and nose. In other words, she just extinguished his life. Verna Vaudreuil was convicted of manslaughter and sentenced to 10 years, later reduced to 4 years on appeal. Judge Thomas Gove was appointed Commissioner to inquire into Matthew's death and his November 1995 report is entitled the "Report of the Gove Inquiry into Child Protection in British Colombia." Judge Gove was diligent in the examination of this small and vulnerable child's short life of unceasing suffering. In his report, he described Matthew at the time of his death, saying:

... Matthew weighed only 36 pounds.

Honourable senators, a 5 year-old boy weighed only 36 pounds.

His face, arms, legs and back were covered in bruises. There were what appeared to be rope burns on his shoulders and wrists, as if he had been bound. His buttocks were covered in bruises and welts. He had a fractured arm, 11 fractured ribs and what looked like the imprint of a foot on his back. Matthew had been tortured and deprived of food before he was killed.

Judge Gove continued:

Not including supervisors, 21 ministry social workers had been responsible for providing him with services. At least 60 reports about his safety and well-being had been made to the ministry. He had been taken to the ministry. He had been taken to the doctor 75 times and had been seen by 24 different physicians.

Judge Gove's report concluded that throughout the ordeal of Matthew's short life:

... he was not protected ... not by his community and not by those charged with protecting British Colombia's children.

and:

As a result ... he died.

Judge Gove's report tells us that six days after Matthew died, the Superintendent of Family and Child Services authorized a file review of Matthew's case, but she did not order a full review until March 3, 1994, two years later. About her March 1994 decision, Judge Gove concluded that this:

... review into Matthew's life and death was motivated primarily by a desire to control damaging publicity to the ministry and its employees.

About this Superintendent's actions, Judge Gove continued:

The superintendent's final draft eliminated all of the inspector's statements that were critical of the ministry, downplayed or eliminated his references to poor social work practice by ministry employees in Matthew's case, and in other instances, reversed or misrepresented the inspector's findings.

Honourable senators, I am not talking about 100 years ago; I am talking about two years ago.

The superintendent's final draft was an attempt to obscure inadequate practice by ministry social workers, and an effort to shift blame away from the Ministry of Social Services.

Judge Gove added:

... the seriously inadequate decision-making by social workers and district supervisors in Matthew's life was the direct result of flawed decision-making and poor management by the ministry's executive.

The Hon. the Speaker: Senator Cools, I regret to interrupt you but the 15-minute time period is up.

Senator Cools: Honourable senators, I ask leave to continue as I have only a few minutes more./p>

The Hon. the Speaker: Is leave granted?

Hon. Senators: Agreed.

Senator Cools: The Gove report drives home the fact that Matthew's story is not unique, and informs that the files held by the Superintendent of Family and Child Services and the Deputy Superintendent reveal that from 1986 to 1995, the Ministry knew of the deaths of 264 children who were either in the care of the Superintendent, or were known pursuant to protection reports or requests for services.

Judge Gove's Inquiry reviewed the files of 63 deceased children who were, like Matthew, not in the care of the ministry. Of these, 49 cases noted at least one protection complaint prior to the death. The analysis of some of these 49 deaths is as follows:

In 12 of the 49 cases where protection complaints had been documented, the ministry had judged that the complaints were unsubstantiated or did not pose a risk. Such a determination was sometimes made without thorough investigation by the ministry. Four of these children were later killed by other people; four died in suspicious circumstances; two died in a suspicious fire; and two of the deaths were considered to be Sudden Infant Death Syndrome.

This is terrible. Honourable senators, the child protection services failed Matthew and these children, and Judge Gove has articulated the reason. He said:

Although the ministry's legal and financial authority was to provide services to protect Matthew, services were in fact directed more to the benefit of his mother. The ministry, its employees ... lost sight of why a child protection service exists, and who they were supposed to be protecting.

I repeat, the ministry and its employees lost sight of why a child protection service exists, and whom they were supposed to be protecting. The protection this child needed was from his own mother. Yet, the agency was protecting the mother. This is very common in the child welfare field, that workers confuse their roles.

Honourable Senators, newspapers report daily about child maltreatment. Recently, The Toronto Star of December 9, 1995, relates the tragic story of little Afua Boateng, a 4-year-old Rexdale girl whose mother has been charged with her second-degree murder. The Star quoted Colin Maloney, director of the Catholic Children's Aid Society of Metropolitan Toronto, saying, "... We've known this case for five weeks...." In fact The Toronto Star informs us that a Children's Aid worker had visited Afua's home the day before the child was found dead and reported that everything seemed normal. A neighbour dissatisfied with the social worker's report that everything was all right, checked on Afua, and found her small, helpless body.

Honourable senators, Judge Gove indicts British Colombia child protection agencies in the case of Matthew Vaudreuil, saying that many of the decisions made were:

... based on social workers' self-interest, Verna Vaudreuil's interest or the ministry's interest, rather than Matthew's interest. If those decisions had been child-centred, it is likely that Matthew would have been taken into care, either by apprehension or by agreement.

The state must abandon the posture that the best interests of the child are synonymous with the best interests of the child's mother. The Gove report suggests that child protection regimes must amend their focus so that:

... the safety and well-being of children are the paramount considerations.

Honourable senators, governments must abandon the premise that the child is the property of its mother and that the best interest of the mother is the best interest of the child. Child protection workers and agencies must yield undivided loyalty to the child's needs, safety and well-being, particularly in situations where the mothers are clearly the source of the abuse. Matthew Vaudreuil's maltreatment and death shames us all.

Judge Thomas Gove's report is an enormous contribution to child welfare in this country, and I commend it. I commend him.

On motion of Senator Berntson, debate adjourned.

Senator Cools' speech is reproduced here as it appears in the Canadian Senate Hansard