Prem Singh

- vs -

Kirpal Singh

Judgment

HT Chao JC

1. This is an application under s 3 of the Mental Disorders and Treatment Act (Cap 178, 1985 Ed) for an order directing an inquiry for the purposes of determining whether the subject person, Mdm Kishen Kaur (hereinafter called ‘the patient’) who is also the wife of the respondent, is or is not of unsound mind and incapable of managing herself and her affairs.

2. This application is initiated by three of the children of the patient and is opposed by the respondent and five other children of hers. Pursuant to an application by summons-in-chambers, I granted an order giving liberty to the patient to intervene by her solicitors. Let me first set out some patient background.

3. There is no doubt a deep division within the respondent’s family, with the three applicants on the one side and the respondent and the other five children on the other. The conflict appears to exist in 1974, if not earlier. The animosity between the two sides is so intense that on 16 June 1988 the first and second applicants placed a notice in The Straits Times renouncing the respondent as their father.

4. While it is not entirely clear why the dispute came to a head in 1985, it seems to concern the mother who, the applicants alleged, has been mistreated by the respondent. The applicants say that the respondent assaulted and abused their mother from the six ties until the mid-seventies because of the respondent’s allegedly illicit relationship with another women. Because of the alleged abuse the mother suffered mental anguish which led to schizophrenia.

5. It is not disputed that the patient was brought by Mr. Harbajan Singh, a son, to see Dr Paul Ngui, a consultant psychiatrist, on 25 August 1973. Dr Ngui was told that the patient was not mentally well in the previous four years; she was withdrawn, complained of being persecuted and behaved abnormally like talking to herself and laughing or smiling without apparent reason. She was seen by Dr Ngui irregularly until 1976 when she failed to turn up. She was diagnosed as suffering from schizophrenia and treated with neuroleptic drugs. In those few years, because of the irregularity in follow-up and default in treatment, it would appear that the patient made very little progress and did not improve in her mental state.

6. After a lapse of nine years, the patient was, on 9 September 1985, brought by the first and second applicants to see Dr Ngui for psychiatric review. He was of the opinion that the patient’s mental state had become worse since he last saw her in 1976 and there was a definite deterioration in her personality. Dr Ngui’s detailed opinion is set out in his report dated 19 September 1985.

7. During that month of September 1985, there were numerous incidents between the parties so much so that the police had to be brought in. This led to an agreement (hereinafter called ‘the first agreement’) reached between the parties, which was recorded in a police report made on 21 September 1985. In accordance therewith the respondent agreed:

   (a)	to be responsible for psychiatric care and expenses for Kishen Kaur and to ensure attendances regularly. The parties agree to see Dr Nagulendran;
   (b)	to continue Kishen Kaur’s attendance on Dr Ong Swee Law and to be responsible for expenses hitherto;
   (c)	to employ and be responsible for expenses of a full-time Filipino maid;
   (d)	to contribute a minimum sum of $1,000 per month. The sum to be banked into the savings account of Kishen Kaur, Harbajan Singh and Sarjit Kaur to be joint signatories of the account. That Sarjit and Harmohan agree to provide for Kishen Kaur but will not stipulate minimum sum;
   (e)	to allow all family members (the children) and in-laws complete access to Kishen Kaur. To allow them to take her on outings and to allow them to have Kishen Kaur to stay with them sometimes; and
   (f)	that 38E Jervois Road will not be given or willed away to a person who is not a member of the family. ‘Family’ for this particular purpose is defined as including only Harbajan Singh, Harmohan Singh, Diljit Singh, Manjit Singh, Jasbir Kaur and Kishen Kaur (mother).

8. Following this agreement, the patient was brought to see Dr Nagulendran, a consultant psychiatrist, in October 1985. She has since attended Dr Nagulendran regularly, initially on a fortnightly basis and subsequently on a monthly basis.

9. However, this agreement did not end the dispute between the two sides. Allegations were made by the applicants that notwithstanding the fact that the respondent agreed to allow all family members complete access to the patient, the respondent did not keep his promise and began to impose restrictions on their access. This and other matters led to further conflicts between the two sides culminating in numerous legal proceedings being instituted in court.

10. Through the intervention of intermediaries, a deed was entered into on 15 April 1988 by the respondent of the first part, Prem Singh of the second part and seven other children (Harbajan Singh, Harcharan Singh, Diljit Anthony Singh, Manjit Singh, Sarjit Kaur, Jasbir Kaur and Harmohan Singh) of the third part whereby the parties agreed to withdraw all writs/complaints/summonses filed against the other parties within two weeks of the execution of the deed. Among the other terms of the agreement are :

    1. respondent should arrange a meeting within two weeks for Dr Nagulendran to meet with the children ‘for a discussion of the state of mental health and the treatment being given to Kishen Kaur’;

    2. respondent would supply to all parties copies of the reports received from Dr Nagulendran on the condition and treatment of Kishen Kaur;

    3. respondent would ensure that Kishen Kaur would continue to receive psychiatric treatment and general medical attention as and when she might require;

    4. respondent agreed that all the children would have free access to their mother between the hours of 9 am to 9 pm daily.

11. The agreement embodied in the deed proved to be short-lived. Barely two months later, the present originating summons was instituted by the applicants on the ground that the respondent has failed to fulfill his obligations set out in the deed.

12. From the evidence before me, it is quite clear that the patient has been suffering from schizophrenia for many years now. Dr Paul Ngui, who first saw Kishen Kaur in 1973 and then intermittently until 1976, last saw her in September 1985. His opinion is to that extent dated. Dr Ngui has not been able to furnish an up to date report because, according to the applicants, the respondent has prevented them from bringing the patient to be seen by Dr Ngui. Dr Ngui in his letter dated 16 August 1988 said that when he saw her in 1985 ‘her mental state had become worse (than) I last saw her in 1976 and there was a definite deterioration in her personality’. He opined that ‘given her mental status on 9 and 16 September 1985, she could not have functioned independently and would not have been able to manage herself and her affairs for some period of time’.

13. Dr Nagulendran came into the picture pursuant to the first agreement. In his affidavit filed herein on 16 August 1988, Dr Nagulendran said he diagnosed the patient as suffering from a condition of schizophrenia. It is at present of the residual type. He said she 'does not exhibit any overt symptoms of psychotic disorder such as delusions, hallucinations, paranoia or irrational behaviour. The symptoms she exhibits are what are called negative symptoms of schizophrenia' namely, a lack of spontaneity and a somewhat withdrawn personality’. In his interview with her she was able to understand question put to her which she responded. However, her replies were short.

14. In conclusion, Dr Nagulendran said that in his view ‘it would be better by reason of considerations for their welfare and her wishes, not to change her present environment, especially if, as reported, she is in fact performing the task she is doing’. He also expressed the view that ‘it is neither necessary nor desirable to put her through an inquiry as this may subject her to unwanted stress which may cause a flare-up in her symptoms’.

15. Dr Ong Swee Law, at whose clinic the patient has been attending for general medical treatment in the last 30 years, confirmed in his affidavit that she is in good physical health for a person of her age though she is overweight. Dr Ong also said that she has never shown signs of neglect or complained of neglect.

16. After the initial hearing of this originating summons, the patient was examined by another psychiatrist, Dr Fong Yeng Hoi, on 12 October 1988. Dr Fong, in his medical report dated 10 October 1988 said that ‘she is suffering from schizophrenia which has reached the state where there are no longer any florid psychotic symptoms. Instead her current symptom comprises a residual quiescent state of just negative symptoms. She has become withdrawn into herself and her own preoccupation and interacts to a lesser extent with friends, relatives, and her immediate environment’. Dr Fong, who also made a home visit, reported that ‘as far as can be seen, she is functioning reasonably well at home by herself and with the support provided by the children at home. I noted that on some occasions during my visit she was able to exercise a bit of her matriarchal authority and pointed out things which the others missed’. Dr Fong concluded that ‘under the present circumstances of her home environment, she is coping adequately. The medication that Dr Nagulendran is maintaining her on presently will help to stabilize her mental state and reduce any risk of relapse.’

17. The patient has also been examined by Prof Seah Cheng Siang, senior physician, Singapore General Hospital, who referred her to Dr Teo Seng Hock, the medical director of the Woodbridge Hospital, for an assessment of her mental state. Dr Teo, in his medical report dated 7 November 1988 to Prof Seah, stated, inter alia, the following:

    she was mentally alert and was able to give details about her personal particulars. She was relevant in her talk content. She was initially a little slow in replies but when a familiar figure, her elder son, was asked to be with her, she spoke more spontaneously. My examination did not reveal any evidence of hallucination or delusion. Her mood state was normal and her affective response was appropriate. Her cognitive functions (i.e. memory orientation, concentration and attention) were satisfactory for her age. She knew how much money she has and also what she intends to do with it. There was no defect in her ability to make sensible decision and judgment. My conclusion is that she is in remission of her schizophrenia for which she is being treated by Dr Nagulendran. I am of the opinion that she is mentally capable of managing herself and her affairs.

18. Mr. Hassan Almenoar, in his submission to me, made the point that not all the previous medical reports on the patient were placed before Dr Teo particularly those of Dr Paul Ngui. But it seems to me that in a matter of this kind, while the background may be relevant, it is the clinical examination by Dr Teo which is most relevant and important. Even assuming I accept the opinion expressed by Dr Paul Ngui that the patient would not be likely to be able to manage herself and her affairs, that does not necessarily mean I ought to grant an inquiry.

19. Section 3(1) of the Mental Disorders and Treatment Act clearly gives a discretion to the court to determine whether in a particular case where a person is alleged to be mentally disordered, an inquiry should be ordered. The English equivalent on this subject is set out in the Lunacy Act. It does not follow that an inquiry must be ordered in every case where it is shown that the person is of unsound mind and incapable of managing herself and her affairs. In Ex parte Tomlinson, Broadhurst, Eldon LC ruled that he was not bound to issue a commission of lunacy whenever the fact of lunacy is established. He went on to say:

    as the object of such a proceeding being the welfare of the party, I know, that by granting it in many cases, I might forever prevent the cure. The true point upon this application for me to consider in the exercise of this most delicate and important authority, committed to me, is, whether it is really necessary for the benefit of the lunatic with reference to his mental health and his property that a commission should issue.

20. In Re Claire, the petition which was presented by the son-in-law of Mr. Claire, the alleged lunatic, was opposed by Mrs. Claire, with whom he was residing, on the ground that, though of unsound mind, he was not in need of protection of the court either for himself or his property. The Lord Chancellor declared that the jurisdiction was for the purpose of giving protection to the party alleged to be a lunatic. Having reviewed the evidence and concluded that the lunatic would not require any further protection than that which he already possessed in the care and attention of his wife and family, the Lord Chancellor refused to issue the commission. The principles governing the manner in which the court should exercise its discretion were further elucidated by Lindley LJ (no doubt obiter) in Re Cathcart and I need only quote the following passage at pp 559-60:

    (i)	It is obvious that no proceedings in lunacy can be justifiably taken against anyone who is not reasonably supposed to be of unsound mind.
    (ii)	If insanity is believed to exist, still proceedings by inquisition ought not to be had recourse to unless the supposed lunatic has shewn himself to be incapable of managing himself and his affairs ¨ Unless a person’s insanity is so marked and of such a nature that he is not able to manage himself and his affairs, he ought not to be found lunatic; and, unless there is considerable evidence of his inability, no inquiry ought to be set on foot.
    (iii)	Assuming that there are grounds for supposing a person to be insane and to be incapable of managing himself or his affairs, it does not follow that there is any occasion to institute proceedings by inquisition against him. It is necessary to consider his position, and what management is wanted in his particular case, and whether his friends and relatives are bestowing such care and management as are required. A person who is insane, but who is living at home and is carefully and judiciously looked after, may well be left alone: while an insane person in a different position, even if harmless to himself and others, may require protection which can only be afforded through the medium of an inquiry.

21. I have reviewed the facts of the present case. There is no allegation that there has been any physical assaults committed by the respondent on the patient since the mid-seventies. The allegation of assaults would appear to relate mainly to the period in the sixties. Since October 1985, the patient has been seen regularly by Dr Nagulendran who has been prescribing maintenance medication for her illness. It must be noted that the appointment of Dr Nagulendran as psychiatrist to the patient was pursuant to the first agreement between the two sides and this agreement was further affirmed in the deed of 15 April 1988. It is not challenged that Dr Nagulendran has been attending to her on a regular basis. She has also been seen by other doctors. It may be, as contended by the applicants, that this arrangement was brought about because of the efforts of the applicants in forcing the respondent to ensure that the patient is given proper medical treatment. Nevertheless, the point is that since October 1985 she has been getting proper medical care.

22. In this regard, I have borne in mind the opinion of Dr Teo Seng Hock. His report indicates that while the patient is suffering from schizophrenia, she is nevertheless able to manage herself and her affairs. Even if the opinion given by Dr Teo is not absolutely correct and that another psychiatrist, say, Dr Paul Ngui, could, on examination of the patient, have given a different opinion, that does not detract from the fact that she is now being cared for and seems reasonably well settled with the respondent and her other children, two of whom are also advocates and solicitors like two of the applicants.

23. As I have stated in the beginning, it seems to me the conflict in the family is somewhat deep-rooted. What was the cause of the early turmoil is not known but I have the distinct feeling that the mother, Kishen Kaur, is slowly becoming a pawn in the conflict. She appears reasonably settled in her home and I do not see any useful purpose in having an inquiry. She has a house help to assist her in her domestic duties. In so far as her property is concerned, there is no evidence that she has anything more than the two POSB accounts. Nothing has been shown that these two accounts require any special attention. Bearing in mind the object of such an inquiry and particularly the comments of Dr Nagulendran that ‘it is neither necessary nor desirable to put her through an inquiry, as this may subject her to unwanted stress which may cause a flare-up in her symptoms’, I am of the view that the holding of an inquiry at this time would not advance the interest of the patient nor would it be to her benefit.

24. The court’s jurisdiction under the Mental Disorders and Treatment Act should only be exercised for the benefit of a mentally disordered person. I do not think this court ought to sanction a course of procedure which is likely to lead to further distress t o the patient on account of the bitter dispute between the respondent and some of his children.

25. Finally, I ought to mention the following for the record. At the conclusion of the initial hearing in chambers of this originating summons, I granted an order for an inquiry. Pursuant to a written request by the respondent, I agreed to hear further arguments. In the light of the further submissions made to me and the additional facts placed before me, I am now of the opinion, for the reasons given above, that an inquiry should not be ordered.

26. As regards costs, I think no order as to costs is appropriate in all the circumstances. While I felt that the mother is slowly becoming a pawn in the conflict between the applicants and the respondent, I do not think I can say that the applicants did not also have their mother’s interest at heart when they made this application.

27. Application disallowed.

Cases

Ex parte Tomlinson, Broadhurst [1812] 1 V & B 57; 35 ER 22; 2 Re Claire [1846] 3 Jo & LAT 571; Re Cathcart [1892] 1 Ch 549

Legislations

Mental Disorders and Treatment Act (Cap 178, 1985 Ed): s.3

Representations

Hassan Almenaor for the applicants.

Michael Khoo for the intervener/patient.

Davinder Singh (Muthu Arusu with him) for the respondent.