The Ontario Domestic Violence
Death Review Committee (DVDRC)
Established in response to recommendations
from two major Coroner’s inquests into the
killings of Gillian Hadley and Arlene May by
their estranged male partners;
 In 2002, DVDRC was established under
authority of the Coroner’s Act;
 Our 5th annual report was released in 2008;
 Our committee currently only one in Canada.

The Ontario DVDRC
Mandate: To assist the Coroner’s office with
the investigation and review of deaths
involving domestic violence with the goal of
making recommendations aimed at prevention
of similar deaths;
 Review criteria: Homicides of a person and/or
their child(ren) by an intimate partner or expartner who may also have commit suicide
following the homicide.

The Ontario DVDRC
Objectives:
(1) to conduct confidential, in-depth reviews of
some cases;
(2) to maintain a comprehensive database on
all cases to identify trends, risk factors &
patterns;
(3) to identify systemic gaps or shortcomings
so as to make recommendations for
improvements.
Reviews 2003-2007
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Total reviews: 62 cases, involving 100 deaths
Victims: 94% women; 6% men
Accused: 92% men; 8% women
Type of homicide event:
- 39% homicide only
- 37% homicide-suicide
- 6% multiple homicide-suicide
- 3% multiple homicide
- 15% attempt homicide-suicide
Reviews 2003-2007
Type of relationship:
- 56% legal spouses
- 26% boyfriend/girlfriend
- 18% common-law partners
 Length of relationship:
- 61% 10 years or less
- 38% More than 10 years
 Children in common: 58%

Top 10 risk factors over 5-year period
#1:
#2:
#3:
#4:
#5:
#6:
#7:
#8:
#9:
#10:
Actual or pending separation (79%)
History of domestic violence (75%)
Perpetrator depressed (63%; non-medical)
Obsessive behaviour by perpetrator (63%)
Escalation of violence (50%)
Prior threats to kill victim (45%)
Prior threats to commit suicide (44%)
Prior attempts to isolate victim (44%)
Access to/possession of firearms (42%)
Excessive alcohol or drug use (40%)
Preventable deaths?
The DVDRC considers a case predictable, and
potentially preventable, if there are 7 or more
risk factors present.
Between 2003-2007:
 84% of the cases had 7 or more risk factors;
 8% of cases had 4-6 risk factors;
 10% of cases had 1-3 risk factors.
…thus, the majority of cases appeared to be
preventable in hindsight!
Recurring Themes
Multiple recommendations directed at some
key areas between 2003-2007, including:
(1) Education;
(2) Risk assessment;
(3) Universal screening;
(4) Marginalized communities;
(5) Intersection of family and criminal law;
(6) Coordination of services.
Education:
Recommendation #11-2007
“It is recommended that the Ministry of
Education who provides funding for adult
education, alternative education programs, and
regular school programs that may involve
young parents, ensure that education and
training is provided to individuals who deal
with young parents in such programs on how
to respond to suspected or known cases of
intimate partner violence among their clients.”
Risk Assessment
Recommendation #14-2007
“It is recommended that community agencies
in partnership with government should explore
the creation of an easily accessible, nonthreatening mechanism for friends and family
to get information or to consult with a trained
individual regarding situations where they
have concerns that a woman is at risk from her
intimate partner.”
Universal Screening
Recommendation #5-2007
“It is recommended that healthcare providers
be taught to be mindful of the dynamics of
domestic violence and the potential for
lethality, especially when working with
patients who have a history of drug abuse,
depression, anxiety, and suicidal ideation,
particularly when there is high conflict in their
marriage and a history of numerous
separations.”
Marginalized communities
Recommendation #7-2007
“We recommend that first Nation communities
be prioritized by government to address the
enormous lack of resources available to them,
including
making
available
culturally
appropriate service providers that would be
adequately trained in providing an effective
response to the complex issues facing
Aboriginal families.”
Intersection of family/criminal law
Recommendation #24-2004
“It is recommended that before deciding on
the nature of access, assessment reports for
family court judges, prepared by qualified
assessors with domestic violence training,
should be considered. This assessment is
especially valid when dealing with someone
who has a history of domestic violence as
demonstrated by a prior criminal record for
related offenses.”
Coordination of Services
Recommendation #11-2006
“It is recommended that a protocol be
established to ensure that when Children’s Aid
Societies (CAS) receive information about
domestic abuse from other professionals such
as school guidance counselors, that the
information be forwarded in a structured way
to all appropriate authorities, including police
so that monitoring of such cases should
involve and link all appropriate agencies.”
‘No blame or shame’ culture of reviews…
…a must if committees are to achieve the
3Cs – communication, cooperation and
collaboration – a crucial element in the
prevention of domestic violence related
deaths.
Our ultimate goal?
To understand and recommend change;
OR
To understand and implement change.
Where do we go from here?
Recommendation #1
“It is recommended that the Ministry of the
Attorney General take a leadership role in
creating an inter-ministerial committee that
will methodically review all community,
agency and government responses to
recommendations that have been made by the
DVDRC since its inception.”
Thank you!
To register go to:
https://rabbit.vm.its.uwo.ca/ConfCDH/