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A new trial has been ordered in the case of Guy Turcotte, a Quebec cardiologist who stabbed his two children to death.Ivanoh Demers

A former Quebec doctor who walked free after admitting to killing his kids returned to court Thursday to face renewed first-degree murder charges in their slayings.

Guy Turcotte, his hands cuffed and head bowed, shuffled into a courtroom one day after the Quebec Court of Appeal ordered a new trial in the 2009 stabbing deaths of his children, Anne-Sophie, 3, and Olivier, 5.

The ex-cardiologist's appearance came more than two years after a jury found him not criminally responsible in their deaths, a controversial verdict that made him a well-known figure in the province and enraged many Quebecers.

His case was one of several notorious court decisions that helped lead to new federal legislation designed to make it more difficult for those found not criminally responsible to gain their freedom.

During his high-profile first-degree-murder trial in 2011, Turcotte admitted to stabbing his daughter and son a total of 46 times one night, amid a messy breakup with their mother.

He then drank windshield-wiper fluid in what he said was a failed attempt to commit suicide.

A jury found him not criminally responsible when they accepted his argument he could not remember the events and had experienced blackouts.

Turcotte was later deemed fit for release from a mental institution, where he had been locked up after a total of 46 months in psychiatric care.

But on Wednesday he surrendered to police after the appeals court overturned the 2011 decision, because of perceived legal errors, and authorities issued a warrant for his arrest.

He was back in a prisoner's box Thursday for a brief appearance at the courthouse in Saint-Jerome, Que., north of Montreal.

Turcotte did not utter a word in the chamber and is scheduled to return to court Jan. 10, when a date will be set for a new trial. There will be no preliminary hearing.

"Until then, he will be detained," prosecutor Rene Verret said outside the courtroom.

"When a person is charged with murder he has to be detained, unless the defence presents a request before a Superior Court judge...

"We have not received such a request, but if we receive a request like this then we will have to debate [it] in front of a judge."

Verret, who did not work on Turcotte's 2011 trial, said he did not know when the trial would actually begin. He hoped it would start some time in 2014.

"When the trial will be fixed on Jan. 10 we will be ready to proceed," he said.

The Crown prosecutor also said he had not received any notice the defence might appeal Wednesday's ruling to the Supreme Court.

Turcotte did not enter a plea Thursday. Verret said he was not obliged to.

Members of the defence team did not speak with reporters outside the courtroom.

Inside the chamber, Turcotte's ex-wife, Isabelle Gaston, stared at him from the third row of the gallery as he stepped into the prisoner's box.

The 41-year-old Turcotte did not look in her direction and, for the most part, looked toward the floor during his appearance.

Gaston, an emergency-room physician who has become a vocal advocate for justice reform since the deaths of her kids, did not speak to reporters outside the courtroom.

She endured painful testimony about the deaths of her children by attending his original trial and subsequent hearings.

The prosecution argued that a not-criminally-responsible verdict should be reserved only for cases of mental illness, not ones where a suicide attempt might have triggered an after-the-fact blackout.

The appeals court verdict sided with such critics.

"The burden of proof was on the accused to show that he was suffering from an incapacitating mental illness — distinct from the intoxication symptoms — and it was the jury's job to decide," the ruling said.

"But the judge did not remind jurors of that distinction."

In the decision, the court conceded that the judge had a difficult role and wasn't helped by the fact the prosecution argued its points in a way that was "sometimes confused."

Still, according to the appeals-court ruling, "his instructions [to the jury] were deficient, which necessarily had a major impact on the verdict."