The College and the Doctor
Comments. Considerations. Questions.
by Kenneth Bagnell
My aging memory sometimes fails me but at other times surprises me with recollections so vivid they’ll remain forever. For example, it’s now almost 30 years since I went to a medical specialist, now deceased, for my yearly checkup in his area. He was an affable Jewish man so it was natural we talked about congregational matters, in his faith and mine. He knew I had served as a lay member on a board overseeing one of the professions. I was chair of the board’s “complaints committee”, my term being six years. It was an interesting experience which had just ended a week or so before I went to my specialist. I told him that a friend suggested the day before that I put my name forward to be considered for an equivalent panel: the College of Physicians and Surgeons of Ontario. Immediately he dropped whatever he was holding and spoke in a way I can never forget: “Oh, for God’s sake don’t do it. I’m on that board and it’s hell….”
Obviously I put it out of my mind and in the years that followed, the newspapers give me reason to be glad I did. One illustration – get ready, it’s repugnant – will suffice. A couple of years ago, a senior Toronto anesthesiologist was found guilty of 21 sexual assaults on women to whom he gave anesthetic in the operating room. (He had a screen that somehow was between himself and the other staff.) Most of the victims testified against him and all were taken most seriously in the courtroom. Many of the dreadful acts he was charged with are too repugnant to include here. In the end he was found guilty and sentenced to 10 years in prison. Moreover, the College of Physicians and Surgeons gave specific notice to him that the mandatory penalty for sexual abuse to a patient is a revoked license and a public reprimand. His career was over. It’s not pleasant but a recent check with the current agenda of Ontario’s College of Physicians and Surgeons shows that several physicians appearing in August and September are charged with similar (if not as repetitive) sexual misconduct.
Obviously the Ontario Physicians’ College is strong, but no matter how stressful, it’s also meticulously fair. The proven evidence regarding the above now jailed doctor was beyond overwhelming. But we must also hope the tribunal now hearing other evidence from other physicians is as meticulous as it can be. There’s a tragic dimension to it all: careers will be either tarnished or finished; families will be broken; reputations will be ruined. The College – every province has one– must be exceedingly scrupulous. That is but one of the reasons my late specialist tried to fulfill and found it all too stressful being on the physicians college. At times, some issues brought before the board are small and inappropriate. For example: I recall a CBC television story, about a decade or more ago from Nova Scotia. It was based on a very small town less than an hour from Halifax. It was not, in any way, an abusive matter. It was just a case of the young local doctor –- if memory serves there was only one doctor in the village — having a fiancé who became for a time, his patient. Hence, as I recall it, the Nova Scotia College of Physicians called him on the mat. In short order he was cleared, after all he was fully reputable and given the context, acting ethically. In my view they should have let the single doctor have his fiancé. (It reminds me of earlier times when many ministers often found their wives in the choir or Sunday School of his first congregation. Nobody complained. (Today church attitudes have changed so much that, here and there, intruders regard a single minister having a relationship with a single woman in the congregation “inappropriate” on his part. In fact such relationships virtually always yield fine marriages, fine families with fine students.)
An inquiry as to the ethics and conduct of the medical doctors of Ontario, is encouraging. For your interest there are, according to a very recent report, 41,719, practitioners of family medicine and 28,955, who are specialists. Given that population, the fact that in August and September, in Ontario alone, about a dozen physicians have or will be brought before the College’s conduct board; this should not be shocking or discouraging. The allegations are mostly (a) incompetence, (b) sexual abuse, or (c) incapacity. (An overview of the current charges does reveal that sexual interference is the major one.)
In that regard the College is to be commended for the depth and detail it has gone to to prevent what appears, shamefully, to be the major intrusion: abusive sex which includes a single unwarranted touch to the horrific conduct of the doctor who received the 10 year sentence. The sad fact is that sexual misconduct by physicians has been around for a long, long time. I didn’t know until very recently that it’s actually included in the ancient Hippocratic Oath, dating to 400B.C. In it, is included this preference: “I will abstain from every voluntary act of mischief and corruption; and further from the seduction of females or males…..” We can be almost certain that before 1991, when this aspect was flagged by the Physicians’ College, the intrusion, minor or major, was not rare. (Why? I expect mainly because nobody dared suspect the possibility from the most revered of professionals – the physician.)
Today, the Ontario College — and I expect every provincial college — has a detailed description of what sexual interference is. The reason for its being late is, I infer, the power and prestige of the medical profession in human history and regard. Moreover, as the Ontario College’s document on physician sexual interference says: “Trust is the cornerstone of the physician-patient relationship. When patients seek care from a physician, they trust that the physician is a professional and as such will treat them in a professional manner. To maintain trust, a physician must avoid making or responding to sexual advances. Sexualizing the relationship is a clear break of trust….” Well said.
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