MEDICINE

‘Zero tolerance’

A task force says “no” to sex abuse by doctors

D’ARCY JENISH June 10 1991
MEDICINE

‘Zero tolerance’

A task force says “no” to sex abuse by doctors

D’ARCY JENISH June 10 1991

‘Zero tolerance’

MEDICINE

A task force says “no” to sex abuse by doctors

According to the victim, the incidents occurred on Tuesday and Thursday afternoons over a threeto fourmonth period during the mid-1970s. Jean Halliwell, now 55, a grandmother and owner of a small photography studio in London, Ont., was seeing a psychiatrist about her fear of darkness. She said that the doctor began giving her intravenous doses of a stimulant and a barbiturate during her twice-weekly visits. While she was in a drug-induced euphoric state, said Halliwell, the psychiatrist would insist that she perform oral sex or engage in sexual intercourse. Halliwell was one of nearly 400 women who earlier this year shared their experiences with a task force set up by the College of Physicians and Surgeons of Ontario to investigate sexual abuse of patients. Last week, the task force released a preliminary report that estimated that about 10 per cent of Ontario’s 22,000 practising doctors may take sexual advantage of their patients. As well, the report called for a lifetime suspension of physicians found guilty in the future of sexually abusing patients.

In a 92-page report containing 60 recom-

mendations, the five-member task force, made up of two doctors and three nonmedical professionals, urges the college to adopt a policy of “zero tolerance” towards sexual abuse. The recommended penalties, including fines of up to $10,000 for doctors who commit sexual improprieties—including remarks considered demeaning to their patients—would be among the harshest in North America. Following publication of the report, a meeting of the college’s 27-member council, made up of 21 doctors and six laymen, last week unanimously endorsed the concept of “zero tolerance.”

Although the Ontario task force report is the first of its kind in Canada, the problem of sexual abuse of patients is attracting attention elsewhere in the country. In British Columbia and Alberta, the provincial colleges of physicians and surgeons are considering setting up inquiries into sexual abuse by doctors. Dr. Kenneth Brown, registrar of the Manitoba College of Physicians and Surgeons, said that the college censured two doctors and temporarily suspended a third last year for sexual misconduct. As well, the college is currently investigating complaints against five other physicians. And in

British Columbia last week, 67-year-old psychiatrist Dr. James Tyhurst of Vancouver was on trial before the provincial Supreme Court on four counts of indecent assault and one count of sexual assault. One of four female complainants has testified that Tyhurst hypnotized her, whipped her and forced her to perform sexual acts. Tyhurst, a former head of the psychiatry department at the University of British Columbia, has pleaded not guilty to all the charges.

Some of the women who testified before the Ontario task force said that after doctors took advantage of them sexually, they suffered a variety of reactions, from headaches, nausea and blurred vision to chronic emotional and psychological problems. Said Halliwell: “There is a time when you have to do something, when you cannot sit on the fence anymore. My anger will not allow me to be silent anymore.”

Despite the apparent prevalence and severity of sexual abuse by doctors, the task force report contended that the Ontario college’s current procedure for investigating complaints is heavily weighted in favor of protecting doctors rather than helping patients. Task force chairman Marilou McPhedran, 39, a Toronto lawyer, said that the college rarely investigates a doctor unless there are complaints by two different people. Said McPhedran: “We want the college to do the same thing in sexual abuse cases as they do in cases of medical incompetence. Those doctors must not be allowed to practise again.”

The Ontario college set up the task force last January after receiving a growing number of complaints by women against its members. At the time, said Dr. Michael Dixon, the college’s

registrar, social workers and other professionals who deal with victims of sexual abuse were also receiving numerous complaints about doctors. In many cases, said Dixon, the victims told social workers that they did not complain directly to college officials be-

1 cause they did not trust them.

Said Dixon: “That’s a very SL - bad perception to have out

there in the community.”

In setting up the task force, the college’s governing council was also responding to a number of highly publicized cases during the past year involving doctors accused of sexual abuse of patients. Dixon said that one incident involved a Toronto doctor accused of removing his pants and pressing a female patient’s face against his groin. But a college discipline panel made up of four doctors and one layman came to the conclusion that there was insufficient evidence to convict the physician. The name of the doctor was never made public.

Women’s groups also expressed outrage last year when Ontario divisional court judges either overturned convictions by college discipline panels or reduced the penalties.

In one of four such cases, Abdullah Khan, a Toronto doctor, was convicted of molesting a three-year-old girl while the child’s mother sat in the waiting room. Police investigators reported finding semen and saliva stains on the child’s clothing. But the court ruled that the college’s discipline panel had accepted inadmissible evidence and ordered a new hearing. However, a judge of an Ontario general division court later convicted Khan of sexual assault.

According to the task force report, sexual abuse cases that go before a college discipline panel, or reach the courts, represent only a tiny fraction of the actual number of incidents. The report said that during the past 11 years, only 27 cases were forwarded to a discipline panel after being investigated by a complaints committee.

Thirteen of those cases were subsequently dismissed. But during its twomonth investigation, the task force received more than 300 phone calls and nearly 100 letters, most of them from women who claimed to have been sexually abused by doctors. Of those, 174 reported “detailed, specific incidents of abuse.”

In a chapter of the report entitled “Voices,” the task force published graphic accounts of the sexual incidents involving doctors reported by 36 women and two men. One woman told the task force that her doctor had prescribed acu-

puncture for lower-back pain. She said that the doctor would masturbate while she had a needle in her back. Another woman said that she and her husband went to a psychiatrist to resolve a sexual problem. The psychiatrist eventually suggested individual therapy and, during his first session with the woman, he persuaded her to have sexual intercourse. A third woman said that she went to see her doctor about abdominal pain and that, during the examination, he tried to make her have an orgasm. The same doctor later asked her to remove her panties while examining a rash on her hip.

According to McPhedran, the women who related their experiences to the task force reported feeling both astonished and ashamed at what had happened. She said that many of the victims said that they found it difficult to believe their doctors would engage in such behavior. McPhedran added that in many cases, even family and friends doubted their stories, and that most of the victims felt that complaining to police or medical authorities would be pointless. The task force report concluded: “The clearest message we received from the public was that the college is a selfserving organization that protects doctors from members of the public.”

In her testimony before the task force, Halliwell said that she could not convince college officials to look into her case. She said that she told her husband about her experiences with her doctor and that he questioned the psychiatrist about it. Halliwell said that the

psychiatrist told her husband that she was being overly emotional because of her phobias, and may have been fantasizing. During a subsequent appointment, said Halliwell, the psychiatrist threatened to have her committed to a psychiatric hospital. She added that about three years ago, she complained to the college but was told that there was nothing the college could do because the doctor had moved to another province—and because she was the

only person who had complained about him.

Besides recommending harsh penalties for physicians found guilty of sexual impropriety or abuse, the task force also made a number of sweeping proposals for eradicating sexual activity between doctors and patients. As part of their education, it said, doctors should be required to pass exams on women’s issues, the nature and impact of sexual abuse, and methods of treating sexual abuse. The task force also recommended that Ontario’s Health Disciplines Act be amended to make it mandatory for a doctor to report cases of sexual abuse by a colleague to the college. As well, the task force recommended that Premier Bob Rae’s New Democratic Party government amend the act to make sexual abuse a recognized offence, in addition to the existing offence of sexual impropriety. The latter includes such things as demeaning comments, watching a patient undress or requesting a date, and can result in punishment ranging from a reprimand to a temporary suspension of a doctor’s licence.

If the task force’s recommendations are accepted, any doctors found guilty by the college of sexual abuse would automatically have their licences permanently revoked, although doctors could still appeal such decisions through the courts. Because sexual abuse is currently regarded as misconduct, along with a number of other offences, the college can impose a range of penalties from a reprimand to a permanent suspension of the doctor’s licence, but the doctor has the right to continue practising while appealing his suspension. The

task force suggested that abuse be defined as “sexual contact of any kind, whether initiated by the patient or not.” McPhedran said that both doctors and patients “need a clear sense of where the line is drawn.” If the task force’s philosophy of “zero tolerance” is put into practice, there will be no forgiveness for doctors who cross that line.

D’ARCY JENISH