CANADA

Breaking the silence

Sexually abused patients are speaking out

JOHN DeMONT February 1 1993
CANADA

Breaking the silence

Sexually abused patients are speaking out

JOHN DeMONT February 1 1993

Breaking the silence

CANADA

Sexually abused patients are speaking out

JOHN DeMONT

BARRY CAME

Nearly a decade has passed since the incident. But for Allyson, a 35-year-old Fredericton woman who declines to be identified by her last name, the memories are still painful.

In 1983, she says, she visited her doctor to be fitted for a diaphragm. After closing the door to his office, he asked her to undress for an internal physical examination—and then had sexual intercourse with her. “I tried to rationalize and excuse what he had done,” Allyson recalls. In fact, she returned to the same doctor the following year—but when he tried to have sex again she resisted his advances. Finally, in 1989, she complained to the College of Physicians and Surgeons of New Brunswick, which found the doctor guilty on two counts of sexual impropriety. But she says that the three-month suspension he received was hardly worth the degrading cross-examination she endured during the inquiry. Declared Allyson, now a university student in Fredericton: “I’m not sure which was worse—the abuse or the events that followed.”

In spite of those misgivings, she and other female patients have begun to break the conspiracy of silence that has protected doctors who sexually exploit those in their care. In most provinces, the medical establishment is now considering or implementing new procedures for handling complaints of sexual misconduct. Although the precise measures vary, the new rules reflect a determination to prevent all forms of sexual relationship, even consensual, between doctor and patient. Another common thread is a requirement that doctors who know of such cases report them immediately to their provincial college of physicians and surgeons.

At the same time, those who are most vocal in demanding harsher punishment acknowledge that sexual offences by people in positions of authority cannot simply be legislated out of existence. “This sort of abuse does not exist in a vacuum,” said Elizabeth Hamilton, a Fredericton librarian who has filed a sexual abuse complaint with the New Brunswick college. “What is needed is a dramatic change in societal attitudes.”

No one really knows how widespread the problem is—in part, experts say, because most victims are reluctant to come forward. Several

U.S. studies have concluded, based on information supplied by doctors themselves, that between seven and 13 per cent of physicians have had sexual or erotic contact with patients. And in Ontario, a recent Price Waterhouse survey found that eight per cent of female respondents reported having been sexually harassed or abused by doctors. Even so, James Maclean, communications director for the province’s College of Physicians and Surgeons, says that the college last year received only 197 sex-related complaints, involving an unspecified number of doctors. The New Brunswick college received written complaints against five doctors last year.

But when the college established an experimental hotline last October, it received 45 abuse complaints within one month.

Some victims are reluctant to come forward because of a fear that they will not be taken seriously. But in many jurisdictions the medical profession is getting tougher about disciplining ethical abuses. On Dec. 1, the Ontario college permanently revoked the licence of a Toronto general practitioner, James Sears, who pleaded guilty to three counts of sexual misconduct with patients and to a fourth charge of “disgraceful, dishonorable and unprofessional” conduct. Sears, who operated a

house-call service known as Dial-a-Doctor, has since appealed to the courts to restore his licence, telling reporters that he is the victim of a conspiracy by “feminist lesbian groups.” Such cases have failed to reassure many victims. They point to a recent case in Ottawa involving Hector Wames, a psychiatrist who began a sexual relationship in 1979 with a 21year-old woman patient. He continued to have sex with the woman in his office three times a week for three years, while billing the Ontario Health Insurance Plan for his time. In September, 1991, the Ontario college found him guilty of misconduct and revoked his licence. By then, however, Wames had moved to Montreal, where he is still licensed to practise. He now conducts clinical research in a Montreal hospital and is appealing the Ontario ruling.

Also controversial was a Nov. 4 decision by a New Brunswick provincial court judge to throw out 45 sexrelated charges brought by the RCMP against Floyd MacDonald, a prominent physician in the New Brunswick farming community of Hartland. Judge James Harper ruled that while MacDonald’s actions may have been “morally reprehensible,” they were not necessarily criminal. And he concluded that the 35 patients who had complained about the doctor had either consented to the acts or had failed to make their objections known to MacDonald. Responded Rosella Melanson, director of communications for the New Brunswick Advisory Council on the Status of Women: “If the word of 35 women isn’t enough, just what is?”

The New Brunswick attorney general’s department is now considering whether to appeal Harper’s ruling—or to bring the case directly to trial with a preferred indictment. Meanwhile, a board of inquiry representing the province’s medical college, which suspended MacDonald’s licence for nine months last June after he admitted committing a I sexual impropriety with a pag tient, is investigating 14 addiz tional sex complaints against u the doctor, all of which he denies. “We are asking for a decision of not guilty on all of the college’s charges,” said lawyer Rodney Gillis, who represents MacDonald. As that controversy drags on, new allegations of abuse by doctors in other parts of the country continue to surface.

JOHN DeMONT with BARRY CAME in Montreal