At times, the trial seemed too shocking to be true. During 10 days of testimony that was laced with accounts of drugs, gambling and hit men, it became clear that Surrey, B.C., physician Joseph Charalambous was obsessed with stopping a former patient, 19-year-old Sian Simmonds, from testifying against him at a sexual misconduct hearing before the College of Physicians and Surgeons of British Columbia. Charalambous, 42, who was previously disciplined for sexual misconduct with another teenage patient—she later became his wife—faced revocation of his licence to practise and the loss of his $450,000 annual income. Last week, in the Vancouver suburb of Westminster, B.C. Supreme Court Justice Ronald McKinnon found him guilty of first-degree murder for his role in plotting
Simmonds’s slaying in January, 1993—and sentenced him to life in prison. But the ruling did little to allay the anger of many who believe the B.C. college could have acted sooner to stop Charalambous—and save Simmonds’s
life. “There should be zero tolerance for doctors who abuse their trust,” says Bonnie Agnew, a spokeswoman for the Vancouver Rape Relief and Women’s Shelter. “These are highly educated men, and they know what is right and what is wrong.”
The Charalambous case is a sensational example of a disturbing reality. In British Columbia alone, the number of sexual abuse complaints against doctors climbed to 72 in 1993 from 27 in 1991—a rise due, at least in part, to increased reporting of incidents. Several provinces have responded by conducting inquiries into the handling of professional misconduct cases, focusing on the role played by provincial colleges of physicians and surgeons, the doctor-run bodies that regulate the medical profession. In British Columbia and Ontario, legislative changes have 5 been made to strengthen the ac^ countability of doctors. But last week, | the registrar of the B.C. college, Dr. ^ Tom Handley, said that nothing in 52 the new rules could have prevented actions as extreme as those of Charalam-
bous. If so, others say, much more
should be done to prevent such tragedies. “We need a much tougher, ongoing scrutiny of what these self-regulating bodies are doing,” says Toronto lawyer Marilou McPhedran, who chaired a 1991 task force into the prac-
tices of Ontario’s college of physicians and surgeons. “No one ever pays any attention to these problems unless there is fresh kill.”
The events that led up to Sian Simmonds’s death began in September, 1991, when she and her sister Katie complained to the B.C. college of physicians and surgeons that Charalambous hugged and kissed them in his office. In response, the college scheduled a disciplinary hearing for early March, 1993. The doctor’s estranged wife, Shelley Charalambous, testified at the non-jury trial that her husband became agitated after learning of the hearing in November, 1992, and that he believed his career and his livelihood were at stake. “He was thinking of anything possible to keep the hearing from going ahead,” she said.
Finally, he asked a friend, Brian Gerald West, 43, to help him deal with the sisters. West coerced another man, David Schlender, 41, into tracking Sian down at her Surrey apartment, and gave him a gun, bullets and a silencer. During the trial, Schlender, who was earlier convicted of second-degree murder for shooting and bludgeoning Sian to death on Jan. 27, 1993, testified that he owed a $6,000 drug debt to West.
At the trial’s end, Christopher Simmonds, Sian’s father, criticized the B.C. college for failing to move more quickly on the case— there was an 18-month delay between the time of her complaint and the date set for a hearing. In most instances, said college registrar Handley, delays have now been reduced to the absolute minimum, about seven months. And in any event, he maintained, time was not the issue in the Charalambous case. ‘What was responsible was the character of the individuals who perpetrated the crime,” he said. “This was a unique and horrible circumstance. There was no reason to anticipate what happened.”
But some experts say that doctors should undergo a much more rigorous screening process to prevent a person of obviously poor character from joining the profession. During the trial, for example, Charalambous’s estranged wife (they have three children) testified that her husband is an addicted gambler who spent most of his $450,000 annual income at casinos and the racetrack. He often beat her, she said. Charalambous also faces criminal charges that could not be made public while his trial was in progress. There are six charges of sexual assault involving three former patients, and he is a co-accused in a case of procurement: he is alleged to have traded drugs for sex with the 16-year-old daughter of a cocaine addict.
The haunting question last week was whether Charalambous could have been stopped before it was too late. At the very least, Simmonds’s death—preventable or not—may help refocus scrutiny on one of society’s most delicate relationships, that of physicians and their patients.
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