A testified before the Committee that their relationship ended badly. In , she commenced a civil action against Dr. Sliwin, which was eventually settled. She also filed a complaint with the College which ultimately resulted in the proceedings before the Committee. The definition of sexual abuse of a patient by a doctor is extremely broad.
Sexual abuse is defined as:. In order to find wrongdoing, the Discipline Committee must find a concurrence between the sexual relationship and the doctor-patient relationship. It does not matter which relationship began first. If they carried on simultaneously, an infraction has been committed. The reasoning behind this legislation is quite straightforward. Patients are deemed to be vulnerable, by definition, and therefore in need of protection.
In this case, for example, one of the defences raised by Dr. Sliwin was that Ms. A was a "sophisticated consumer" of cosmetic surgeries who should not be considered vulnerable in the usual sense. She did not consider herself to have been sexually abused although she was not aware of the legal definition of that term and she had made it clear to the Committee that the relationship had been consensual.
This particular argument was rejected by the Committee. The Committee noted that courts have accepted that there is a power imbalance between a doctor and a patient so that as far as the court is concerned, no sexual relationship between a doctor and a patient can ever be truly consensual.
The fact that Ms. A was sophisticated in matters of cosmetic surgery or that she considered the relationship to be consensual was irrelevant. Sliwin also put forward the defence that the two relationships had not been concurrent. This was also rejected. It was found that sexual relations had taken place, although intermittently, between and and during that same period, Dr. A's doctor and performed a number of surgeries. In fact, sex occurred in close proximity to some of these procedures on a number of occasions and certainly within the timeframe of the preoperative and postoperative treatment periods.
Sliwin had been Ms.specansercusum.ga/could-i-have-lyme-disease-chronic-lyme.php
Sexual relationships between doctors and former patients
A's doctor even before the start of their sexual relationship and after the first surgery, he chose to continue the sexual relationship while performing more procedures over the following years. In so doing, Dr. Sliwin was found to have engaged in sexual abuse. The Committee went on to find that Dr. The Health Professions Procedural Code provides for certain mandatory penalty provisions and one of them is mandatory revocation in instances such as those found by the Committee in the case of Dr.
The Committee reconvened a penalty hearing a number of months later.
At that time, Dr. Sliwin moved for an order that the mandatory penalty provisions in the Code were contrary to the Charter of Rights and therefore unconstitutional and unenforceable.
His first argument was that the mandatory revocation regime was never meant to apply to preexisting relationships. The idea behind this argument was that concern about the exploitation of the power dynamic between a doctor and a patient does not arise where the personal relationship predates the doctor-patient relationship. Sliwin, the Ontario Court of Appeal had considered exactly that argument in three earlier cases and dismissed it. There is no exception carved out for preexisting relationships.
In terms of the constitutional validity of the mandatory revocation provisions, the Ontario Court of Appeal in earlier cases also made it clear that "when it comes to sexual relations between a doctor and a patient, there is a black letter, bright line prohibition with a drastic sanction and no exceptions or exemptions Sliwin also put forward the proposition that in a sense, his relationship with Ms.
A was akin to a relationship between spouses and accordingly should be favoured with an exemption from the mandatory revocation provisions. This raises another interesting point in theory although the Committee dismissed this argument as well. Under that legislation, individual regulatory health colleges were given the authority to determine if a limited spousal exception to the mandatory sexual abuse provisions is appropriate for the members of the health profession governed by the College. There was an "opt-in" provision with a limited spousal exception.
Remarkably enough, the College of Physicians and Surgeons of Ontario did not opt in and accordingly, there is no limited spousal exception that applies to physicians in Ontario. This means, in essence, that a doctor is prohibited from providing medical treatment to his or her spouse although the College does have a policy that provides an extremely limited exception for minor or emergency situations.
Somehow, if you are a doctor and you are providing medical treatment to your spouse, normal marital relations with your spouse constitutes sexual abuse by definition.
While one might logically ask why on earth any spouse would lodge a complaint with the College in these circumstances, one must bear in mind that marriages end and angry ex-spouses do all of kinds of nasty things to each other. Both the Ontario Court of Appeal and the College have made it abundantly clear that there is a zero tolerance policy when it comes to sexual relations between a doctor and a patient.
Doctors warned against sex with ex-patients | Society | The Guardian
However, I do have one anecdote that might cast the situation in a somewhat different light. A number of years ago, I was approached by a woman with a complaint that her doctor had sexually abused her. She indicated that she had put a personal ad into the newspaper which was answered by a doctor who had only just become accredited as a doctor.
The classic paradigm, with the single handed usually male practitioner exploiting vulnerable female patients is less likely today because doctors work in multidisciplinary teams, where such behaviour would be exposed. It is also easy to think of examples that verge on the absurd; should junior doctors treating fellow medics in accident and emergency be forever precluded from dating them?
As the patient as consumer comes of age, and the power and status of professionals wanes, is Graeme Catto right or is the doctor-patient relationship now a meeting of equals? As with so many questions that arise in ethics, the honest answer must be, it depends. Recent history is sadly strewn with sobering examples of doctors abusing their power—Rodney Ledward, Harold Shipman, Peter Green. If so many doctors had not abused their power in the past, calls for restraint would not be as loud. Irrespective of the pressure that the softening of traditional hierarchies of authority is bringing to bear, the doctor-patient relationship remains a kind of exemplar.
Patients are often vulnerable when they visit doctors. They can be sick, distressed, and disorientated, even if they express their need in an aggressive or overconfident way. Patients may need to reveal the most private information. Without the expectation that boundaries will be observed and trust respected, they may be less forthcoming, and patient care will suffer.
Information trawled from the internet will never be a substitute for informed professional judgment. It is for the interpretation of such information as much as for its provision that we rely on professionals. So it is a special kind of relationship, rooted in trust as much as contract, governed by professional boundaries that protect doctors as well as patients, and subject in complex ways to the ebb and flow of power.
The GMC has a difficult job to do. In falling short of a blanket ban, in recognising that there will always be exceptions, it has made a wise choice. National Center for Biotechnology Information , U. Journal List BMJ v. Julian Sheather , senior ethics advisor. Author information Copyright and License information Disclaimer.
This article has been cited by other articles in PMC. Department of Health Committee of Inquiry.
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