Doctors And Ethics

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ChemGal

ChemGal

One with keen eye
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Right now, I don't think doctors are being held to a high enough standard when it comes to ethical behaviour, particularly when it comes to the harassment and assault of others.

When they engage in criminal activity that is directly harmful to others but is not workplace related, how should that affect their practice?
What about when it is work related? Should it matter if it's patient related or not?

NDP and Conservatives both sound like they want to ban doctors when it comes to sexual assaults, yet that's not occurring.

This case:
edmontonjournal.com

Edmonton doctor convicted of sexual assaults allowed to practise again

Dr. Ismail Taher can practice medicine again as long as he has a chaperone when seeing female patients, among other restrictions
edmontonjournal.com edmontonjournal.com
Was something I heard a fair bit about as the doctor ended up working near me. I'm also aware of sexual harassment that occurred that he was never actually charged for. A complaint was made to the College, but nothing came about from it.

Then there's this doctor - who was asked to voluntarily step down for the time being. He said no. So the college mandated it. So he took them to court and won and is currently practicing in Calgary. Former St. Albert doctor accused of sexual assault can practise pending trial, court rules

Recently, I went to a walk-in clinic. Things with the appointment were a little odd. I had no knowledge that a chaperone was required to be present and wasn't informed one would be. When the person who took me to the room (where the doctor was already sitting) and she didn't leave I definitely had some alarm bells ringing. Looked it up after the fact - yes she was required to be there. The doctor is not allowed to be alone with any female - patient or staff. He was convicted of sexual assault, more than one instance, with an employee but nothing comes up in the news (I found out the information from the College's website).
 
I would at the very least like to see doctors being suspended during an investigation when what's alleged to have happened is a big risk factor to vulnerable groups (so things like assault - sexual or not, possession of child porn, domestic abuse, hate crimes, etc). If it needs to be with pay due to the whole innocent until proven guilty thing, I would rather see the money be 'wasted' to a doctor who does not provide service and keep people safe. Or they can consult without being present with a patient.

I think all clinics should be required to have a website with all doctors listed within a week of their start date. Dr. Kumar wasn't listed on the Calgary website of the clinic where he's currently practicing. By listing the doctors, someone can be aware before stepping foot into a clinic if they choose. I could not actually find any information about the doctors for the walk-in clinic I went to. The best option I had was facebook recommendations - searching the clinic name in a particular facebook group, I could have discovered the doctor but it's difficult to know if that's up to date. Even now, I'm not certain of the number of doctors at the clinic, I know there are at least 2.

If a doctor requires a chaperone - make that clear! Have it listed on the clinic website. Have it posted in the clinic. When making an appointment or walking in, the receptionist should mention it. This is important for proper informed consent IMO.

If a doctor is found to be guilty of one of the crimes mentioned above, I do not think they should be able to practice for at least a timeframe. This should be automatic, guilty = immediately not seeing patients with maybe a bit of a buffer if there is anything they need to do paperwork-wise for their patients to have timely care. A hearing could occur to determine the timeframe, but no waiting around, letting the doctor see patients in the meantime (the doctor I saw was convicted over a year ago, but his hearing is about 1.5 years after the conviction, still months away). For some, I do think a total loss of the licence is appropriate. The nature of the crime, as well as the number of instances should both be factors. When it is just a suspension, education and awareness plus a show of willingness to change should be mandatory.
 
ChemGal said:
I would at the very least like to see doctors being suspended during an investigation when what's alleged to have happened is a big risk factor to vulnerable groups (so things like assault - sexual or not, possession of child porn, domestic abuse, hate crimes, etc). If it needs to be with pay due to the whole innocent until proven guilty thing, I would rather see the money be 'wasted' to a doctor who does not provide service and keep people safe. Or they can consult without being present with a patient.

I think all clinics should be required to have a website with all doctors listed within a week of their start date. Dr. Kumar wasn't listed on the Calgary website of the clinic where he's currently practicing. By listing the doctors, someone can be aware before stepping foot into a clinic if they choose. I could not actually find any information about the doctors for the walk-in clinic I went to. The best option I had was facebook recommendations - searching the clinic name in a particular facebook group, I could have discovered the doctor but it's difficult to know if that's up to date. Even now, I'm not certain of the number of doctors at the clinic, I know there are at least 2.

If a doctor requires a chaperone - make that clear! Have it listed on the clinic website. Have it posted in the clinic. When making an appointment or walking in, the receptionist should mention it. This is important for proper informed consent IMO.

If a doctor is found to be guilty of one of the crimes mentioned above, I do not think they should be able to practice for at least a timeframe. This should be automatic, guilty = immediately not seeing patients with maybe a bit of a buffer if there is anything they need to do paperwork-wise for their patients to have timely care. A hearing could occur to determine the timeframe, but no waiting around, letting the doctor see patients in the meantime (the doctor I saw was convicted over a year ago, but his hearing is about 1.5 years after the conviction, still months away). For some, I do think a total loss of the licence is appropriate. The nature of the crime, as well as the number of instances should both be factors. When it is just a suspension, education and awareness plus a show of willingness to change should be mandatory.
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Recall that doctors are held on a pedestal ... from high places there is potential to fall ... hubris vs nemesis!

Few understand the complexity! KISS Prin. follows ... works with other professions also! One has to get through with this process so delicately to keep from offending the governing factions! Nothing worse than a corrupted power --- Lord Acton!
 
Not sure if that is just because of the doctors shortage- but its not just doctors who get away easy. Professional regulatory bodies are made up out of - volunteer professionals. And while they are somewhat concerned about the professional reputation, they also know what the consequences are and that they are in the same boat.
I think they should outright loose their licence, period- as long as it is clearly proven. Which might be the issue here?
Maybe thus the chaperone- because it wasn’t clear?
Doctors, police officers,politicians, lawyers, ministers- anybody in a position of power should not have the chance to regain that power again if proven guilty. Unfortunately, even if politicians are convicted guilty, it doesn’t seem to automatically remove them from power.
Just got an information brochure from my professional organization and insurance, in which they are warning people about overstepping the professional boundaries with the example of an OT, whose license was revoked because she started a relationship with a client while treating him in 2015, despite the fact that the treatment took place several years before and the OT and the client now were married. It also mentioned that the Ontario OT licensing body will never reinstate OTs whose licence was revoked for sexual abuse or misconduct.
 
Sects ... don't cross those lines ... the dark side of everything is nothing to sneer at! Be weary ...

There are rules that do not allow emotional involvement ... and thus chilly relations and report! Beyond that ... something better is out there ... rite of intuit!
 
Mrs.Anteater said:
Not sure if that is just because of the doctors shortage- but its not just doctors who get away easy. Professional regulatory bodies are made up out of - volunteer professionals. And while they are somewhat concerned about the professional reputation, they also know what the consequences are and that they are in the same boat.
I think they should outright loose their licence, period- as long as it is clearly proven. Which might be the issue here?
Maybe thus the chaperone- because it wasn’t clear?
Doctors, police officers,politicians, lawyers, ministers- anybody in a position of power should not have the chance to regain that power again if proven guilty. Unfortunately, even if politicians are convicted guilty, it doesn’t seem to automatically remove them from power.
Just got an information brochure from my professional organization and insurance, in which they are warning people about overstepping the professional boundaries with the example of an OT, whose license was revoked because she started a relationship with a client while treating him in 2015, despite the fact that the treatment took place several years before and the OT and the client now were married. It also mentioned that the Ontario OT licensing body will never reinstate OTs whose licence was revoked for sexual abuse or misconduct.
Click to expand...
In the first case, it was pretty clear he was guilty.
In the 2nd, it has not yet gone to trial, so I don't think too many details are known, as there would be legal consequences. It happened on a family vacation with a child relative.
In the 3rd, I was surprised no details could be found online. He was convicted though, and was said to have sexually assaulted the person 5 times and the time period was fairly short (3 months) Considering the burden of proving sexual assault I am trusting he is in fact guilty.
 
There's a problem in how we deal with this. Health professionals are governed by colleges. Who sits on the college and makes decisions on these things? Their own colleagues. Who may have similar skeletons in their own closet. It is the old "who watches the watchmen" problem again, similar to police investigating the police. Problem is that there are not really any people outside the professions with the necessary expertise so I am not sure how to fix the problem.
 
Mendalla said:
There's a problem in how we deal with this. Health professionals are governed by colleges. Who sits on the college and makes decisions on these things? Their own colleagues. Who may have similar skeletons in their own closet. It is the old "who watches the watchmen" problem again, similar to police investigating the police. Problem is that there are not really any people outside the professions with the necessary expertise so I am not sure how to fix the problem.
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How much expertise is needed if someone is convicted of a crime? Professional colleagues are only needed in questions of assessment and treatment of patients. There is no reason why the provincial law governing the profession could not include that proven sexual misconduct excludes you from practicing.

Then there is the grey zone of politicians cheating on their taxes or driving drunk- what should be the consequences for that?
 
Mrs.Anteater said:
Then there is the grey zone of politicians cheating on their taxes or driving drunk- what should be the consequences for that?
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There is no grey zone for this, IMHO. They should be charged and tried like anyone else. I would go further and say it should render them ineligible to run until/unless they get a pardon, at least for major felonies. Lesser stuff, maybe until they are off parole.


Mrs.Anteater said:
How much expertise is needed if someone is convicted of a crime?
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Again, none. If a crime against a patient is involved, or a serious crime against anyone, a suspension or loss of license should be automatic. There can be a right of appeal, but the default should be suspension until that appeal is heard.
 
When confronted by a crime against humanity ... who is guided by reason and who by passions/emotions/desires to be left alone?

Do such people feel wronged when left alone? Such a paradox ... unless one has a balanced outlook that watches both self and neighbour ... then the question of self is sometimes claimed to be indeterminate function of; my god we know not what because the connections and interlacing are not taught and understood!

Education on far-fetched conceptions? What a strange cognizance ...

Then does self-regulation work, in the case following:


Making for a great case study on governor err?

Some are supposed to self-correct ... others not! They don;t know how!
 
If I were a doctor today, I would probably opt to have a nurse be present during all physical examinations as witness to my conduct....patient approved of course.
 
Waterfall said:
If I were a doctor today, I would probably opt to have a nurse be present during all physical examinations as witness to my conduct....patient approved of course.
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There is actually a chaperone course, so someone doesn't need the training that a nurse has to be present.
Patients should have the right to decide who they want present though. I have been asked for clear consent when medical students were present, plus they left for an examination. There are situations where I would feel less comfortable with a chaperone present.
 
Mendalla said:
There's a problem in how we deal with this. Health professionals are governed by colleges. Who sits on the college and makes decisions on these things? Their own colleagues. Who may have similar skeletons in their own closet. It is the old "who watches the watchmen" problem again, similar to police investigating the police. Problem is that there are not really any people outside the professions with the necessary expertise so I am not sure how to fix the problem.
Click to expand...
The thing I didn't understand was with the first case the College was saying the province didn't give them enough ability to prevent a doctor from practicing. That one was really confusing to me, and I still don't understand that. I know that other licencing bodies have that capability. Chemguy actually had an issue with false accusations by a former coworker - the coworker ended up dropping all his false complaints (there were multiple, mutliple people) but it was something we were looking into while awaiting to find out about a hearing date.

The province apparently made changes, but that entire thing didn't make sense. There was a bit of a push for it to be a total loss of licence with any sexual crime. The NDP didn't put that aspect through and Conservatives were complaining about them being too soft. But decades of the Conservatives being in power and the College was never given the capability to pull a licence or whatever it was that was limiting them?
 
One can also be messed up and shafted by other professions ... authoritatively and basically unknown if you don;t question morals, ethics and legalities!

Trust not any pure doctrine ... everything is flawed ... mistake designed by mysterious powers to teach us ... pedegogary hated by the hard-liners! Sort of hard as edifice building ... these two will collapse! In tents observation ... rigid perspectives to absorb!
 
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Ugh going off topic from what my intent here was but I am sooooo angry right now.
:mad:
I shared information about the last doctor with online local groups. I had kept any opinions out of it, just stated fact, most copy & paste. One of my posts was deleted (by a man) as he thought I wasn't following a rule related to promoting businesses - at least there was an apology.
Another man responded this morning about how I am wrong about the doctor being convicted, he wouldn't be working if that was the case. Innocent until proven guilty, why am I out to ruin this doctor's career, blah blah blah. Also "delicate female issues".

Seems like a female can't make any type of statement about any sexual assault that occurred with at least one male accusing us of making false statements. If just stating this about a conviction that happened is called out to be false seems like the deck is highly stacked against us about an actual legal accusation.
 
I've been thinking about this. It seems that a male doctor having a chaperone for certain procedures with female patients is becoming the norm. I don't have a problem with that. It can actually be a show of respect.

Not being allowed to be alone with a female patient at all raises alarms for me. I too would be uncomfortable if I walked into an exam room and saw the doctor waiting for me. There's so many things wrong with that.

I have mixed feelings about whether a doctor should practice. There was a doctor practicing in northern BC who had been investigated under the Robert Pickton case. They had been investigating any man who spent time on the DES and who'd had a sexual assault incident. I don't think there had to have been charges involved. At any rate, this man had sexually assaulted a woman to the point she felt her life was in danger. The incident happened in a van. The woman kicked the door to the van in her struggle, causing the inside light to come on. Apparently, this caused the doctor to "come to" and release her. He was still practicing. The community did not apparently know about the incident. For some reason he was allowed to continue to practice. He should have at least lost his ability to be a doctor. Jail or legal consequences would have been good.

I've known of doctors/ health professionals who were in recovery from addictions. They had taken responsibility for their actions. They were open and accountable. They were willing to be held to account. I see no problem with them practicing.

This is an important topic.
 
I have met/ heard of some wacky people as patients, family members and parents of my son’s classmates. There is a whole lot of stuff put on facebook that can ruin a persons career. The existence of professional associations is a good thing to clear a person’s reputation, but stuff published on facebook often stays there forever.
It happens on a regular basis that people who do not get what they think they deserve threaten to go public.
The control through professional associations should probably be more defined and standardized as well as communicated across the provinces.
 
Mrs.Anteater said:
The control through professional associations should probably be more defined and standardized as well as communicated across the provinces.
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I actually wish that health care in general had been given to the feds, not the provinces. While I get that in 1867, it might have been more important to have something like that localized, reality today would be better served by having national standards for payment, care, and professional behaviour. On this issue, it would avoid the problem of a doctor losing a license in one province and managing to hide that when they go to get one in another.

However, since we don't have that, a national database that all the colleges contribute to would be a good second option and surely the colleges could see their way to doing it. The feds and provinces could even pony up funding for it. Tech-wise, just use something like Microsoft Dynamics 365, which runs in MS's cloud (which is one of the most secure of the clouds) and it could be easily adapted for this purpose. I'm sure other options are out there, too. D365 just happens to be the one I work with day-to-day and I can visualize how it might work.
 
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