‘You can’t expect a body to police itself’

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This article was published 22/08/2022 (855 days ago), so information in it may no longer be current.

In the midst of a brewing — but not yet public — alleged sexual abuse scandal involving a rural doctor, Manitoba’s physician watchdog undertook an in-depth review of its misconduct policies.

Critics say it was an opportunity for the College of Physicians and Surgeons of Manitoba to take steps to better protect patients, and while progress was made, important matters went ignored.

The college launched a “sexual boundaries” review in June 2019, citing a need to “reconsider whether the public interest and patient safety are being served” with existing policies, noting that “societal values evolve.”

While it would still be more than a year before Ste. Anne doctor Arcel Bissonnette would be charged with 22 counts of sexual assault, the college was already aware of the allegations. A whistleblower filed a formal complaint with the self-regulatory body in October 2018.

It’s unclear if the Bissonnette case was considered in the review.

The whistleblower says she is “infuriated” by how the college ultimately handled her case and is shocked to learn the review was happening simultaneously. Critics say issues she faced, including communication breakdowns, retraumatization and lack of transparency, should have been addressed in the review.

The college has recently come under fire for how it handles sexual misconduct cases involving doctors following a Free Press investigation.

Earlier this month, the newspaper reported that the college allowed Bissonnette to continue practising — with a condition placed on his licence requiring the presence of a chaperone during sensitive examinations of female patients — after learning he’d been accused of sexually assaulting patients.

The college then appears to have ceased investigating, leaving the matter to police, as is its policy but failed to inform the complainant.

Those issues — failure to suspend physicians who face serious allegations, deferring to police when a criminal investigation is also underway and not communicating decisions with complainants — were not addressed in the review.

Lorian Hardcastle, an associate professor of law with the University of Calgary, said the college’s policy to cease investigating when police are involved is “most troublesome.”

“(Patients) need everyone acting on these cases as soon as possible, because then if one of those entities has delays or drops the ball or something goes wrong, you still have those added layers of protection,” Hardcastle said.

Issues the review did consider include: hiring a support worker for complainants; trauma-informed training for investigation staff; doctors’ fear of seeing their names published for misconduct; the college’s fear of alienating doctors during investigations; and the pros and cons of gender-based chaperones. Aside from training and more supports, the working group mostly recommended the college maintain the status quo for its policies.

Hardcastle said hiring a support person is an “excellent step,” but other issues, such as gender-based conditions on physician licences, along with the policy of deferring to police, warrant further study.

The college told the Free Press that updating standards to “more clearly” define sexual boundary violations and hiring a social worker to support complainants during the investigation process were among the changes it made.

Hardcastle said hiring a support person is an “excellent step,” but other issues, such as gender-based conditions on physician licences, along with the policy of deferring to police, warrant further study.

Hardcastle and others who work in the fields of health, law and advocacy for sexual-violence survivors say those issues would be best addressed by an independent review — something for which Manitoba NDP health critic Uzoma Asagwara has also voiced support.

The province has not commented on the possibility of an independent review.

Simona Jellinek, a Toronto lawyer with extensive experience representing survivors of sexual assault, said the college’s policy of sharing communications between victims and alleged perpetrators is “wholly inappropriate.”

Jellinek said deferring cases while police investigations are ongoing is an “abdication” of the college’s duty to protect patients.

When a complaint is received, the college shares the detailed allegations with the physician, forwards the physician’s response to the complainant and then asks the complainant to respond. The complainant in the Bissonnette case said reading her alleged abuser’s response was “triggering.”

The college has defended the practice, saying it keeps complainants informed of the developments of the investigation. The social worker, hired in August 2020, is also available to provide support, the college said.

Jellinek said deferring cases while police investigations are ongoing is an “abdication” of the college’s duty to protect patients. She said an external agency, as opposed to doctors overseeing doctors with a self-regulating body, would be better suited to handling complaints against physicians.

“You can’t expect a body to police itself,” she said.

“The fact that in their judgment the public wasn’t entitled to know (who was involved) is yet another indication that they don’t get it when it comes to issues of protecting public health and safety and promoting confidence in the integrity of the college itself.” – Arthur Schafer

As for the structure of the boundaries review, the college has said the working group included external parties, such as an ethics expert and representatives from hospital emergency departments and the Women’s Health Clinic, and that the review included a “very public” consultation. However, it won’t say how many members of the public weighed in.

The college provided the Free Press with a copy of the working group’s report with names of those involved blacked out, despite the existence of an unredacted report on its website. The college did not say why it attempted to conceal the identities of the working group.

To one ethics critic, that’s a red flag.

“The fact that in their judgment the public wasn’t entitled to know (who was involved) is yet another indication that they don’t get it when it comes to issues of protecting public health and safety and promoting confidence in the integrity of the college itself,” said Arthur Schafer, founding director of the Centre for Professional and Applied Ethics at the University of Manitoba.

The redaction — among other issues of secrecy — “suggests that the college can’t be trusted to clean up its own house,” he said, adding he also supports an independent review.

katrina.clarke@freepress.mb.ca

Katrina Clarke
Reporter

Katrina Clarke is an investigative reporter with the Winnipeg Free Press.

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