On 6 November 2009, a 26-year-old
(male) doctor, who was about to receive a qualification from the Royal College
of Surgeons of Edinburgh, was convicted of indecent assault on a 15-year-old
girl during his elective period in the A&E Department of Tuen Mun Hospital.
It was reported in newspaper that on 10
February 2009, the girl had stomach discomfort and was seen by the doctor. She lifted up her dress to her rib area for
the doctor to examine. She asserted that
the doctor pushed her dress and her bra up to her collarbone and touched her
breasts without her consent. The
Magistrate found the doctor’s testimony not consistent with the statement given
to the police and found him guilty of indecent assault. The magistrate clearly pointed out that the
offence constituted a breach of trust. When
passing sentence, the magistrate criticized him for taking advantage of a young
and vulnerable girl, and that the doctor had shown no remorse. He was sentenced to imprisonment for nine months.
After serving his sentence, the doctor
needs to face a Medical Council inquiry because of the criminal conviction. There is a high chance that he will be removed
from the General Register for a certain period of time.
Although Glenn Beck in his new book
“Arguing with Idiots: How to Stop Small
Minds and Big Government” wrote that “opinions
should end where facts begin”, the fact for the above case was that might
be no one would know the fact. Even the
two people involved in the case might not know the whole particulars. The doctor might be preoccupied by something
in his mind and thus had done something not in his full consciousness. The girl, on the other hand, might have
mistaken some procedures and firmly believed that the act was a sexual assault.
At this point in time, the only fact was
that the doctor was found guilty.
It is perception that matters. Some doctors believe that the doctor was
innocent and would like to help his appeal. It is a fact that the judge would usually
choose to believe in the patient rather than the doctor when there is
contradicting evidence. It is because it
is hard for a doctor to remember every detail of one patient among hundreds of
patients seen, but it is convincing for the patient to tell every detail of a
single consultation in which she finds problems. Frontline doctors might find them vulnerable
especially in a busy environment in short of nurses to act as chaperons.
Another concern is rehabilitation
of the doctor. No matter the doctor had
committed the crime or not, this event was a real trauma to his career and to
him psychologically. He needs help in
terms of financial assistance, career counseling and psychological counseling. I think the medical school where he graduated
and the HKMA should take the initiative to offer assistance to him during his
trial, during his appeal (if there is any), during his stay in prison, after
his release, during the Medical Council inquiry and afterwards.
For the public, people might also
perceive that they are vulnerable. There
had been cases of sex crimes including inappropriate sex relation of a doctor
and his psychiatric patient, hidden camera installed in a private clinic and
indecent assault committed by a medical student. Doctors and patients are in an unequal position
as doctors are the authority while patients are sick and anxious. One must admit that there exists a real risk,
no matter how small this risk is, that a doctor might abuse his power and
position and do something harmful to the patient. Therefore it is very important to make sure
that doctors do not abuse their positions, and that there are clear mechanisms
to show to the public that doctors will not abuse their power.
It is the role of the Medical
Council “to assure and promote quality in
the medical profession in order to protect patients, foster ethical conduct,
and develop and maintain high professional standards”. In the above mentioned case, apart from
holding an inquiry according to the MRO after the doctor spends his
imprisonment, the Medical Council should make sure that there is no latent
period between his release from prison and the delivery of verdict from the
inquiry. It is because the doctor is
still on the General Register and thus can still practice before there is any
action from the Medical Council. For
public protection, the logistic of the inquiry should be carefully monitored
and there should be an interim measure for suspension of doctors from
practicing if there are criminal offences resulting in imprisonment especially
sex crimes.
Buddhism looks at moral evils in
three levels. The first level is called
anusaya, which means sleep. At this
level moral evil remains dormant in the form of latent tendencies. The second level is called pariyutthana, which
means arising all around. At this level
the latent tendencies are awaken and cause emotional turbulence and excited
feelings. The third level is called
vitikkama, which means going beyond. At
this level our emotions manifest themselves in the form of vocal and physical
actions. The vitikkama is most dangerous
but easiest to control. This can be
controlled by moral discipline (sila) such as Codes and Regulations. Evil at pariyutthana level is controlled by
concentration (samadhi). I regard this
as impulse control training, which should be introduced and reinforced both at
undergraduate and postgraduate level. Wisdom
and insight (panna) is needed to uproot evil at anusaya level. This involves personal development. A good foundation at medical school is very
important.
(Source: HKMA News November 2009)
