Despite popular belief, "First, do no harm" is not in the Hippocratic Oath. What is firmly therein is this: "Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves."
That simple sentence puts into plain, comprehensive context the great magnitude and sweep of the shocking problems uncovered in “Doctors & Sex Abuse,” The Atlanta Journal-Constitution’s ongoing series of investigative reports which began this month.
This newspaper’s best investigative journalists spent much of the past year obtaining, analyzing and reading thousands of records and doing interviews around the country. The core intent was simple: to assess and document how the cases of doctors accused of sexual misconduct are handled around the U.S.
It’s turned out to be an immense project; one that began with a reporter’s observation that two-thirds of Georgia doctors accused of sexual misbehavior were allowed to resume the practice of medicine at some point.
Further exploration to put that worrisome fact into a broader context revealed the startling truth that Georgia is not unusual in how it handles allegations and cases of sexual abuse by doctors.
In fairness to a profession whose work literally involves life-or-death issues and everything between, we would be remiss in not stating clearly that the great majority of doctors do not violate the trust of their patients. As the AJC reported last week, “No one in the medical profession condones sexual abuse by doctors. But silence, secrecy and inconsistent consequences have created a system that puts patients at risk by protecting doctors who abuse.”
Medicine is practiced for the most part by honorable, hard-working people who strive daily – 24/7, really – to live up to the awe-inspiring calling of Hippocrates’ ancient oath. Summarized, its words really do entreat doctors to “do no harm.”
Yet, far too many doctors manage to do harm by sexually abusing their patients. Even given the inevitability of human misbehavior at times, society’s goal should be that even one incident – let alone a handful or more – are too many.
And any such abuse should not be tolerated. Adequate systems should be in place nationally to both encourage reporting of sexual misconduct and adequately investigative such claims.
The rights of abuse victims should be firmly balanced with doctors’ right to due process. That is far from the case now, as many systems tilt the balance of power far toward the corner housing the physician’s stool.
A more equitable goal for society should be to sift out the truth in sex abuse cases and, where warranted, impose discipline, sanctions or punishment. That would best serve the interests of justice – a cause that compares favorably in societal importance to that of medicine.
That cannot happen in a system that, viewed across all 50 states and the federal government, is shockingly haphazard and inconsistent, if not nonchalant at times, in dealing with those who trash bounds of propriety, ethics and legality while practicing medicine.
The AJC’s reporting found that state boards, viewed generally, are far too inclined to shun transparency in favor of operating behind drapes of secrecy. Disclosure, when it happens, is too often incomplete and not easy to access. Different rules and methods of operation by state medical boards combine to create too-large cracks into which relevant information can fall from view.
A better system would see disciplinary records and databases shared publicly in a manner that helps prevent bad operators and serial offenders from resurfacing in other places and resuming the practice of medicine with a clean slate.
This newspaper’s series shows the complexity and immensity of the problem. Its scale should not deter society and medical regulators and associations from moving to improve systems intended to address sexual abuse by doctors. Points where improvements can be made include:
• Beginning efforts to neutralize the nearly automatic reflex by society and the medical profession alike to not believe patients who come forward with claims of sexual abuse by doctors. The pervasiveness of the problems uncovered by the AJC should help dispel erroneous notions that the problems are nearly nonexistent. There is much work to do by many to alleviate the stigma from coming forward with sexual abuse allegations.
• AJC reporting also found that state regulatory agencies or medical boards don’t necessarily track and report sexual offenses in a consistent way. That should change. Lawmakers should demand a comprehensive, nationally consistent accounting of doctors who’ve been sanctioned.
• The issuing of “private” orders for sexual misconduct also deserves a serious re-examination nationally. Some states don’t allow for private discipline in cases of sexual misconduct. They have it right, we believe, and other states should review such practices with a strong eye toward eliminating them.
• Regulators should also find ways to make it easier for patients to search for sanctions levied against doctors. The AJC’s work shows the inestimable value of such information for vulnerable patients.
The AJC’s series shows that there is much work to be done to fix the substandard apparatus intended to address patient sexual abuse by doctors. That will only happen if natural tendencies to minimize the scope of the problem are resisted.
Only then can systems be improved, changed or overhauled as needed to protect the rights of patients at least to the extent that they currently safeguard interests of even bad-actor doctors.
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