One strike is too many for medicine’s practitioners

Editor’s note: This column originally appeared in U.S. News & World Report.

Who is it that, despite all the attention paid to sexual abuse, is still getting away with taking advantage of vulnerable women and men? According to a recently published year-long investigation by The Atlanta Journal-Constitution, it is doctors. The investigation found that more than 2,400 doctors from every state have been sanctioned for sexually abusing their patients. State medical boards, which oversee physician licenses, allowed more than half the sanctioned doctors to keep theirs even after accusations of sexual abuse were determined to be true.

One of the worst offenses a person with power can commit is to use that power to take advantage of another who is weaker, vulnerable or both. Sometimes this form of abuse involves exploiting someone who is desperate for work and will agree to any terms just so they can eat or support their family. Sometimes the exploitation involves sex.

We have seen example after sad example where priests, military officers, faculty members, legislators and police have demanded or cajoled sexual favors from people, often younger – sometimes children. The predator often alleges consent, but the reality of the power inequities and the age of many of the victims make a mockery of any such excuse.

The Catholic Church is the most notorious institution in which power was used by priests to sexually molest, and the problem of sex abuse in the medical profession is tragically very similar. Many years ago, a medical board asked me for my opinion about readmitting a pediatrician to practice. He had been through a treatment program after having been convicted of molesting a child – his own son. I told the board it would be crazy to reinstate him. They could not possibly let such a person care for children ever again, rehab or not. I lost. The doctor was allowed to practice again as long as a nurse or another doctor was in the room.

Medical boards, which are overwhelmingly made up of doctors, are too lenient toward the small number of doctors who molest their patients. Patients are sometimes molested when they are unconscious. Others are told sex is part of their treatment. Some are too intimidated to speak up about a doctor’s advances.

It is a terrible thing to take away a person’s livelihood, especially one that takes a decade or more to secure. But doctors convicted of sexual abuse should not be allowed to practice ever again. Trust is key to doctor-patient relationships. Abuse that trust, and you ought to forfeit your license forever.

One conviction of abuse is one too many. Abusers need help, but patients need protection. Licensing boards ought to make it clear that when you are in the care of a physician, psychologist, dentist or nurse, their primary concern is your and your loved ones’ best interest. One strike and the doctor ought be out.

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Arthur Caplan, Ph.D., is the Drs. William F. and Virginia Connolly Mitty professor and founding head of the Division of Bioethics at New York University Langone Medical Center in New York City.