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Author Topic: Dr. Abelsohn - sexual abuse case
Michelle
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posted 09 January 2004 01:48 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Is anyone else following this disciplinary hearing in the Globe?

Article series on the case.

I read the most recent article just now, and it's really bothering me that Blatchford appears to be blaming the victim and sympathizing with the doctor here. Basically, it sounds like the doctor got way in over his head with a very sick patient that he wasn't qualified to treat anyhow, being a family doctor without much in the way of psychological treatment skills.

The patient has Borderline Personality Disorder, but the doctor completely lost control of the case. It got to the point where the therapy was including the woman masturbating on the floor of his office, and taking his hand and touching herself with it. It's true that the woman hounded him into doing this stuff - but he's the doctor, and he found the situation spiralling out of control, and it was up to him to do something about that.

What really bothers me is that Blatchford is practically demonizing the patient for her actions in all of this, when in actual fact, what the patient was doing was exhibiting symptoms of her illness - fixating on the doctor, stalking him, etc.

I mean, come on. To blame the patient instead of the doctor for this? Well, that's what happens when you take on patients with illnesses that you can't treat. Part of being a doctor is to know your limitations. And I'm sorry, but any fool could figure out that having a patient masturbating in front of you is not appropriate therapy.

Anyone else following this story?


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paxamillion
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posted 09 January 2004 02:07 PM      Profile for paxamillion   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Yes. I really dislike the language of "lost control." This is not an icy patch of road and the doctor did not lose control of his car. This is a mentally ill patient and the doctor chose to do and permit inappropriate actions.

Borderline Personality Disorder patients are terribly difficult to treat -- really requiring someone with a lot of skill at it. I know of three in my community and they are difficult cases all. They show many of the same kinds of behaviour mentioned in the articles.


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Mr. Magoo
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posted 09 January 2004 02:11 PM      Profile for Mr. Magoo   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Certainly he's the architect of his own situation, but then so are teachers who initiate inappropriate conduct with students... so it would seem fair that he should get roughly the same punishment we give them (which is not a hell of a lot, unfortunately).
From: ø¤°`°¤ø,¸_¸,ø¤°`°¤ø,¸_¸,ø¤°°¤ø,¸_¸,ø¤°°¤ø, | Registered: Dec 2002  |  IP: Logged
Michelle
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posted 09 January 2004 02:11 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
I wasn't quite sure how to put it. Reading the articles, I can sort of sympathize about how the doctor got in over his head. But a lot of it is just inexcusable, really.

I mean, what is this:

quote:
Again and again yesterday, as Mr. Griffin would ask him why he acceded to the woman's increasingly bizarre requests, Dr. Abelsohn seemed to search not only for the answer, but also for an arguably more elusive truth.

When, for instance, in January of 1996, she asked for the first time "if she could have an orgasm in the office," he said, "I realize, in retrospect, that I could have said no, and in retrospect I realize I certainly should have said no. But what I did was say if it would be helpful, I would go along with it."

Once that month, and four more times that summer, Dr. Abelsohn admitted that he agreed to the woman's self-devised plan to help her conquer her purported sexual dysfunction by letting her masturbate to orgasm.


If you don't know how to treat a patient, you either consult or refer the case onto someone who can.


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paxamillion
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posted 09 January 2004 02:16 PM      Profile for paxamillion   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Exactly. Completely inappropriate choices on the doctor's part. I believe she should have been seeing someone more qualified.
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Michelle
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posted 09 January 2004 02:28 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
This is why Blatchford's coverage is bothering me so much. She's assuming that the doctor can be the victim in this case. Look at what she wrote here:

quote:
Interestingly, Dr. Hoffman said that fully 75 per cent of borderlines are women. Presumably, all of them are deemed to become utterly powerless, and potential victims, once they step into a doctor's office.

Yes, that is correct. They do become potential victims in a doctor's office because the doctor should be in charge of the treatment. She seems to be suggesting that the woman ISN'T "utterly powerless" in her illness. Well, she wouldn't be mentally ill if she could control the symptoms of her mental illness, now, would she?

And look at this:

quote:
Dr. Abelsohn is a 52-year-old family physician whose training in psychotherapy in the main consisted of several stints he did years before as a medical resident and part-time or weekend courses on what could be called the touchy-feely fringe of the profession.

While at the time he began treating the woman, in late 1994, his practice was about 40 per cent devoted to psychotherapy


Part of being a doctor or health professional is to be able to recognize your limitations. Look at that training. Psychologists have years of training, both theoretical and practical, before they can be fully licensed to practice. This guy does a couple of weekend courses and figures he diagnose and treat cases of profound psychological illness?

Maybe he didn't intend to sexually abuse her. But he is most definitely incompetent, and for such a profound lack of professional judgment he should lose his license to practice not only psychotherapy, but medicine.


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Mr. Magoo
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posted 09 January 2004 02:37 PM      Profile for Mr. Magoo   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
and for such a profound lack of professional judgment he should lose his license to practice not only psychotherapy

I doubt very much that he has any kind of licence to practice psychotherapy. It's impossible to become a licenced therapist without undergoing considerable therapy yourself. Certainly it's not going to follow a few weekend courses on "I'm OK, You're OK".


From: ø¤°`°¤ø,¸_¸,ø¤°`°¤ø,¸_¸,ø¤°°¤ø,¸_¸,ø¤°°¤ø, | Registered: Dec 2002  |  IP: Logged
paxamillion
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posted 09 January 2004 02:39 PM      Profile for paxamillion   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
But he is most definitely incompetent, and for such a profound lack of professional judgment he should lose his license to practice not only psychotherapy, but medicine.

As one of the objectives for therapy of a person with BPD is working on setting limits for behaviour, I'd say lack of professional judgement is a warranted conclusion.


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Michelle
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posted 09 January 2004 02:41 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Actually, anyone can practice psychotherapy. You could hang a shingle out on your front door with "Psychotherapist" on it, and it's perfectly legal. Anyone can do it. It's like "counsellor" or "therapist". Anyone can call themselves one and offer counselling, therapy, or psychotherapy services.

I guess what I meant is, he should have his license to practice anything, including psychotherapy, under the title of "physician" (which IS a regulated title) taken away.

[ 09 January 2004: Message edited by: Michelle ]


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Michelle
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posted 09 January 2004 02:47 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
So therefore there's no such thing as "licensed therapist" because it's not a regulated profession.
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paxamillion
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posted 09 January 2004 02:49 PM      Profile for paxamillion   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
However, one can get an AAMFT designation based on recongized training and many supervised hours.

[ 09 January 2004: Message edited by: paxamillion ]


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Mr. Magoo
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posted 09 January 2004 02:52 PM      Profile for Mr. Magoo   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
I believe it's internally regulated, and not regulated by the state. It's true, you can call yourself a therapist if you want, but you'll get no support from the industry itself until you're certified.
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paxamillion
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posted 09 January 2004 02:54 PM      Profile for paxamillion   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
Originally posted by Mr. Magoo:
It's true, you can call yourself a therapist if you want, but you'll get no support from the industry itself until you're certified.

Also harder to get liability insurance.


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Michelle
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posted 09 January 2004 03:00 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Sure, you can get designations. But internal regulation means pretty much nothing if you don't need that internal designation in order to practice, and there are no procedures in place to stop malpractice beyond losing your membership in the association (which means pretty much nothing since you can practice under that title whether you're a member of the association or not). The average person doesn't know what the various professional associations for this type of therapist and that type of therapist are.

It's true you can get a designation from certain organizations for your training and hours worked under supervision. But so what? Without regulated guidelines for their members to follow, these organizations are little more than dues collecting groups that can do absolutely nothing about it if people using their title are incompetent or harmful.

Just because someone has gone to school and practiced under unregulated supervision does not mean they're qualified.


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paxamillion
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posted 09 January 2004 03:05 PM      Profile for paxamillion   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Fair enough. OTOH, the structure of the profession for medical doctors has hardly been a cure for malpractice has it?
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Michelle
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posted 09 January 2004 03:06 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
So? For an unregulated profession, you don't need liability insurance. It's good to have it, of course, but if I cared so little about professional standards to hang a shingle out with no training, then I wouldn't care enough to get liability insurance either, would I?
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Michelle
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posted 09 January 2004 03:08 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Actually, it probably has. Regulation makes it possible to take away the ability to practice from doctors who malpractice, and to prosecute them by law if they practice without a license.

Can't do that in unregulated professions. I'm willing to bet there are a lot more quacks among unregulated health professionals than in regulated ones. You're never going to be able to eliminate malpractice totally.


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Mr. Magoo
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posted 09 January 2004 03:27 PM      Profile for Mr. Magoo   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
I'm willing to bet there are a lot more quacks among unregulated health professionals than in regulated ones.

Agreed. If I want to tell you that some crystal will heal your cancer, or that your back pain will go away if we put 10 molecules of poison in a glass of water and you drink it, well... that's pretty much legal. So is faith healing, come to think of it... and all manner of quackery surrounding cancer treatments.


From: ø¤°`°¤ø,¸_¸,ø¤°`°¤ø,¸_¸,ø¤°°¤ø,¸_¸,ø¤°°¤ø, | Registered: Dec 2002  |  IP: Logged
Michelle
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posted 09 January 2004 03:41 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Exactly. But they can't call themselves a "physician", a "surgeon", a "chiropractor", a "psychiatrist" a "dentist" or any other regulated title. Also, they can't call themselves a "doctor" professionally while providing health services unless they're a member of one of the regulatory bodies for physicians, chiropractors, optometrists, dentists, or psychologists.

So even if someone does "alternative medicine", they can't call themselves a doctor.


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Mr. Magoo
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posted 09 January 2004 03:46 PM      Profile for Mr. Magoo   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
They can do it exactly the same way this guy did though: if you have a regular M.D., but you also believe in, say, homeopathy, then for all intents and purposes you can be Dr. Michelle, homeopath.
Now you and I know that the M.D. and the homeopathy are two different things altogether, but I suspect that many people would miss that distinction altogether.

I doubt this guy would have been able to act as a psychotherapist without the cred transferred by his M.D.


From: ø¤°`°¤ø,¸_¸,ø¤°`°¤ø,¸_¸,ø¤°°¤ø,¸_¸,ø¤°°¤ø, | Registered: Dec 2002  |  IP: Logged
paxamillion
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posted 09 January 2004 03:49 PM      Profile for paxamillion   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Yes, well, what about offences in larger numbers?

Years ago, the preferred treatment for lupus was an oral cortico-steroid (Prednisone) taken daily at a dose of around 30mg. Within a few short years, a surprising number of them needed hips replaced and experienced a whole whack of other symptoms due to osteoperosis from their doctors' prescriptions.

Regulation can also result in large-scale harm.


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Michelle
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posted 09 January 2004 04:20 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
Originally posted by Mr. Magoo:
They can do it exactly the same way this guy did though: if you have a regular M.D., but you also believe in, say, homeopathy, then for all intents and purposes you can be Dr. Michelle, homeopath.

Now you and I know that the M.D. and the homeopathy are two different things altogether, but I suspect that many people would miss that distinction altogether.

I doubt this guy would have been able to act as a psychotherapist without the cred transferred by his M.D.


Yes, he could.

As for the homeopathy, yes, a licensed physician can practice homeopathy if (s)he wants to. But as soon as they are reported to the College of Physicians and Surgeons for using "cancer crystals" or some other such rot, they can be disciplined by having their license taken away. After which, they can no longer use the title "Doctor", nor call themselves a physician.

Same with this guy - if the service he has offered has been found to be harmful or inappropriate or incompetent, he will no longer be able to practice as a doctor.

But, if he wants to hang a shingle out the next day after losing his license with "psychotherapist" on it, he is perfectly free to do so, and to use his educational degrees as "proof" that he is qualified.

And he could do that whether he's a medical doctor or not. I could get a bachelor's degree in psychology and use that to convince people that I am a qualified psychotherapist or counsellor if I so choose, and as long as people believe me (and lots of people would since most people don't know what kind of qualifications it takes to become a health professional), I can treat them as long as I don't perform a controlled act such as invasive procedures or giving a diagnosis.


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Lima Bean
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posted 09 January 2004 04:26 PM      Profile for Lima Bean   Author's Homepage        Edit/Delete Post  Reply With Quote 
I seem to recall hearing in the news not long ago (or perhaps reading it somewhere?) that doctors are actually pretty well insulated against malpractice suits actually doing them any professional harm. Legal representation and protection of doctors is a huge thing, and most suits brought against doctors fail, leaving the malpracticing Dr. to continue malpracticing.

The insulation seems to come from a combination of it being extremely difficult to prove malpractice, and it being extremely difficult to match the resources (both financial and legal) to carry a suit to any satisfactory resolution.

I'll see if I can scare up a link on this...


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paxamillion
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posted 09 January 2004 04:28 PM      Profile for paxamillion   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
True, LB, but the College of Physicians and Surgeons have their own procedures outside of civil court. As Michelle points out, they can be relatively quick and comprehensive.
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Mr. Magoo
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posted 09 January 2004 04:30 PM      Profile for Mr. Magoo   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
Yes, he could.

I should have been more clear. I meant "successfully". Not many people choose a therapist by walking along the street looking for handmade signs in people's windows. You ask another health care professional for a referral if you're smart. So ya, he could try...


From: ø¤°`°¤ø,¸_¸,ø¤°`°¤ø,¸_¸,ø¤°°¤ø,¸_¸,ø¤°°¤ø, | Registered: Dec 2002  |  IP: Logged
Lima Bean
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posted 09 January 2004 04:35 PM      Profile for Lima Bean   Author's Homepage        Edit/Delete Post  Reply With Quote 
Found it. It was on CBC's Disclosure.

quote:
“It’s driven by protect[ing] the doctor’s reputation, almost at all costs,” he says. “If it’s necessary, they would spend $100,000 protecting the doctor against a $5,000 claim.”

Also found the College of Physicians and Surgeons of Ontario's policies on misconduct here, but apparently no policies for consequences of such misconduct or actions to be taken by the College at the discovery of such misconduct.

There is, however, a list of doctors found guilty of professional misconduct and the penalties they received.

[ 09 January 2004: Message edited by: Lima Bean ]


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Lima Bean
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posted 09 January 2004 04:53 PM      Profile for Lima Bean   Author's Homepage        Edit/Delete Post  Reply With Quote 
If these cases are anything to go by, Dr. Abelsohn will most likely not have his credentials revoked, and may be back on his feet in no time.

For example:

quote:
On November 18, 2003, the Discipline Committee found that Dr. Bothwell committed an act of professional misconduct, in that he engaged in disgraceful, dishonourable or unprofessional conduct. Dr. Bothwell engaged in sexual relations in his office with a former patient, whom he had performed surgery on six months earlier, knowing that she had a history of depression. The Committee ordered a recorded reprimand, a two-month suspension, and imposed specified terms and conditions on Dr. Bothwell's certificate of registration. In addition, the Committee ordered him to pay the College's costs fixed in the amount of $2,500.


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Michelle
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posted 09 January 2004 05:21 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
It all depends on the details of a case, Lima Bean. There are lots of other cases where doctors get their licenses revoked, period. Just going through the list alphabetically, I've found lots who did.

quote:
On March 11, 2002, the Discipline Committee accepted Dr. Ahmed's guilty plea and found him guilty of professional misconduct, in that he sexually abused a patient. The Committee revoked Dr. Ahmed's certificate of registration and ordered a recorded reprimand.

quote:
In July 1994, the Discipline Committee found Dr. Alfred guilty of professional misconduct, in that he engaged in acts of sexual impropriety with a patient. The Committee revoked Dr. Alfred's certificate of registration and ordered a recorded reprimand.

quote:
In May 1993, the Discipline Committee found Dr. Alvarez guilty of incompetence, and professional misconduct, in that he engaged in acts of sexual impropriety with a patient. The Committee revoked Dr. Alvarez's certificate of registration.

quote:
In September 1992, the Discipline Committee found Dr. Artinian guilty of professional misconduct, in that he falsified a record in respect of an examination or treatment of a patient; he knowingly submitted a false or misleading account or charges for services rendered to a patient; he failed to maintain the standard of practice of the profession; and he engaged in disgraceful, dishonourable or unprofessional conduct. The Committee revoked Dr. Artinian's certificate of registration.

quote:
On May 26, 2000, the Discipline Committee found Dr. Bacon guilty of incompetence and professional misconduct, in that he failed to maintain the standard of practice of the profession, particularly with respect to his prescribing practises. The Committee revoked Dr. Bacon's certificate of registration.

For some professional lapses, they impose a revoking of the license until the doctor completes a program that will teach them the error of their ways, whether procedural or clinical. Example:

quote:
In December 1995, the Discipline Committee found Dr. Arnold guilty of incompetence and professional misconduct, in that she failed to maintain the standard of practice of the profession. In addition, she made improper use of her authority to prescribe, dispense or sell a drug, including falsifying a record, and she failed to maintain the records that are required to be kept respecting her patients. The Committee ordered a recorded reprimand, and a 12-month suspension of her certificate of registration, which shall continue for the full 12-month period unless and until Dr. Arnold meets specified conditions, including the resignation of her privilege to prescribe narcotics for a minimum one-year period. In the event that the 12-month suspension is served, following completion of the suspension, Dr. Arnold's certificate of registration will be subject to specified conditions, including the termination of her privilege to prescribe narcotics for a minimum one-year period.

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Lima Bean
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posted 09 January 2004 05:27 PM      Profile for Lima Bean   Author's Homepage        Edit/Delete Post  Reply With Quote 
Yeah, fair enough. There seems also to be a big number of doctors who committed sexual abuses and were not revoked, though. And quite a few I noticed with short suspensions or nothing more than a recorded reprimand.

I'm sure it has to do with the severity of the transgression, or other such factors. Clearly, though, there's some discretion available to the discipline board.

I guess we'll have to wait and see what happens to this guy.


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Michelle
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posted 09 January 2004 05:28 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
And by the way, the imposition of terms and limitations on your certificate of registration is a serious thing. In one of those cases, the limitation was that the doctor could only have male patients. That's a pretty serious limitation. In the case you cited there, Lima Bean, it doesn't say what the term or limitation is on his certificate, and it could be quite significant.

Also, probably the reason his certificate wasn't revoked completely is because starting a relationship with a former patient from months ago, while serious, isn't quite the same thing as having a sexual relationship with a patient you're treating on an ongoing basis. They do take individual circumstances into account, I would think.


From: I've got a fever, and the only prescription is more cowbell. | Registered: May 2001  |  IP: Logged
Michelle
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posted 12 January 2004 02:44 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
MD says he did not encourage masturbation

Yet another article by Blatchford where she subtly blames the victim for her illness and the doctor's incompetence in treating it.

But this is an excellent response by a psychotherapist to Blatchford's assumptions.


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paxamillion
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posted 12 January 2004 02:50 PM      Profile for paxamillion   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
quote:
It's time we understood that the responsibility for safe boundaries is 100 per cent the psychotherapist's.

Yesssssssssss.


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Michelle
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posted 12 January 2004 03:00 PM      Profile for Michelle   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
I know. I felt a great degree of satisfaction when I read her letter. I've been so annoyed while reading Blatchford's coverage.
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hibachi
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posted 12 January 2004 08:00 PM      Profile for hibachi   Author's Homepage     Send New Private Message      Edit/Delete Post  Reply With Quote 
Christie Blatchford seems to be better on gruesome murder cases and glorifying police, ambulance and paramedic staffs.

When it comes to people who are mentally ill and not always in control of their actions, she seems, like most conservatives, to take the position of the punitive rather than the compassionate.

This might put her on the side of this doctor, and perhaps squads of cops who would beat and possibly kill people like Otto Vass, Edmond Yu, myself, and many others I have met.


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N.R.KISSED
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posted 14 January 2004 05:26 PM      Profile for N.R.KISSED     Send New Private Message      Edit/Delete Post  Reply With Quote 
There are a few things disturbing about this case, most of them revolve around the myths and realities surrounding "Borderline Personalities"

The majority of people who receive this label are women and survivors of severe childhood trauma, not surprisingly they might be more likely to experience extreme distress and symptoms. It also makes them more likely to be open to sexual exploitation from amongst others therapists.

I also find it disturbing that this woman's testimony is automatically dismissed on the basis of the "Psychiatric expert", and what he associates from the label. Forensic psychiatry is even more pseudo scientific than an already dubious endeavour. So on the basis of this "experts" testimony the woman's story is dismissed. Since therapy consists only of the therapist and the patient we are left with only one side of the story.

I also agree that even if the Doctors story is entirely accurate it does display an astounding level of incompetence.

It is also worth noting that psychiatry has historically labelled people with this diagnosis as "manipulative" again saying more about their inability to work with traumatized people than anything else.


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