discipline summaries sexual relationship in 2001. It was not disputed that Dr. Sliwin and Ms A engaged in sexual acts captured by the mandatory revocation provisions of the Health Professions Procedural Code. However, to make a finding of sexual abuse the Discipline Committee must find the sexual relationship was concurrent with the doctor-patient relationship. The defence argued, among other things, that there was not a current doctor-patient and sexual relationship and the case must be dismissed. The Committee found as a fact that there was a doctor-patient relationship between Dr. Sliwin and Ms. A at the relevant time period. The Committee rejected the defence that Patient A’ s sophistication in returning for more and more cosmetic surgery put her in a category other than a patient, or that the fact that the relationship was consensual somehow changed her status as a patient. The Committee noted that Courts have accepted that there is a power imbalance between a doctor and a patient so that no sexual relationship between a doctor and patient can ever be truly consensual. The Committee found that it was clearly established that a concurrent doctor-patient and sexual relationship existed between Dr. Sliwin and Ms A. Sexual relations between them took place, albeit intermittently, between 2001 and 2007. During that same time period, Dr. Sliwin was Ms A’ s doctor and performed a number of surgeries, including major surgeries under general anesthesia. Having regard to the pre-operative and post-operative periods for such surgeries, the Committee concludes that the concurrency of the doctor-patient and sexual relationships grounds a finding of sexual abuse. The Committee found that sexual activity occurred in close proximity to Ms A’ s surgical procedures on more than one occasion, and certainly within the time frame of the treatment period. It is clear that a doctor-patient relationship between a surgeon and patient includes a time period for assessment and treatment pre- and postsurgery. It is not limited to the day of surgery. This period includes a sufficient period of time before surgery for consultation, requisition for devices, assessment( history and physical, blood work, ECG, x-rays), consent, and after surgery for assessment of complications, suture removal, wound healing, and( on Dr. Sliwin’ s evidence) up to one year or longer for assessment of the scar and development of any deformity. Although the Committee focused on and found as a fact that Dr. Sliwin had sex with his patient Ms A during the treatment period for a number of surgeries, despite his denials, there is an evidentiary basis for a finding that Dr. Sliwin was her doctor throughout the period from March 14 / 15, 2001 through 2008, the period when she returned to him repeatedly for various procedures. Dr. Sliwin had been Ms A’ s doctor even before the start of their sexual relationship. After the March 16, 2001 surgery, Dr. Sliwin chose to continue their sexual relationship, while performing intermittently the various surgical procedures she requested over the following years. As a physician, he should not have continued to perform surgeries on her, while maintaining a sexual relationship. In so doing, the Committee found that Dr. Sliwin has engaged in sexual abuse of a patient, as Ms A was his patient in the specified period. In the Committee’ s view, sex with her in that period in the circumstances also constitutes sexual abuse. The Committee rejected Dr. Sliwin’ s defence that College policy on sexual relationships with patients was ambiguous and that he was led to believe his conduct was not sexual abuse. The Committee found that Dr. Sliwin understood that a sexual relationship with Ms A was prohibited. During the medical consultation and the discussion of risks which would have taken place with any patient, Ms A testified that Dr. Sliwin said something to the effect that,“ If you do this, then I can’ t be your lover anymore.” Dr. Sliwin left her to make the choice and she opted to go ahead with the surgery. To maintain a doctor-patient relationship with Ms A while engaging in a sexual relationship in the same time period, knowing it to be wrong, disregards the well understood principle that this is not in a patient’ s best interest and violates the clear prohibition of the College against such conduct.
Dr. Sliwin also failed to maintain proper boundaries with Ms A over the long period he was her physician. The Committee found this to be disgraceful, dishonourable and unprofessional conduct.
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Issue 4, 2016 Dialogue 73