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Sexual Misconduct Case Against Doc Raises Debate

A P Kamath in Cambridge, Ontario

The case against Dr Allan Khitab, accused on 11 counts of sexual misconduct, has raised a debate that isn't likely to die down soon. Shrill questions are being asked about whether a doctor, particularly someone from abroad, is screened before a hospital hires him.

Pakistan-born Khitab, 62, worked with Indian and Pakistani immigrants in England for several years. He spent many years working with young men and women who faced psychological problems. Recently released documents show he faced 23 counts of sexual misconduct in Scotland against 23 young males in the late 1970s and early 1980s and was acquitted due to a lack of evidence.

Critics of the Canadian medical establishment such as Dr Jason Millar hope the proper medical bodies will record situations like these and, perhaps, the criminal trial will open this subject. Dr Millar feels the Cambridge Memorial Hospital that hired Dr Khitab should have given a serious attention to the incident in Scotland, though he was acquitted. Dr Khitab was hired by the CMH in 1989 as the city's only full-time psychiatrist.

"When there is a lack of staff, there is the thought that somebody is better than nothing," he said.

"I hope this (trial) will somehow make it easier for colleges and organizations to release this kind of information. (And) hopefully the Cambridge Memorial Hospital will pay attention next time (a doctor is hired)," Dr Millar said.

He emphasized that it is not just CMH that has to be wary of hiring practices but other hospitals as well. He noted that just like Saint John, North Brunswick, Cambridge was under-serviced in the psychiatry field. He said often a doctor was hired simply because that person was available and was needed in a hurry.

On Wednesday, Dr Khitab stood in the front row for only a few minutes while the court decided to meet again on October 28 to set a date for the criminal trial.

Dr Khitbab's lawyer, Susan Rothfels of Toronto, was on hand. Like her client, she refused to comment on the case.

Arrested on July 27, Dr Khitab faces four counts of sexual assault, five counts of sexual exploitation and one count each of sexual interference and invitation to sexual touching of five young boys over a five-year period, as per the court documents. From 1989 to 1994, boys aged 12 to 16 were sexually assaulted on hospital grounds, authorities charge.

His arrest have raised questions about the image of doctors and what happens when a physician is found guilty of medical practice or another crime, and how the community is affected.

A University of Toronto psychiatry professor says it is not common for psychiatrists to face a criminal trial but when a doctor of any kind does, the community and the medical profession pay the price.

"For individual patients, (an offense) is a breach of trust," said Dr Gail Erlick Robinson, also the director of women's health programming for the University Health Network in Toronto.

"It makes others nervous for going to the doctor's (office) because they think something terrible will happen to them. It stains the profession as a whole because you have to work even harder to gain the patient's trust," she said in an interview.

Not commenting specifically on the Dr Khitab case, Dr Robinson said there are different types of offenders within the medical field.

Stating that sexual assaults are not confined to psychiatrists (very few of them abuse patients), he mentioned two kinds of offenders. One is the doctor who gets involved with a single patient and the other is the "abuser," tending to be repeat offenders. Dr Robinson said there are cases where doctors move from province to province and their doctor's license is renewed because there has been no conviction.

"When a doctor gets closer to getting caught, that doctor will clear out and start fresh, going to a completely new province which has no history on him or her," Dr Robinson said.

In most cases, she said the dominating factor is the abuse of power.

A professor of sociology from Carleton University in Ottawa thinks that is the biggest contributor to any doctor committing an offense.

Dr Walter DeKeseredy said the notion of power leads to the feeling of being invisible -- making the offenses more dangerous and troublesome.

"The key motivator for abuse is power and the knowledge that you can get away with it and even manipulate that trust," he said yesterday. "Doctors are given carte blanche to shape (patients' lives) and some abuse that power."

Emphasizing assaults occur in all types of professions, there is the tendency for doctors to feel exempt from the law, Dr DeKeseredy said. They think they have more credibility and are less likely to get convicted if an allegation is brought against them. Contributing to the problem is the fact that meetings between doctors and patients are behind closed doors.

"It often becomes a character contest and the person with more credibility usually wins," he said.

For example, Dr DeKeseredy said less than five per cent of women report abuse to the police. When assaults are made against males, they are even more fearful to come forward because they think their masculinity will be challenged.

But as the medical field deals with their own committing assaults, the community where these assaults take place has its own grief to go through.

Dr DeKeseredy said residents can feel cynical, angry and even vindictive. The victims, he continued, need to know the community won't ostracize them. They need to know people are there for them and that could be done privately, he said. Dr Robinson urged people to educate themselves on what is appropriate behavior by doctors.

"If (a doctor) is doing anything sexual, run to the college or the police right away," she said.

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