The medical profession and the people who govern it stand indicted.
Their crime: Indifference.
The evidence is strong.
For more than a year, AJC journalists have compiled an astonishing record of harm done to thousands of Americans, most of them women. Over and over again, the reporters have presented cases of doctors' violating the sanctity of their patients' trust to satisfy their own needs for sex or sense of dominance.
In any other setting, many of these violations would be crimes.
Doctors, their regulators — and to some degree all of us — allow this to persist because we irrationally set doctors in an extraordinarily powerful — in fact nearly mystical — position to do what they wish. Art Caplan, a medical ethicist at NYU’s Langone Medical Center, suggests the AJC’s reporting shows that the powerful imbalance with patients should be re-calibrated.
“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,” Dr. Caplan wrote in his Dec. 2 blog.
After enduring the insult of violation, patients most often suffer in silence, unwilling to endure the cold wrath of a system that almost certainly will either ignore them or shuffle their complaints into a stifling bureaucracy.
In the few cases where outraged women have mustered the courage to aggressively pursue their violators, they often suffer public exposure and deep suspicion — even cynical allegations that they are the ones at fault.
And in those rarest of cases where doctors are held to account, they often retain their medical licenses – and some continue abusing.
To be honest, the scale of this menace was nearly impossible to detect until the its shadow appeared during the newspaper's unique and sophisticated approach to analyzing the scant public records on these cases.
Then using the very low-tech skills of reading documents, making countless phone calls and knocking on doors, the reporters identified thousands of doctors accused of sex abuse. They found more than 3,000 doctors who had been publicly disciplined following allegations of sexual abuse, 2,400 of which involved patients.
Anesthesiologists raped and fondled unconscious patient; ob-gyns penetrated women during exams; psychiatrists lured child abuse victims into sexual relationships. Doctors often preyed upon the most vulnerable victims – some with drug addictions and profound mental disabilities.
For all we now know, our reporters have exposed only the tip of the iceberg.
Who is accountable for allowing these abuses to go largely unchecked? The answer is complex — but much of the blame lies within the profession and its too-cozy regulators. The system protects doctors and is often operated by doctors.
In the absence of federal protections, we are left with a patchwork of state laws, regulation and governance. In truth, the country that was worked so hard to protect vulnerable people in so many other arenas done almost nothing to protect patients. In Georgia, you can't be a licensed real estate agent if you've committed sexual assault, but you can be a doctor.
This indifference could be explained in part by a lack of awareness — which can no longer be excused in light of what the AJC has found. How can anyone who cares about patients look away now?
These cases have names.
Maria Zito.
Pauline Trumpi Evans.
Yolanda Moore .
Yvonne Vazquez.
Elgin Stafford.
LaToya Davis.
Thelma Brumett.
Erin Vance.
Cathryn Blue.
Tara Batrice.
In today’s newspaper, six of these women tell their own stories of abuse and humiliation. They speak for thousands. Their stories are wrenching and damning; their struggles for justice alarming. All were damaged by their experiences.
The AJC’s report – the accuracy of which has not been contested – vacates any claim of ignorance.
In response to this indictment, doctors and their regulators must address two broad and difficult issues – regulation and culture. While neither is easy, the harder part may be attacking the unhealthy way we all view doctors – as gods and patriarchs . If nothing else, the AJC’s reporting shows that doctors are all too human.
David Clohessy, the executive director of SNAP, a support and advocacy organization for people sexually abused by priests, doctors and others, said patients place far too much trust in their doctors.
“We are so reliant on them, we are so helpless and vulnerable and literally in pain oftentimes when we go in there,” Clohessy, told the AJC. “We just have to trust them.
“So when they cross the boundary and their hands go into the wrong places, we are in shock, we are paralyzed, we’re confused, we’re scared. We just do not want to believe, first of all, that a doctor is capable of this, and secondly that their colleagues and supervisors will not address this immediately and effectively when we report it.”
Laws must be changed to bring more transparency to the process and to make sure that doctors who are convicted of abusing patients may not return to practicing medicine. Many states discipline doctors in private, and some say they won’t even consider discipline until there are multiple allegations. They regard the first complaint a case of “he-said-she-said.”
Chaperones should be present for examinations. Women must not feel punished by merely complaining about inappropriate behavior and medical professionals should be required to report misbehavior when they learn about it.
But the first step is to stop looking away. It can take years of monstrous and widespread abuse to prompt even modest reform. How can this be?
Knowing all we now know and doing nothing may, in the end, may be the biggest crime of all.
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