Feminist Theory and Medical Paternalism in a Sexual Abuse Case

Case Summary

In a 2016 Toronto Star article, journalist Gallant describes the ongoing legal battle between Sveta Kohli and her former neurologist, Paul O'Connor. Kohli has accused O'Connor of sexual abuse. After the complaint was formally lodged, a complex bureaucratic process ensued whereby the entire case appears to have been stalemated. The College of Physicians and Surgeons of Ontario has a committee that formally handles complaints, and the Health Professions Appeal and Review Board (HPARB) is a civilian body that hears appeals specifically from that same College.

The bureaucratic complications run deeper still. According to the journalist, the College of Physicians and Surgeons also has an Inquiries, Complaints and Reports Committee. The HPARB ordered on two separate occasions that this Committee keep Kohli's case open and launch a full investigation. The Committee failed to comply and admitted that it "failed to adequately review her allegations from when she was his patient." The Committee also admitted that it had reviewed the facts of the case only after the doctor-patient relationship had been terminated. Doctor O'Connor denies the allegations, but he officially resigned from his position and agreed not to reapply for any physician license in any other jurisdiction. According to Gallant (2016), the Committee "took into account" the doctor's resignation and his agreement not to practice medicine any longer.

Recently, the Inquiries, Complaints, and Reports Committee agreed to take another look at the case but refused to refer it to the College's discipline committee. The discipline committee would have allowed for a public hearing. Moreover, the Committee claimed that too much time had passed since the initial allegation and that the doctor lacked sufficient ability to mount his defense. Kohli's attorney cited numerous other instances of potential College misbehavior — for example, the College initially failed to forward the complaint to the Inquiries, Complaints, and Reports Committee in 2006 when Kohli filed the first official complaint. Ten years of back-and-forth stagnated the case and led to a deterioration in Kohli's mental health.

The College of Physicians and Surgeons of Ontario also claimed that "there has been a considerable societal shift in attitude towards allegations of sexual abuse since the complaints committee first considered this case," without offering any specifics as to what those changes might have been. The College suggested that if Kohli had filed her first complaint today, the results might have been different — a statement that does not appear relevant to their continued unwillingness to treat the case seriously.

The College did finally ask that O'Connor appear in person so they could "caution" him informally. No formal discipline hearing was ordered, because doing so would have meant "O'Connor would have faced a range of penalties." Those penalties, if he had been found guilty of sexual abuse, could have included loss of his license and an obligation to pay for Kohli's mental healthcare costs related to counseling over the years since the alleged incident. Kohli had initially wanted to keep the matter private, but her frustration at the College's inaction led her to come forward to the media. Potential outcomes had the College and the HPARB issued a disposition would have included "taking no further action, providing advice or recommendations, cautioning the physician, or requiring the doctor to complete a continuing education program."

Kohli had been seeing the doctor from 1998 to approximately 2003 or 2004, during which time she claims he made both verbal and physical advances toward her. After their professional relationship ended, Kohli did continue to see O'Connor and remained in contact by email. In late 2005, Kohli insists that Doctor O'Connor "tried to pin her down in her home and kiss her," though she maintains this was not the first time he had made such advances. Doctor O'Connor does not deny that these incidents occurred, but insists they took place after the patient-doctor relationship had ended. Kohli did file a report with the Toronto Police, but charges were never laid. O'Connor is now claiming to have a "serious medical condition" that prevents him from appearing before a disciplinary hearing. Kohli simply wants the doctor's license revoked, pointing out that his resignation still leaves open the possibility that he might practice again, despite his claim that illness will prevent it.

Explanation of Theory

Although a number of theoretical viewpoints can be used to frame this case — including structural-functionalism and symbolic interactionism — gender and medical paternalism are at the forefront of the issues. A feminist perspective therefore allows for a particularly fruitful investigation. The feminist perspective reveals how structural inequities built into a paternalistic medical system work against a female petitioner like Kohli. It provides the underlying framework for understanding sexual harassment and abuse, the abuse of power in the doctor-patient relationship, and the dismissal of allegations — since not being taken seriously is a core complaint of Kohli's. The bureaucracy's ability to pass the buck and avoid accountability for a member of the medical profession also reflects the entrenchment of patriarchal institutions. This is not a matter of the gender of the individuals on the Committee or in the College; it has to do with the role and function of these bodies, which are specifically designed to uphold the paternalistic organizational culture of healthcare. That culture is predicated on protecting the status quo, as evidenced by the fact that Kohli's initial complaints against Doctor O'Connor were never forwarded as required. A feminist perspective also explains why Kohli waited so long to use the media. As the journalist notes, Kohli "wanted to remain anonymous. She felt ashamed and isolated." The shame and isolation Kohli experienced are equally explicable through feminist sociological theory.