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 .
Full decisions are available online at www . cpso . on . ca . Select Doctor Search and enter the doctor ’ s name .
Issue 4 , 2016 Dialogue 73