Dialogue Volume 13 Issue 3 2017 - Page 51

DISCIPLINE SUMMARIES Confidentiality Agreement On November 24, 2003, Dr. Brooks signed a Confi- dentiality Agreement with the Hospital, confirming that except where he was legally authorized or required to do so, he would not inspect or receive paper or electronic patient-related information from Health Re- cords or from notes, charts, and other material related to patient care. The Hospital’s policy stated that it was a breach of confidentiality to access patient or health information when not required to provide care to a patient or in the performance of duties. REASONS FOR PENALTY The Committee was provided with evidence of Dr. Brooks’ suspension of privileges at his hospital for three months, together with enhanced monitoring of his access to medical records. The hospital also required Dr. Brooks to present at quarterly meetings on the topic of privacy to the medical staff for one year after reinstatement. The hospital also required Dr. Brooks to lead hospital-wide Grand Rounds on the topic of patient privacy. The Committee also received evidence of Dr. Brooks’ completion of an online course on privacy and confidentiality, as well as his completion of a preceptorship in ethics and privacy with the vice- president of medical professionalism of the Canadian Medical Association. A report from the Canadian Medical Association’s vice president stated that Dr. Brooks readily acknowledged his mistakes and errors What does this mean? We provide definitions for the legal terminology used in the discipline process Admission The physician admits that the facts alleged amount to professional mis- conduct and/or incompetence. Plea of No Contest The physician does not contest the facts. The College files a statement of facts as an exhibit at the hearing. The Discipline Committee can accept the facts as correct and make a finding of professional misconduct and/or incompetence. The physician does not admit to the facts or findings for the purpose of any other proceeding. Agreed Statement of Facts A statement of facts that are negoti- ated and agreed to by the College and the physician. It is filed as an exhibit at the hearing. Joint Submission on Penalty A penalty that is proposed to the Committee as an appropriate penalty by both the College and the physi- cian. In law, the Discipline Committee must accept a joint submission on penalty unless it would be contrary to the public interest and bring the ad- ministration of justice into disrepute. Contested Hearing The physician denies the allegations. The College must prove the allega- tions on a balance of probabilities (the civil standard of proof) by calling evidence such as witnesses. If one or more of the allegations is proved, a penalty hearing is scheduled. The College and the physician may agree and jointly propose a penalty to the Committee or they may disagree and a contested penalty hearing takes place. Aggravating, Mitigating Circumstances Aggravating and mitigating circum- stances may be considered by the Discipline Committee in determining an appropriate penalty. Mitigating and aggravating circumstances are considered by the Committee, so that the penalty imposed is proportionate to the gravity of the physician’s con- duct, and the degree of responsibility of the physician. Mitigating circum- stances tend to reduce penalties, whereas aggravating circumstances tend to increase penalties. Aggravating circumstances could include: a high degree of vulnerability of the person(s) affected by the phy- sician’s conduct; a prior disciplinary history with the College; and a lack of insight by the physician into his or her own misconduct. Mitigating circumstances could in- clude: a clean disciplinary record; an admission to the facts underlying the allegations in advance of a hearing; cooperating with the investigation; a demonstration of remorse or regret about the effects of the misconduct on others; taking remedial steps on the physician’s own initiative prior to a finding or an order by the College. ISSUE 3, 2017 DIALOGUE 51