Dialogue Volume 13 Issue 4 2017 - Page 73

DISCIPLINE SUMMARIES engaged in by Dr. Dubins brings into disrepute the reputation of the profession as a whole. The jointly submitted penalty proposed in conjunction with the undertaking to resign and never to re-apply will con- vey to the public and the profession that a physician who engages in such misconduct will not be permit- ted to remain a member of the profession. Aggravating factors in this case include the following: 1. Dr. Dubins had previously been cautioned in person by the Complaints Committee, in Janu- ary 1995. The complainant at that time was also received smoking cessation therapy and complained of the excessively graphic and sexual images during the aversion therapy. The Com- mittee was struck by the similarities of this past example of misconduct to the current case, and was appalled by Dr. Dubins’ insensitivity and poor judgment. Dr. Dubins displayed a disre- gard for the authority of the College as a self- regulatory body by his failure to comply with the earlier caution from the College. A physician must accept the authority of his regulatory body. Disregard for that authority is considered very seriously by the Committee. It puts the public at risk and can erode the confide nce that the public must have in the College to regulate the profes- sion in the public interest. 2. The context of the treatment in this case is hypnotherapy, where patients relinquish control and are in a very vulnerable state. It is particu- larly important that physicians recognize and not abuse the vulnerability of their patients under hypnosis (or in any other situation). Particularly concerning was Dr. Dubins’ instruction to his patient to undo his belt and pants button and lower his fly while he was undergoing the hyp- nosis, and not before. The patient would have been most influenced by suggestion during the hypnosis. 3. Dr. Dubins exposed his patients to unnecessary harm. The expert witness concluded that the reli- ance upon sexually-themed aversive imagery was excessive, not specifically required for positive clinical effect, and, in some cases, could render the treatment ineffective. But most importantly, this treatment could be harmful. Patients with a history of anxiety and depression who are known to have difficulty in stopping smoking would be at highest risk for an adverse effect from Dr. Dubins’ approach to treatment. The only mitigating factor in this case is Dr. Dubins’ admission of his misconduct. He accepted responsibility for his actions, did not dispute the facts, and his admission saved the time and some of the expense of a lengthy hearing. Most importantly, it spared the patient and other witnesses from the need to testify. The immediate and permanent resignation of Dr. Dubins from the practice of medicine made it unnec- essary to consider the imposition of an order of revo- cation, that otherwise may have been imposed. The departure of Dr. Dubins from the practice of medi- cine will demonstrate to the profession and the pub- lic that the disgraceful behaviours exhibited by Dr. Dubins will not be tolerated. Given the undertaking to resign and never to re-apply to practise medicine signed by Dr. Dubins, the Committee concluded that the jointly-proposed penalty of a reprimand was an appropriate penalty in the circumstances. Regarding costs, the Committee found that having regard to the serious findings made of professional mis- conduct, it was appropriate that Dr. Dubins should pay $5,000 of the costs incurred by the College in this case. ORDER In summary, it was ordered that Dr. Dubins appear before the panel to be reprimanded; and pay to the College costs in the amount of $5,000. On August 29, 2016, Dr. Dubins executed an undertaking with the College to resign and never re-apply to practise medicine in Ontario or any other jurisdiction, effective August 29, 2016. For complete details of the Order, please see the full decision at www.cpso.on.ca. Select Find a Doctor and enter the doctor’s name. At the conclusion of the hearing, Dr. Dubins waived his right to an appeal and the Committee administered the public reprimand. Full decisions are available online at www.cpso.on.ca. Select Doctor Search and enter the doctor’s name. ISSUE 4, 2017 DIALOGUE 73