DISCIPLINE SUMMARIES from being alone with anyone under 18 years of age, including while he practised as a physician. His bail was varied on February 16, 2012 and March 1, 2012. After the College was made aware of the charges against Dr. Johnston, an investigator was appointed on March 20, 2012. At the College’s request, Dr. Johnston voluntarily entered into an undertaking on November 5, 2012 that mirrored the terms of his criminal recognizance, so that the College could monitor Dr. Johnston’s compliance. This undertak- ing remained in effect after Dr. Johnston’s criminal process came to an end. After allegations against Dr. Johnston were re- ferred to the Discipline Committee, the Inquiries, Complaints and Reports Committee of the College provided Dr. Johnston with notice that it intended to impose an interim order against him pending resolu- tion of the discipline allegations. In response, Dr. Johnston entered into a new voluntary undertaking (replacing the 2012 undertaking) dated March 17, 2016 which required him to have a College-approved practice monitor for all professional encounters with patients under the age of 18, until the allega- tions against him were resolved. Subsequently, Dr. Johnston chose to cease practising medicine until the hearing. REASONS FOR PENALTY Counsel for the College and counsel for Dr. Johnston made a joint submission that called for the revoca- tion of Dr. Johnson’s certificate of registration, a reprimand, and the payment of costs. The Committee considered the proposed penalty in light of accepted penalty principles, including, foremost, the protection of the public, as well as maintenance of public confidence in the integrity and reputation of the medical profession, and its ability to self-regulate in the public interest. This was the first case to be heard by the College’s Discipline Committee regarding the viewing, pur- chasing, and possession of pornographic images of young children. The purchase and possession of such images demean the participants who are below the age of consent, and encourage and allow the continu- ing exploitation of children. The Committee was of the opinion that Dr. John- ston’s involvement with child pornography repre- 78 DIALOGUE ISSUE 4, 2017 sented one of the most serious forms of misconduct possible by a physician, and is deserving of the most serious sanction. While the legal definition of sexual abuse does not include possessing and viewing child pornography, the Committee found that it was con- duct of a sexual nature with the potential to demean and traumatize young persons. Purchasing, viewing and possessing child pornography by a physician cannot be countenanced. Neither can voyeurism, by placing cameras in a public bathroom, for its delib- erate, secretive, devious, intrusive, and demeaning ways. There is an expectation of moral behaviour by persons granted the privilege to practise medicine. Dr. Johnston’s engagement in the consumption of child pornography and voyeurism demonstrated con- duct that is totally unbecoming of a physician. The Committee was presented with certain mitigat- ing factors. A no contest plea spared witnesses from having to testify and the Committee the time and expense of conducting a lengthy contested hearing. Since 2011, Dr. Johnston practised under restrictions imposed by the courts and by voluntary undertakings to the College in 2012 and 2016. Subsequently, he chose to cease practising until the hearing. There was ongoing cooperation by Dr. Johnston with the Col- lege. However, none of these factors were meaningful in assessing the proposed penalty because they did not speak to the danger that child pornography poses to children. As a further mitigating factor, counsel for Dr. John- ston raised the issue of his recent bipolar diagnosis. The Committee was presented with no evidence re- garding the basis for diagnosis, or that Dr. Johnston’s conduct was in any way the result of this medical condition. Aggravating factors included Dr. Johnston’s part in encouraging the commercialization and availability of child abuse pornography, and victimization of the affected children, as well as the moral reprehensibility of this type of pornography. Child pornography is not a victimless activity. The children portrayed and directed to perform actions are being traumatized and victimized. There was no question in the Committee’s mind on examining the police reports that Dr. Johnston was fully aware of the nature of the images he downloaded. Furthermore, Dr.