Thursday, June 16, 2011

Should a Convicted Rapist be Allowed to Practice Medicine?

In 2008, a military court convicted Dr. Mark Seldes, a Flight Surgeon serving in South Korea, for raping a civilian colleague. Dr. Seldes served three years in prison. When he emerged from incarceration he applied for reinstatement of his Florida license. Two weeks ago, the Florida Board of Medicine voted to allow Dr. Seldes to return to medical practice.

Here's the gist of the Health News Florida article about the board's decision:
Board members wrestled with the question of whether a rape conviction precludes a health professional from being able to practice with skill and safety, as Florida statutes require.

The rape victim was not a patient, and thus Seldes's attorney, Kenneth Haber, said the case had nothing to do with the practice of medicine. Haber also said that the rape offense was not violent and that Seldes had previous sexual contact with the victim before the rape. An account of the case in Stars and Stripes said the rape victim was asleep, under medication, at the time the assault occurred.

“He was a man who made a terrible mistake to engage in a relationship with an individual who was not his wife, and has destroyed his career and has certainly brought dire consequences on his marriage,” Haber said.

Seldes's wife sat next to him as the Board went back and forth over what conditions Seldes must meet in order to return to practice.

"Anytime the word rape is used, it rises to a level that gives me great concern, and I'm unwilling to say that this doctor should keep practicing in Florida," said Don Mullins, a consumer member of the board.

"I take a different view," Dr. Zach Zachariah shot back. "In my personal opinion, he has paid his penance."

The board ultimately agreed that Seldes could practice, as long as he works in a government facility while he is under supervision by PRN, a monitoring program for troubled physicians.

He must also complete at least 300 hours of community service within the next three years and give all patients a questionnaire that asks how they had been treated. Seldes requested not to be placed on official "probation," since that might prevent him from being able to get a job with the VA or some other agency, and the board agreed.
If the only question the board had to answer was whether Dr. Seldes would be able to "practice with skill and safety," they could examine him the way candidates for board certification are examined and see if he passed.

But that's not the criterion physician Zach Zachariah and consumer Don Mullins were using.

Zachariah believed that by serving his jail sentence, Seldes had "paid his penance." From the perspective of justice, Zachariah is right. We should help ex-convicts reenter society and become constructive citizens. Jesus's teaching - "let he who is without sin cast the first stone" - deserves universal respect.

Mullins didn't challenge the idea that Seldes had "paid his penance," but he believed it simply didn't make sense to give a rapist a medical license. He was also right.

From the perspective of ethics, predicting Dr. Seldes's ability to perform with "skill and safety" isn't the only question. The Hippocratic oath includes this sentence: "In purity and holiness I will guard my life and my art." Anyone who has committed rape has not guarded his life "in purity and holiness." This is the value Mullins guided himself by, and he was right to do so.

If medical practice were simply a form of body repair, analogous to plumbing, tiling and painting, the Hippocratic precept would not apply. But medical care is built on a relationship and stands and falls with trust. And it isn't just the individual physician who must be trusted - it's the profession itself.

The Florida Board of Medicine made a serious error when it concluded that rape doesn't disqualify a physician from being part of the medical community.

(For a post about the question of whether someone who had been convicted for murder should have been accepted into medical school, see here.)

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