Power imbalance makes medical students vulnerable to abuse: ethicist

Medical students are sometimes powerless if they try to speak up against their superiors, a university ethicist says, after a Winnipeg oncologist was disciplined because of "flagrantly unprofessional" intimate relationships that he pursued with two students.

"Basically, your entire future depends on the evaluations of the people who are directly above you," said Brendan Leier, a professor at the University of Alberta's Dossetor Health Ethics Centre.

"There's not a medical school in Canada that doesn't have processes to vet complaints and things like that, on paper, but in the real world these are grave, grave issues," he said. "If you leave a residency program, is it possible to get into another one? It's highly unlikely."

That reluctance sealed the lips of one student, described as X in the decision by the College of Physicians and Surgeons of Manitoba's inquiry board. X's mentorship with Dr. Gary Allan Joseph Harding progressed to conversations of a sexual nature and inappropriate sexual touching, beginning in 2012.

X disclosed the improper relationship to a counsellor in 2013, who urged him many times to report it, but he was hesitant because of worries his career would be jeopardized if he spoke out.

He refused to name the faculty member when he later met the associate dean of student affairs in response to his "significant academic issues" in late 2014 and disclosed the relationship.

Student comes forward

Days later, X was asked directly if Harding was the perpetrator, which he confirmed.

His disclosure triggered the university's investigation and, upon learning this, Harding resigned in June 2015.

Soon thereafter, CancerCare Manitoba, an affiliate of the faculty, terminated his employment.

Harding has not practised or taught medicine in Manitoba or any other jurisdiction since 2015, the college reported.

In a decision that was made public this week, the inquiry panel ruled Harding was guilty of professional misconduct. Harding was found to have initiated unwanted sexual contact, provided gifts and offered invitations to his home.

The decision bars Harding from practising medicine for six months and he must pay $125,000 in investigation costs. He can only regain his licence if he undergoes "rigorous and specific" evaluation, the panel ruled.

Leier said students are almost compelled to silence when a career in the medical profession — something they've spent years working toward — is at stake.

"Although medical students are treated sometimes, and perceived sometimes, as entitled elites, they're in an incredibly vulnerable situation."

He said a mentorship is vital to students who want to find success.

"It's from your mentor that you learn the art of medicine, and not the factual science."

Another student, described in the ruling as Y, tried to push back in early 2014 when he told Harding he wanted to remain his mentee and friend, but did not want to sleep over. Harding became angry after hearing this.

During previous sleepovers, Y reported, he awoke to find Harding's hand on his genitals.

The sleepovers would continue until Y's medical placement took him out of the city.

The report says Harding eventually harassed Y to the point, in late 2014, where he threatened the student with a citation that he claimed would ruin his professional reputation. Y hired a lawyer to make the harassment stop.

Naomi Levine, a retired Winnipeg lawyer who helped the University of Manitoba develop its approach to sexual harassment complaints, said professors must discourage friendly relationships with their students that might become something inappropriate.

She said some students have an expectation of a friendly relationship, which faculty are sometimes inclined to match.

"Faculty members often forget that they are not psychiatrists. They are not the people who deal with the emotions, feelings, the sensitivities, the domestic lives of their students. They are there to teach them," she said.

The University of Manitoba has been criticized for its handling of sexual misconduct complaints after former jazz professor Steve Kirby quietly retired from the institution last year after an internal investigation was kept under wraps.

The Berklee College of Music later hired Kirby after speaking with individuals at the U of M, who provided "uniformly positive" references. Kirby was promptly fired by the Boston-based college when it became aware of the allegations.

Levine said students must have clear pathways to report wrongdoings to senior personnel or authorities.

And they shouldn't have to worry that faculty members will bind together rather than point fingers at one of their own, she said.

Leier agrees, saying untoward behaviour such as Harding's undermines the credibility of their profession.

University response

The University of Manitoba's Rady Faculty of Health Sciences did not comment specifically on the allegations against Harding, but said it is committed to providing various mechanisms for students to report misconduct, including an anonymous online reporting tool.

"We are committed to supporting individuals who disclose and building a culture of safety, respect, consent, prevention and education," the school said.

Winnipeg police would not say whether they're investigating the allegations outlined in the decision, but said a report from a college is enough to initiate a preliminary investigation.

CancerCare Manitoba's own investigation concluded that no patients were adversely affected.

Neil McArthur, director of the Centre for Professional and Applied Ethics at the U of M, hopes Harding's violations are a wake-up call.

"This is happening too often, I'll put that bluntly," he said. "There are too many of these boundary violations, inappropriate relationships or outright harassments happening in academics."​