Tribunal Backs Doctor’s Right to Decline Patient amid Abusive Interactions


An appeals tribunal has ruled that a specialist from the Sault area was within his rights in declining to treat a patient attributed to the patient’s mother’s abusive behaviour.

Inspectors from the Health Professions Appeal and Review Board, however, contended that it is pertinent for doctors, considering this ruling, to conscientiously maintain records of any adverse interactions with the patients’ caregivers, anticipating possible disputes in the future.

The cipher for these deliberations began unfolding in June 2020 when a non-verbal patient was brought in to the Sault Area Hospital’s emergency department. Initially diagnosed with lymphoma according to the board’s decision, his actual malady was discovered only after some time. He was, interestingly, suffering from a rather unusual condition unrelated to lymphoma.

The expertise of a hematologist was sought during the process, who interacted in-person with the patient and his mother, twice in the summer of 2020, besides a few telephonic conversations. The delay in arriving at the correct diagnosis seemingly agitated the patient’s mother. The specialist recalls her as “aggressive, argumentative, intimidating, belligerent, irate, sarcastic, and belittling”. She accused him of incompetence at his practice and the hematologist alleges her demeanour to be decidedly abusive.

While the specialist undeniably found these confrontational exchanges disturbing, he confessed to the uncertainty regarding whether a patient’s chart ought to carry detailed accounts of a patient’s mother’s demeanour.

In a surprising turn of events, a year later, as the patient was being shifted back to northern Ontario, another hematologist from Toronto who was treating the patient desired a Sault-based specialist to take over. The previously harassed specialist, recalling the patient’s mother’s disruptive behaviour, declined to accept the case.

Through a subsequent consultation with the hospital administration in October 2021, he verbalised his discomfort at the prospect of dealing with the patient’s mother again, ultimately refusing to be a part of the patient’s transformative care citing her incessant antagonism.

Despite his refusal, he recommended alternatives- other hematologists in Toronto and Sudbury, who could offer virtual care to the patient.

This refusal incited the mother to lodge a complaint with the College of Physicians and Surgeons of Ontario (CPSO). She claimed that the hematologist’s refusal to accept her son as a patient exemplified “unprofessional” behaviour. She further alleged that his declination was driven by his unfavourable perception of her despite a dearth of other hematologists in their vicinity to discern this care.

The complaint, however, was debunked by CPSO in April 2022. The mother appealed, but to no avail. Last month, the board reinforced their original decision, reminding the specialist of the importance of documenting difficult interactions with patients and their families.

The board, despite acknowledging the mother’s enduring advocacy for her son, reiterated the right to respectful treatment for everyone, inclusive of doctors.

The committee identified the mother as fiercely dedicated, who has had to manoeuvre health care since her son’s birth. The board, however, upheld the need to respect physicians, stating they should not be subjected to verbal abuse, as the hematologist felt he had experienced in this particular case.


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