In 2024, the investigative journalism television program Zembla investigated sexual misconduct within hospitals after receiving an anonymous tip. The investigation uncovered shocking cases that were quickly picked up by various news platforms. In the two cases examined by Zembla, male physicians in senior positions were found to have engaged in sexual misconduct toward women working as medical trainees or interns. Martin Buijsen, Professor of Health Law at Erasmus School of Law, appeared on the Zembla Podcast episode 'Onveilige artsen'.
Headlines such as "Surgeons at Haga Hospital harassed female trainee doctors: 'He wanted to French kiss" and "Maasstad Hospital internist dismissed for groping interns" highlight the seriousness of this issue. However, how can such behaviour be addressed?
The Maasstad Hospital case
In 2021, three female students were completing their residency in the internal medicine department at Maasstad Hospital in Rotterdam. During their residency, they worked under a renowned internist known for his expertise and role as head of the section. On the final day of their residency, the internist asked the three interns if they were interested in receiving additional training in conducting research. The interns, feeling honoured by this opportunity, readily agreed.
The internist proposed teaching them how to perform ultrasounds in the groin area. What started as a learning opportunity soon turned into an uncomfortable situation. Behind a curtain, the interns were instructed to undress, after which the internist entered without their consent. The partially undressed women were made to perform the procedures on each other while the internist gave instructions on positioning and technique. The situation escalated further when the internist secretly began recording videos of the ultrasounds. One of the students noticed something was amiss and questioned the internist, who then ran to the restroom and deleted the footage.
Disciplinary law
Following the incident, the three interns reported the matter to the hospital, filed a police report, and lodged a complaint with the healthcare disciplinary tribunal. However, what exactly is disciplinary law? Disciplinary law is a specialized form of justice applied to certain professions, such as medicine. These professions establish their own rules and self-regulate. In Zembla, Buijsen explains: "Disciplinary law is a form of justice by the profession, for the profession, about members of the profession."
The second disciplinary norm
Recent changes in disciplinary law have introduced an interesting development. Since 2019, healthcare professionals can also bring colleagues before the disciplinary tribunal if they believe a colleague's behaviour has negative consequences. Previously, only patients themselves could file disciplinary complaints. Thanks to this expansion, known as the second disciplinary norm, four cases of sexual misconduct have already been addressed.
Buijsen sees this as a step in the right direction: "This is an important development because it creates a new pathway for those working in healthcare, who often find themselves in dependent relationships, to report misconduct while being in a relatively weaker position than the accused. Of course, issues can be raised with a confidential advisor or a supervisor, but that does not always lead to action. However, this pathway seems to hold promise."
From title revocation to criminal proceedings
The most severe sanction a disciplinary tribunal can impose is removing a healthcare professional from the BIG register. For doctors, this means they can no longer practice medicine. However, the purpose of disciplinary law is not punitive. Buijsen explains in the podcast that disciplinary law focuses on the quality and safety of individual care. In the case of the Rotterdam internist, the disciplinary tribunal initially imposed the heaviest penalty: the revocation of his professional title. On appeal, however, the tribunal reduced the penalty to a one-year suspension. Since then, another disciplinary complaint has been filed against him.
The criminal case against the internist is still pending. The Public Prosecution Service in Rotterdam informed Zembla that two patients have also come forward in addition to the complaints filed by the three interns. This suggests that the extent of the internist's misconduct may be far greater than initially thought.
