Mussani v. College of Physicians, (2003) 172 O.A.C. 1 (DC)

• Judge: Then, E.I. MacDonald and Sedgwick, JJ.
• Court: Superior Court of Justice of Ontario (Canada)
• Case Date: May 20, 2003
• Jurisdiction: Ontario
• Citations: (2003), 172 O.A.C. 1 (DC)

Mussani v. College of Physicians (2003), 172 O.A.C. 1 (DC)

MLB headnote and full text

Temp. Cite: [2003] O.A.C. TBEd. MY.075

Dr. Anil Mussani (appellant) v. The College of Physicians and Surgeons of Ontario (respondent) and The Ontario Medical Association and The Attorney General of Ontario (intervenors)

(629/00)

Indexed As: Mussani v. College of Physicians and Surgeons (Ont.)

Court of Ontario

Superior Court of Justice

Divisional Court

Then, E.I. MacDonald and Sedgwick, JJ.

May 20, 2003.

Summary:

A doctor found guilty of professional misconduct for sexually abusing a patient had his certificate or licence to practice revoked by the Discipline Committee of the College of Physicians and Surgeons. The Mandatory Revocations Provisions in the Health Professions Procedural Code provided for a mandatory revocation of a physician's certificate for a period of no less than five years for professional misconduct by sexual­ly abusing a patient. The doctor appealed the penalty imposed, submitting that the Manda­tory Revocation Provisions (zero tolerance penalty regime) violated ss. 7 (deprivation of liberty or security of the person) and 12 (cruel and unusual punishment) of the Char­ter of Rights and Freedoms and were of no force and effect. If successful on the consti­tutional validity issue, the doctor submitted that an appropriate penalty was a reprimand. The Ontario Medical Association (in­tervenor) submitted that the Mandatory Revocation Provisions violated freedom of association (Charter, s. 2(d)).

The Ontario Divisional Court dismissed the appeal. The Provisions did not violate ss. 2(d), 7 or 12 of the Charter. Alternatively, any Charter rights violation would be saved as a reasonable limit prescribed by law.

Civil Rights - Topic 651.2

Liberty - Limitations on - Right to practice one's profession - The Ontario Medical Association submitted that although the right to liberty under s. 7 of the Charter did not generally protect economic inter­ests, the right to liberty should protect the interests of a professional facing the loss of a licence to practice - The Ontario Divisional Court held that "the s. 7 right to liberty does not encompass a constitutional right to practice one's profession" - See paragraphs 64 to 65.

Civil Rights - Topic 660.6

Liberty - Limitations on - Sexual relations with patients, clients, etc. - The Ontario Divisional Court held that there is no binding authority supporting the proposi­tion that the right to liberty under s. 7 of the Charter guaranteed any person the right to "consensual sexual relations" - The court stated that "it is difficult to discern a valid 'liberty' interest in sexual relations be­tween physician and patient, even if con­sensual, given the concern over the power imbalance, the 'inherently suspect' nature of any 'consent', the exploitive nature of the relationship, and in circumstances where the cultural values of our society have held for centuries the belief that sexual contact between physician and patient is fundamentally improper" - See paragraphs 49 to 63.

Civil Rights - Topic 721

Liberty - Charter of Rights and Freedoms - General - The Ontario Divisional Court held that the s. 7 Charter right to liberty and security of the person was engaged outside the criminal context if there was "state action which directly engages the justice system and its administration" - See paragraphs 45 to 48.

Civil Rights - Topic 1200

Security of the person - General - [See Civil Rights - Topic 721 ].

Civil Rights - Topic 1415

Security of the person - Professional oc­cupations - Sexual relations with patients, clients, etc. - The Mandatory Revocations Provisions in the Health Professions Pro­cedural Code provided for a mandatory revocation of a physician's certificate or licence to practice for a period of no less than five years for deemed professional misconduct involving certain types of sexual abuse of a patient - A physician whose licence was revoked for having a consensual sexual relationship with a pa­tient submitted that the Provisions violated his right to security of the person in a manner not in accordance with the prin­ciples of fundamental justice - The Ontario Divisional Court held that, assuming security interests were engaged, any denial of the right to security was in accordance with the principles of fundamental justice - The court rejected submissions that the meaning of "patient" was impermissibly vague, that the Provisions were overly broad, and that exclusion of consent as a defence and the removal of the Discipline Committee's discretion was contrary to the principles of fundamental justice - The Provisions struck a fair balance between the rights of the public and the individual - Had the Provisions violated s. 7, the court would have found them saved under s. 1 of the Charter as being demonstrably justified - See paragraphs 66 to 120.

Civil Rights - Topic 2103

Freedom of association - General - Scope of right - The Mandatory Revocations Provisions in the Health Professions Pro­cedural Code provided for a mandatory revocation of a physician's certificate or licence to practice for a period of no less than five years for deemed professional misconduct involving certain types of sexual abuse of a patient - A physician whose licence was revoked for having a consensual sexual relationship with a pa­tient submitted that the Provisions violated his s. 2(d) Charter right to freedom of association by restricting who he could have a sexual relationship with - The Ontario Divisional Court held that the physician's freedom of association was not violated - The court stated that "the pur­pose of s. 2(d) is to promote social interac­tion and collective action, not private sexual relationships. The courts have re­peat­edly refused to find that intimate per­sonal relationships are protected under s. 2(d). ... In order to enjoy the guarantee of freedom of association, the association in question must advance some social value deserving of constitutional protection. ... a sexual relationship between a doctor and patient is of no social value due to the harmful effects it often has on the patient." - See paragraphs 165 to 170.

Civil Rights - Topic 3107

Trials - Due process, fundamental justice and fair hearings - General principles and definitions - Void for vagueness doctrine - [See Civil Rights - Topic 1415 ].

Civil Rights - Topic 3107.2

Trials - Due process, fundamental justice and fair hearings - General principles and definitions - Overbreadth principle - [See Civil Rights - Topic 1415 ].

Civil Rights - Topic 3807

Cruel and unusual treatment or punishment - General - Punishment - Meaning of - Mandatory revocation of professional's licence to practice - The Mandatory Revo­cations Provisions in the Health Profes­sions Procedural Code provided for a mandatory revocation of a physician's certificate or licence to practice for a period of no less than five years for deemed professional misconduct involving certain types of sexual abuse of a patient - A physician whose licence was revoked for having a consensual sexual relationship with a patient submitted that the Provisions constituted cruel and unusual punishment contrary to s. 12 of the Charter - The Ontario Divisional Court held that s. 12 did not apply - The revocation of a profes­sional's licence to practice by his gov­erning body was neither "punishment" nor "treatment" within the meaning of s. 12 - Alternatively, even if s. 12 was engaged, licence revocation was not cruel and un­usual treatment and punishment - Revoca­tion as a penalty was not grossly dispro­portionate to the gravity of the proscribed misconduct - See paragraphs 121 to 150.

Civil Rights - Topic 8344

Canadian Charter of Rights and Freedoms - Application - Exceptions - Principles of fundamental justice (Charter, s. 7) - [See Civil Rights - Topic 1415 ].

Civil Rights - Topic 8348

Canadian Charter of Rights and Freedoms - Application - Exceptions - Reasonable limits prescribed by law (Charter, s. 1) - [See Civil Rights - Topic 1415 ].

Civil Rights - Topic 8546

Canadian Charter of Rights and Freedoms - Interpretation - Particular words and phrases - Life, liberty and security of the person - [See Civil Rights - Topic 721 ].

Constitutional Law - Topic 2501.1

Determination of validity of statutes or Acts - General principles - Jurisdiction - A physician was found guilty of professional misconduct for sexually abusing a patient - The Discipline Committee of the College of Physicians and Surgeons imposed a mandatory revocation of his certificate or licence to practice for at least five years, as required under the Mandatory Revocation Provisions of the Health Professionals Procedural Code - The physician chal­lenged the mandatory provisions as violat­ing his Charter rights - The Ontario Divi­sional Court rejected the Attorney Gen­eral's submission that the constitutional issue need not be dealt with since the Discipline Committee indicated that it would have revoked the certificate even if it was not mandatory - The court stated that "the foundation of the claim in this case still exists. In fact, since the provi­sions are mandatory, whether or not the Discipline Committee would have given the same penalty if permitted to exercise its discretion is irrelevant. The Discipline Committee was required to apply these provisions. Therefore, this court must resolve the issues of whether the Manda­tory Revocation Provisions violated the appellant's Charter rights." - See para­graphs 35 to 40.

Medicine - Topic 2186

Discipline for professional misconduct - Punishments - Revocation of licence - The Mandatory Revocations Provisions in the Health Professions Procedural Code pro­vided for a mandatory revocation of a physician's certificate or licence to practice for a period of no less than five years for deemed professional misconduct involving certain types of sexual abuse of a patient - A physician's licence was revoked for having a consensual sexual relationship with a patient - The Ontario Divisional Court held that the mandatory licence revocation did not violate s. 2(d) (freedom of association), 7 (liberty and security of the person) or 12 (cruel and unusual treat­ment or punishment) of the Charter of Rights and Freedoms - If there was a Charter rights violation, the court would have found the Provisions saved under s. 1 of the Charter as having been demon­strably justified.

Cases Noticed:

Phillips et al. v. Richard, J., [1995] 2 S.C.R. 97; 180 N.R. 1; 141 N.S.R.(2d) 1; 403 A.P.R. 1, dist. [para. 36].

Blencoe v. Human Rights Commission (B.C.) et al. (2000), 260 N.R. 1; 141 B.C.A.C. 161; 231 W.A.C. 161; 190 D.L.R.(4th) 513 (S.C.C.), refd to. [para. 46].

Fancy v. Shephard (1997), 164 N.S.R.(2d) 274; 491 A.P.R. 274 (S.C.), dist. [para. 50].

A.B. v. College of Physicians and Sur­geons (P.E.I.) (2001), 205 Nfld. & P.E.I.R. 131; 615 A.P.R. 131 (P.E.I.T.D.), dist. [para. 53].

Norberg v. Wynrib (1992), 138 N.R. 81; 9 B.C.A.C. 1; 19 W.A.C. 1; 92 D.L.R.(4th) 449, refd to. [para. 59].

Reference Re Compulsory Arbitration, [1987] 1 S.C.R. 313; 74 N.R. 99; 78 A.R. 1; 38 D.L.R.(4th) 161, refd to. [para. 64].

Reference Re Public Service Employee Relations Act (Alta.) - see Reference Re Compulsory Arbitration.

Wilson v. British Columbia Medical Com­mission, [1989] 2 W.W.R. 1 (B.C.C.A.), refd to. [para. 64].

Karmash v. Ontario Association of Profes­sional Engineers (1998), 109 O.A.C. 334 (Div. Ct.), refd to. [para. 65].

Walker and Robertson v. Prince Edward Island (1993), 111 Nfld. & P.E.I.R. 150; 348 A.P.R. 150; 107 D.L.R.(4th) 69 (P.E.I.C.A.), affd. (1995), 181 N.R. 158; 130 Nfld. & P.E.I.R. 181; 405 A.P.R. 181; 124 D.L.R.(4th) 127 (S.C.C.), refd to. [para. 65].

Reference Re Sections 193 and 195.1(1)(c) of the Criminal Code (1990), 109 N.R. 81; 68 Man.R.(2d) 1; 77 C.R.(3d) 1 (S.C.C.), refd to. [para. 65].

R. v. R.P.F. et al. (1996), 149 N.S.R.(2d) 91; 432 A.P.R. 91 (C.A.), refd to. [para. 68].

Rodriguez v. British Columbia (Attorney General) et al., [1993] 3 S.C.R. 519; 158 N.R. 1; 34 B.C.A.C. 1; 56 W.A.C. 1, refd to. [para. 69].

R. v. Nova Scotia Pharmaceutical Society (No. 2), [1992] 2 S.C.R. 606; 139 N.R. 241; 114 N.S.R.(2d) 91; 313 A.P.R. 91, refd to. [para. 80].

Ontario v. Canadian Pacific Ltd. (1995), 183 N.R. 325; 82 O.A.C. 243; 125 D.L.R.(4th) 385 (S.C.C.), refd to. [para. 80].

Suresh v. Canada (Minister of Citizenship and Immigration) (2002), 281 N.R. 1 (S.C.C.), refd to. [para. 80].

R. v. Briggs (W.) (2001), 149 O.A.C. 244; 55 O.R.(3d) 417 (C.A.), leave to appeal refused (2001), 292 N.R. 193; 165 O.A.C. 45 (S.C.C.), refd to. [para. 81].

Boodoosingh v. College of Physicians and Surgeons (Ont.) (1990), 39 O.A.C. 51; 73 O.R.(2d) 478 (Div. Ct.), affd. (1993), 63 O.A.C. 173; 12 O.R.(3d) 707 (C.A.), leave to appeal refused (1993), 164 N.R. 402; 69 O.A.C. 159 (S.C.C.), refd to. [para. 83].

Jaswal v. Medical Board (Nfld.) (1996), 138 Nfld. & P.E.I.R. 181; 431 A.P.R. 181; 42 Admin. L.R.(2d) 233 (Nfld. S.C.), refd to. [para. 83].

George L. v. College of Physicians and Surgeons (Alta.) (1993), 145 A.R. 377; 55 W.A.C. 377; 110 D.L.R.(4th) 214 (C.A.), refd to. [para. 83].

Hirt v. College of Physicians and Surgeons (B.C.) (1986), 34 D.L.R.(4th) 331 (B.C.C.A.), refd to. [para. 83].

R. v. Heywood (R.L.), [1994] 3 S.C.R. 761; 174 N.R. 81; 50 B.C.A.C. 161; 82 W.A.C. 161, refd to. [para. 86].

R. v. Sharpe (J.R.), [2001] 1 S.C.R. 45; 264 N.R. 201; 146 B.C.A.C. 161; 239 W.A.C. 161, refd to. [para. 89].

Davidson v. Slaight Communications Inc., [1989] 1 S.C.R. 1038; 93 N.R. 183; 59 D.L.R.(4th) 416, refd to. [para. 89].

Eaton v. Board of Education of Brant County, [1997] 1 S.C.R. 241; 207 N.R. 171; 97 O.A.C. 161, refd to. [para. 89].

R. v. Audet (Y.), [1996] 2 S.C.R. 171; 197 N.R. 172; 175 N.B.R.(2d) 81; 446 A.P.R. 81; 106 C.C.C.(3d) 481; 135 D.L.R.(4th) 20, refd to. [para. 99].

R. v. Matheson (G.C.) (1999), 119 O.A.C. 1 (C.A.), refd to. [para. 100].

R. v. Jobidon, [1991] 2 S.C.R. 714; 128 N.R. 321; 49 O.A.C. 83; 7 C.R.(4th) 233; 66 C.C.C.(3d) 454, refd to. [para. 102].

R. v. Welch (J.) (1995), 86 O.A.C. 200; 25 O.R.(3d) 665 (C.A.), refd to. [para. 103].

R. v. McDonald (C.) (1998), 111 O.A.C. 25; 40 O.R.(3d) 641; 127 C.C.C.(3d) 57; 17 C.R.(5th) 1 (C.A.), refd to. [para. 113].

Cunningham v. Canada, [1993] 2 S.C.R. 143; 151 N.R. 161; 62 O.A.C. 243; 80 C.C.C.(3d) 492, refd to. [para. 114].

R. v. Oakes, [1986] 1 S.C.R. 103; 65 N.R. 87; 14 O.A.C. 335; 26 D.L.R.(4th) 200, refd to. [para. 116].

R. v. Smith (E.D.), [1987] 1 S.C.R. 1045; 75 N.R. 321; 34 C.C.C.(3d) 97; 40 D.L.R.(4th) 435, refd to. [para. 124].

R. v. Goltz, [1991] 3 S.C.R. 485; 131 N.R. 1; 5 B.C.A.C. 161; 11 W.A.C. 161; 67 C.C.C.(3d) 481, refd to. [para. 126].

Melunsky v. College of Physiotherapists (Ont.), [1999] O.A.C. Uned. 8 (Div. Ct.), not folld. [para. 130].

Reference Re Section 94(2) of the Motor Vehicle Act (B.C.), [1985] 2 S.C.R. 486; 63 N.R. 266; [1986] 1 W.W.R. 481; 23 C.C.C.(3d) 289, refd to. [para. 137].

R. v. Middlebrook, Miller and Laporta (1988), 29 O.A.C. 95; 65 O.R.(2d) 746 (C.A.), refd to. [para. 137].

Condo v. Registrar of Motor Vehicles (Ont.) (1999), 123 O.A.C. 111 (Div. Ct.), refd to. [para. 137].

Billard v. Liquor Licensing Board (Nfld.) (1990), 85 Nfld. & P.E.I.R. 1; 266 A.P.R. 1 (Nfld. T.D.), refd to. [para. 137].

Arsenault et al. v. Charlottetown (City) (1991), 94 Nfld. & P.E.I.R. 91; 298 A.P.R. 91 (P.E.I.T.D.), refd to. [para. 137].

Chiarelli v. Minister of Employment and Immigration, [1992] 1 S.C.R. 711; 135 N.R. 161, refd to. [para. 138].

R. v. Wigglesworth, [1987] 2 S.C.R. 541; 81 N.R. 161; 24 O.A.C. 321; 61 Sask.R. 105; 45 D.L.R.(4th) 235, refd to. [para. 138].

Bartashunas v. Psychology Examiners, [1992] O.J. No. 1845 (Div. Ct.), refd to. [para. 138].

Carruthers v. College of Nurses (Ont.) (1996), 96 O.A.C. 41; 31 O.R.(3d) 377 (Div. Ct.), refd to. [para. 138].

Knutson v. Saskatchewan Registered Nurses' Association (1990), 90 Sask.R. 120; 75 D.L.R.(4th) 723 (C.A.), refd to. [para. 138].

Horsefield v. Registrar of Motor Vehicles (Ont.) (1999), 118 O.A.C. 291; 44 O.R.(3d) 73 (C.A.), refd to. [para. 142].

Fetherston v. College of Veterinarians (Ont.) (1999), 117 O.A.C. 334 (Div. Ct.), refd to. [para. 142].

R. v. Lyons, [1987] 2 S.C.R. 309; 80 N.R. 161; 82 N.S.R.(2d) 271; 207 A.P.R. 271; 61 C.R.(3d) 1; 37 C.C.C.(3d) 1; 44 D.L.R.(4th) 193, refd to. [para. 145].

R. v. Singh, [1992] O.J. No. 219 (C.A.), refd to. [para. 156].

R. v. Litchfield, [1993] 4 S.C.R. 333; 161 N.R. 161; 145 A.R. 321; 55 W.A.C. 321; 86 C.C.C.(3d) 97, refd to. [para. 156].

Cuddy Chicks Ltd. v. Labour Relations Board (Ont.) et al., [1991] 2 S.C.R. 5; 122 N.R. 361; 47 O.A.C. 271, refd to. [para. 162].

Dunmore et al. v. Ontario (Attorney Gen­eral) (2001), 279 N.R. 201; 154 O.A.C. 201 (S.C.C.), refd to. [para. 166].

R. v. M.S. (1996), 84 B.C.A.C. 104; 137 W.A.C. 104; 111 C.C.C.(3d) 467 (C.A.), leave to appeal refused (1997), 214 N.R. 160 (S.C.C.), refd to. [para. 167].

R. v. Skinner, [1990] 1 S.C.R. 1235; 109 N.R. 241; 98 N.S.R.(2d) 181; 263 A.P.R. 181, refd to. [para. 168].

Catholic Children's Aid Society of Metro­politan Toronto v. T.S. and C.S. et al. (1989), 33 O.A.C. 213; 69 O.R.(2d) 189 (C.A.), refd to. [para. 168].

Horbas v. Minister of Employment and Immigration, [1985] 2 F.C. 359; 22 D.L.R.(4th) 600 (T.D.), refd to. [para. 168].

R. v. McLean (1986), 28 C.C.C.(3d) 176 (B.C.S.C.), refd to. [para. 169].

Bourgoin v. Liquor Licensing Board (N.B.) (1992), 123 N.B.R.(2d) 366; 310 A.P.R. 366 (Q.B.), refd to. [para. 169].

Statutes Noticed:

Health Professions Procedural Code - see Regulated Health Professions Act.

Regulated Health Professions Act, S.O. 1991, c. 18, Schedule 2 (Health Profes­sions Procedural Code), sect. 1(1), sect. 1(3), sect. 1.1, sect. 51(1)(b.1), sect. 51(2), sect. 51(5), sect. 72(1), sect. 72(2), sect. 72(3) [para. 9].

Counsel:

W. Niels Ortved, Jonathan C. Lisus and Andrew B. Matheson, for the appellant;

Lisa Brownstone, for the College of Physi­cians and Surgeons;

Christopher Bredt, Ira Nishisato and David Akman, for the Ontario Medical Asso­ciation;

Sarah Kraicer, for the Attorney General.

This appeal was heard before Then, E.I. MacDonald and Sedgwick, JJ., of the On­tario Divisional Court.

On May 20, 2003, Then, J., delivered the following judgment for the Divisional Court.