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  • Reverend James Squire

Ethics Case Study:A Surgeon and a Resident

There is a complex case in the Philly Court System this week. I will try to make the complicated simple.

A surgeon, John Abraham, and a resident, Jessica Phillips, are accusing one another of damaging each other’s reputation as a result of having sex at a party to thank residents at Abraham’s home. The AMA declared relationships between supervisors (Abraham) and trainees (Phillips) are unacceptable because of inherent inequalities of status and power. It can also affect patient care.

Both are accusing the other of having sex where the woman has indicated that she was plied with liquor by Abraham and woke up in his bed bruised and naked. Abraham has indicated that she plied him with liquor. (Note 90% of all rape cases involve alcohol.) Both institutions, Rothman and Jefferson have rules against supervisors having sex between a supervisor and a student. Was it consensual sex or does that even matter? It doesn’t.

The court case glosses over two things that are an important context. Abraham asked the bartenders to water down his drinks. Why? The party itself sounds a bit like a scene from the movie, “Animal House.” Phillips called her husband and told him that she didn’t know if the sex was consensual. She was too drunk.

Both institutions’ faculty handbooks indicated that consensual or non-consensual sex between a supervisor and a student, as well as the partner agreement that Abraham had with Rothman, is wrong.

The incident was not reported by either institution as part of the physicians’ files as was normally required to track any future behavior. Attorneys for both institutions would not provide a reason.

(Studies reflect that doctors are not very good at convicting their peers and holding them accountable. Women make up only 7% of orthopedic surgeons. It’s a man’s world.)

Rothman hired an investigator who seemed to put the blame on Phillips. Dr. Vaccaro, CEO of Rothman, got a voluntary resignation of Abraham’s position from Jefferson which meant he could continue practicing medicine in another location affiliated with Rothman in New Jersey. When Phillips learned this, she accused Vaccaro and Jefferson of cutting her out of the process. Later Rothman would fire Abraham for not bringing in his share, 1.3 million dollars, of business per year. He said they “squeezed him out.”

Abraham was invited to speak with Rothman’s board while Phillips was not. Jefferson had refused to release the legal documents related to the case until this week. They claimed confidentiality. The court did not see it that way, and required them to release all documents.

Ironically without this case, no one would know how Rothman and Jefferson handled or didn’t handle the situation.

The title 9 laws (equal treatment for women) don ‘t allow for a no charge solution between a professor and a student in this kind of situation.

A lawyer made two observations about the trial (and I think this pertains to Trump’s rape trial as well) “We can’t have a liar without someone else who is truthful. A lie can travel halfway around the world before truth gets its shoes on.” I just learned that Trump was convicted of sexual abuse and defamation of Ms. Carroll's character and will have to pay her 5 million dollars.

Here are my interim questions as the case makes its way through the court procedure. Abraham accuses Phillips of forcing him to drink? What about those words to the bartender? Who cares as Abraham had a power position over someone that was depending on him for a recommendation. He said that he knew it was unethical, but is making his case that institutions and Phillips damaged his reputation. You are responsible for your own reputation.

When it comes to consensual sex, it doesn’t matter what she did. It is in the “eye of the beholder.” It is what he did as per the various expectations of behavior that he signed off on.

My sense of things is that both institutions and both physicians are not free from culpability. I think this is going to be decided on the basis of questions, “Who is less wrong? Whose actions are the most unethical? Whose actions are legal or illegal? If it is illegal does that mean it is unethical and vice versa?

Yes, ethics takes us into the world of wrong/wrong where you are dealing with percentage of guilt for those involved.

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