DISCIPLINE COMMITTEE OF

THE COLLEGE OF NURSES OF ONTARIO

PANEL: Jim Attwood, RN Chairperson Deanne Barber, RPN Member

Glenda Hayward, RN Member

Fay Cole Public Member

Michael Ternovan Public Member

) NICK COLEMAN

) for College of Nurses of Ontario

-and- )

) NO REPRESENTATION

) for Pablito Quiogue

PABLITO QUIOGUE ) CHRIS WIRTH and

) JOHANNA BRADEN

) Independent Legal Counsel

) Heard: November 18, 2004

June 1 & 2, 2005

This application for reinstatement came before a panel of the Discipline Committee on November 18, 2004 and June 1 & 2, 2005 at the College of Nurses of Ontario (the “College”) at Toronto. The Applicant, Pablito Quiogue, was not represented by legal counsel.

Overview

The Application for Reinstatement stems from a revocation of the Applicant’s Certificate of Registration by the Discipline Committee of the College dated December 17, 1993. The revocation was the result of incidents that occurred at the [ ] Hospital in October 1989, March 1990, and December 19, 1991, where the Member was found to have sexually abused three patients in his care. The Member eventually pleaded guilty to criminal charges involving these incidents and was sentenced to 9 months imprisonment in December 1993.

The reinstatement hearing began November 18, 2004, was adjourned to allow for the psychiatric evaluation of the Applicant. The hearing reconvened on June 1, 2005. The Application was dismissed.

The Evidence

Position of the Applicant

The Applicant sought to have his Certificate of Registration reinstated by this panel. He testified on his own behalf and stated that he:

was no longer the person of ten years ago;
wanted another chance to be a part of the nursing profession;
had taken responsibility for these “heinous” actions and was not making excuses to justify mistakes made in the past;
was confused, afraid and was not being true to his sexual identity at the time of the incidents, which caused him to act out in terrible ways;
did not know where to seek help in the past;
had been in a stable relationship for ten years; and
had rehabilitated himself with the help of his family and partner and without professional counselling.

The Applicant called five witnesses to testify to his love of nursing and to the positive changes in his behaviour in the eleven years since his registration was revoked. The witnesses included two of the Applicant’s sisters, his partner, and partner’s sister and mother. The evidence provided by all of these witnesses was anecdotal in nature.

The Applicant submitted a copy of the Pardon he received from the Government of Canada, dated May 28, 2004 (Exhibit 5).

Position of the College

Counsel for the College requested that the Application for Reinstatement be dismissed.

Counsel tendered [Dr. A], a Consultant Psychiatrist [ ], as an expert in forensic psychiatry. The Applicant did not object to [Dr. A] being tendered as an expert witness, and the panel accepted that [Dr. A] was qualified to give his expert opinion in this case.

[Dr. A] testified that he and [Dr. B] conducted a psychiatric assessment of the Applicant in December 2004, which was detailed in a written report (Exhibit 6). That report reveals that during the assessment, the Applicant denied some details related to the sexual assaults as alleged by the patients. The Applicant also reported that the assaults had happened within the same year, when in fact the Applicant knew they had taken place over three years.

The assessment showed no evidence of any psychiatric illness or any clear reason why the Applicant sexually assaulted the patients in his care. [Dr. A] concluded that, considering both the empirical and clinical evaluations, the Applicant was at a low-moderate risk of sexually aggressive behaviour when compared to the general population and should not have “unsupervised, or supervised, access to patients.”

Counsel for the College referred the panel to a Book of Documents (Exhibit 2) related to this case, which included the following.

a) The decision of the Discipline Committee of the College of Nurses of Ontario dated May 13, 1991, where the Applicant lied under oath and denied having assaulted the two complainants. The panel made no findings of professional misconduct with regards to the sexual assault of two patients.

b) The decision of the Discipline Committee of the College of Nurses of Ontario dated April 27, 1992, where the Applicant lied again and denied having assaulted the complainant. Again, the panel made no findings of professional misconduct with regards to the sexual assault of one patient.

c) The decision of the Divisional Court dated May 18, 1993, ordering that the April 27, 1992 decision be rescinded and a new panel undertake a rehearing.

d) The decision of the Discipline Committee of the College of Nurses of Ontario dated December 22, 1993, ordering the revocation of the Applicant’s Certificate of Competence after the Applicant had pleaded guilty to three criminal charges of sexual assault. These related to the three patients he had denied assaulting during his first two discipline hearings.

Counsel for the College submitted that the Application be dismissed on the following grounds.

The original misconduct of sexual assault of three neurologically impaired patients was more serious given these patients were more vulnerable due to a limited ability to communicate or defend themselves. The patients were further victimized when the Applicant successfully denied the allegations at two separate hearings, implying that the complainants were lying or, in the words of one complainant, “nuts”.
The assaults took place over a period of three years, the last of which occurred within six months after the initial Discipline Hearing, indicating that the Applicant was not deterred even when his behaviour was under close scrutiny.
The Applicant lied under oath during two separate Discipline Hearings, showing a fundamental dishonesty.
The Applicant displayed a pattern of minimizing his misconduct during the psychiatric assessment when he said the assaults took place over one year rather than three and in not being able to recall the details of the assaults.
The Applicant had a limited connection to the profession in that he practiced for only three years and has not been involved in health care for fourteen years. The sexual assaults took place throughout the Applicant’s short nursing career.
The Applicant has not received formal treatment or rehabilitation outside of the conditions of his parole and could show no proof that his issues were resolved except for his personal reassurances that he was at peace with his sexuality.
The psychiatric assessment showed no clear or convincing assessment of what motivated the assaults and therefore, no proof that the misconduct would not be repeated should the Applicant encounter future stressors. The risk assessment showed the Applicant to be at a low to moderate long term risk of sexually aggressive behaviour.
The public interest and those of the profession take priority over the Applicant’s desire to return to nursing and there was no evidence in this case that the Applicant would not repeat his behaviour.

Decision

The panel deliberated and decided to dismiss the Applicant’s request for reinstatement.

Reasons for Decision

In a reinstatement hearing, the Applicant bears the onus of proving that the public would be protected should he be reinstated as a member of the College. The Applicant must show that there has been a change in circumstances and that the conduct that gave rise to the revocation is no longer a concern. The panel is entitled to consider such factors as:

the past conduct of the Applicant, including the motivation, surreptitiousness and exploitiveness of the misconduct;
current evidence of good character and rehabilitation;
evidence of treatment and the future prognosis of the Applicant; and
the current competence and skills of the Applicant, particularly if he has not practiced for a significant period of time.

In this case, the evidence submitted by the Applicant and family members consisted of oral testimony stating that the Applicant was sorry for his actions and had changed since his conviction for the sexual assault of three patients. The panel found this evidence insufficient to meet the burden of proof.

The panel agreed with the submissions of Counsel for the College that the public and profession would not be adequately protected should the Applicant be readmitted to the College. The panel accepted the expert assessment of [Dr. A] that the Applicant should not have “unsupervised, or supervised, access to patients” and determined that, in these circumstances, a low to moderate risk of re-offending was significant enough to dismiss the application.

Order

The panel orders that the application for reinstatement be dismissed.

I, Jim Atwood R.N., sign this decision and reasons for decision as Chairperson of this Discipline panel and on behalf of the Discipline panel members listed below.

Chairperson Date

Panel Members:

Deanne Barber, RPN Member