Alberta Surgeon Found Guilty of Professional Misconduct for Hanging a Noose in the Hospital

A recent case before the Hearing Tribunal (comparable to our Discipline Committees) of the College of Physicians and Surgeons of Alberta (“CPSA”) found that a physician’s conduct in taping a piece of rope knotted into the shape of noose onto an operating room (“OR”) door was unprofessional conduct, but that there was not sufficient evidence to conclude that this action was racist.

The recently released decision was with respect to the conduct of Dr. Wessels, an orthopaedic surgeon at Grand Prairie Queen Elizabeth II Hospital (the “Hospital”). Dr. Wessels admitted to taping the piece of rope to the OR door and admitted that doing so was an act of professional misconduct. The only contested issue before the Hearing Tribunal was “the gravity, significance, and symbolism of the rope.”

Dr. Wessels submitted, through counsel, that his actions were motivated either by an inside joke with a nurse, N.R., or to encourage team-building within the orthopaedic surgery department.

Facts

Dr. Wessels testified that on June 14, 2016, he was standing outside of an operating room with a nurse (N.R.). Dr. Wessels found a piece of surgical rope, and was tying knots in it as they spoke, which is something that he is in the habit of doing.

Dr. Wessels and N.R. discussed the state of discord at the Hospital where there was discord among the surgeons, who were divided into two groups. N.R. discussed her frustrations regarding the general lack of discipline in the Hospital regarding “difficult behaviours,” and they were discussing improving the system at the Hospital. Dr. Wessels related that when he was a Scout, they did a team-building exercise where individuals were tied together, with arms tied to arms, and legs tied to legs.

As Dr. Wessels and N.R. were speaking, another doctor (Dr. S.W.) walked by and asked what Dr. Wessels was doing. Dr. S.W. was in one of the “two groups,” identified above, and Dr. Wessels was in the other. Dr. Wessels replied that he was tying knots. Dr. S.W. asked if the knot was for Dr. O.O. Though not stated in the decision, it seems from several news stories covering this incident that Dr. O.O. is black, and Dr. S.W. and Dr. Wessels are both white. Dr. Wessels replied that it was not for Dr. O.O., it was for anyone who was not acting as a team member. At the end of his conversation with N.R., Dr. Wessels placed the rope on the door of the OR where Dr. S.W., Dr. O.O., and N.R. were scrubbing in at the time.

When Dr. S.W. saw the rope, he removed it, and reported the incident to the Hospital’s administration. Another physician, Dr. T.A., also complained to the Hospital regarding the rope. Although he did not complain to Hospital administration at the time of the incident, Dr. O.O. submitted a letter to the Hearing Tribunal, in which he stated that he viewed the rope as a symbol of racism and a threat of violence.

Dr. Wessels defence was that he hung the rope as a joke, or as a message of team building, failing to realize that it would be viewed differently by others.

Analysis

Before addressing the contested issue of intention, the Hearing Tribunal concluded that regardless of intention, Dr. Wessels’ actions constituted professional misconduct. Under the CPSA’s code of conduct, physicians are required to treat “colleagues with dignity and as persons worthy of respect.” The Hearing Tribunal found that hanging a piece of rope that was tied in a shape that could be perceived as a noose in a public area of the hospital where it would be seen by colleagues was not treating colleagues with dignity and respect. The Hearings Tribunal also concluded that conduct which offends people and can be perceived as a negative symbol or gesture, regardless of intention, harms the integrity of the profession.

At the hearing, the prosecutor  (Complaints Director) submitted that it was up to the Hearing Tribunal to determine what was the most likely intention of Dr. Wessels, based on the totality of circumstances.

The Complaints Director called evidence to support the position that the conduct was not only a threat or condemnation of the other staff, but racial in nature. Dr. Wessel argued that the conduct was intended as a joke and it was not racial in nature, as he was not aware that a noose could be viewed as a symbol of racism and violence, because it is not generally used as such a symbol in South Africa, where he was raised.

Ultimately, the Hearing Tribunal rejected Dr. Wessels’ submissions that his actions were either a joke or an act to encourage team building.  However, the Hearing Tribunal also found that there was insufficient evidence to conclude that Dr. Wessels had been motivated by racism. It is not entirely clear in the reasons as to the basis for this conclusion.

That said, the Hearing Tribunal stated that “whether used as a racist symbol or not, a rope tied in the shape of a noose and hung on a door would reasonably be viewed as threatening and intimidating and would not be reasonably interpreted as a message of team building.” The Hearing Tribunal concluded that Dr. Wessels was motivated by the discord in the Hospital, and that he hung the rope to send a message, and that such a message would reasonably be interpreted as threatening or intimidating.

Conclusion

This case is an interesting one for many reasons. It is briefly mentioned in the facts that the discord in the Hospital was related in part to complaints of discrimination and racism against hospital administration and orthopedic surgeons, including Dr. Wessels and other physicians. The facts also mention that Dr. O.O., who is also from South Africa, wrote a letter to the Hospital stating that he interpreted the noose as a racist and violent symbol.

The case is also thought-provoking since even if Dr. Wessels’ evidence was accepted, that he was truly ignorant regarding the history and symbolism of the noose, is such ignorance acceptable and in keeping with what should be expected of physicians practicing in a multicultural society like Canada in 2021? There will be a penalty hearing for this matter, not yet scheduled, which may address this issue. As an aside, the Alberta Health Minister recently ordered an independent review of this incident, to determine whether or not it was handled appropriately by the hospital (which, when complaints were received about the incident, simply ordered Dr. Wessels to apologize), which could shed further light on the facts of this case and the nature of the discord within the Hospital.

Ultimately, this decision serves as an important message to health professionals to:

• ·Cultivate cultural awareness and make every effort to be culturally sensitive in interactions with patients and colleagues; and

• Address conflict through the proper channels at the hospital or other work environment and not take these matters into their own hands.