Medical board seeks to yank license of former UCSC psychiatrist over sex acts

A Report in the Mercury News

The state medical board is seeking to revoke the license of a former UC Santa Cruz psychotherapist who authorities say admitted to having a brief sexual relationship with a 21-year-old student whom he was treating for relationship issues and an eating disorder.

Milton Peechuan Huang, 45, of Scotts Valley, was a staff psychiatrist at the Student Health Center during the alleged affair that began in November 2007 and ended the next month, according to a complaint filed by the California Attorney General's Office. Huang resigned his half-time post with UCSC in February after the university launched an investigation that resulted in the medical board probe.

The Medical Board of California is expected to hold a hearing to determine if Huang crossed professional boundaries of therapy and committed unprofessional conduct. If found guilty, Huang's license could be revoked or suspended, or he could be placed on probation.

A spokeswoman with the Attorney General's Office said she did could not say how the university came to learn of the alleged impropriety, and a university spokesman could not immediately provide information about the case. Authorities have not identified the patient.

"We obviously take these allegations very seriously, and have cooperated fully with the state Medical Board during its investigation into this accusation," campus spokesman Jim Burns said Monday.

Huang could not be reached Monday, and an attorney who represented Huang
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during the medical board's investigation did not return several messages. Huang, who worked 5 1/2 years for the university, has maintained a private practice in Santa Cruz, but it's unclear if he is still seeing patients.

A recent posting on Jobster.com indicates Huang is "job hunting." Huang's profile on that site, as well as his own Web site, said that he is interested in the connections between technology, science and emotions.

"This includes learning something about sociology, anthropology, religion, mathematics, cognitive science, neurobiology and philosophy," his site says. "It also includes working on being more true to myself and despite failings, striving to live a better life. I practice tai chi and being a father. I continue to look at how I can best pursue creating change in myself and my personal relationships."

According to a Nov. 6 complaint signed by Barbara Johnston, executive director of the medical board, Huang admitted in an July 29 interview with the agency that he had sexual contact on at least two occasions with the patient, who was first referred to him in January or February 2007. On one occasion, he said the patient told him she was sexually attracted to him.

Students being seen by campus psychotherapists have to transfer treatment to the chief psychiatrist or be referred to a private practice over the summer, so the woman asked to be transferred to Huang's private care in July, the complaint says. After several months of weekly appointments, Huang said the two began sharing "each others' thoughts and emotions" during a Nov. 2 session he described as one of "self-revelation."

The complaint said Huang acknowledged that session was "his first boundary crossing," and said the two started talking to each other on the telephone and exchanging text messages, though he resisted physical contact for two more weeks. During a Nov. 16 session at his office, however, Huang said they both disrobed and touched each other.

At the following session, Huang said he handed his patient a booklet titled "Professional Therapy Never Includes Sex," to which he said she replied, "Shouldn't we have sex first?" The doctor described the next two sessions as "emotionally tense" as they discussed possibly ending their relationship.

Still, Huang said he agreed to the patient's request to hold their Dec. 21 therapy session in her Santa Cruz apartment, where he said they exchanged gifts before entering her bedroom. Huang told the medical board the patient performed oral sex on him and snapped a photo of him standing by her car before he left, after which he said the two did not speak again.

Huang said he did not bill the patient for that session or the preceding one because they were "informal," but all others, including the Nov. 16 session when the two disrobed in his office, were billed for 50 minutes of time.

Since July 2007, the medical board has filed 240 cases of alleged physician misconduct, according to the Attorney General's Office. Thirty-two of the licenses were revoked, but 91 doctors were placed on probation and 87 others were subject to various forms of reprimand.

Houston Psychiatrist's License Suspened Over Cocaine Use

As reported by the Houston Chronicle

The Texas Medical Board temporarily has suspended the license of Houston psychiatrist Dr. Eli Anderson, saying he failed a test for cocaine use and his practice represents a threat to the public's welfare.

Agency documents indicate Anderson, 64, pleaded no contest to a third-degree felony cocaine possession charge in June 2005. He was placed on a five-year order of deferred adjudication, meaning that the offense would be stricken from his record if he met probation-like requirements during that period.

In February 2007, Anderson was arrested in Lubbock on outstanding warrants from Clay County. While in custody, Lubbock police lodged other charges against him, including one for possessing drug paraphernalia.

In August of that year, officials of Anderson's employer, the Lubbock Regional Mental Health and Mental Retardation Center, notified the medical board that the charges had led to his dismissal.

In June, Anderson tested positive for a cocaine metabolite.

Medical board spokeswoman Jill Wiggins said the temporary suspension will remain in effect indefinitely. Anderson may appeal the decision in state district court.

Anderson, a graduate of the Baylor College of Medicine, has practiced in Texas 29 years, most recently at 8240 Antoine Drive. He could not be reached for comment.

Lapses at Psychiatric Solutions Inc., a major hospital chain with high earnings, have put patients at risk, regulators find. Some have even died.

Highlights from a MUCH longer article in the LA Times

Lapses at Psychiatric Solutions Inc., a major hospital chain with high earnings, have put patients at risk, regulators find. Some have even died.

[...]

Since 2005, the 10 hospitals PSI has owned longest have compiled almost twice as many patient-care deficiencies as 10 similar hospitals owned by its closest competitor, Universal Health Services Inc.

The PSI hospitals were cited in three patient deaths and for placing patients in immediate jeopardy four times, the inspection records show. The UHS hospitals received no equivalent citations.

Among private psychiatric hospitals in California, Sierra Vista had the single highest rate of state and federal deficiencies -- about eight times the statewide average.

It has twice been fined $25,000 for endangering patients -- accounting for the only such penalties levied against psychiatric hospitals under a 2006 state law establishing the sanctions. PSI executives declined to be interviewed for this article and, citing privacy law, would not discuss individual patients.

In written responses, they rejected the analysis showing the company's hospitals compared poorly to others, saying: "Your assumptions, calculations and apparent conclusions are invalid."

A spokesman, John Van Mol, said that PSI arguably has improved psychiatric care in the country overall. He cited the comparatively poor performance of state psychiatric facilities around the country in recent years.

PSI officials apologized for incidents resulting in harm to patients, saying they acted immediately to correct any problems. "Any incident involving patient care is one too many in our view, and everyone involved from the hospital level to the corporate level works very hard to prevent them," they wrote.

Recent state and federal inspections show the company's efforts have fallen short:

* Poor patient supervision, understaffing and inadequate worker training have led to instances of chaos and brutality.

A 19-year-old alleged he was raped twice within 24 hours by a fellow patient at an Illinois hospital even after he reported the first assault, federal records show.

Staffers at a Texas facility had to barricade themselves in an office and call in a SWAT team to bring unruly residents under control.

In North Carolina, inspectors found, a 12-year-old boy with a history of sexual aggression was put in a room with a 5-year-old and attempted to force the younger boy to perform oral sex.

* Medical neglect and errors have resulted in grave harm. A nurse at another North Carolina facility gave a 7-year-old boy anti-seizure medication prescribed for an older patient, leaving him so drowsy that a doctor wrote in his chart that "he refuses to wake up."

Workers in Virginia waited almost an hour to call an ambulance for a 17-year-old girl who had suffered a seizure and was bleeding profusely, inspection records show. The girl died later that day.

* In several instances, PSI employees have sought to hide their failings from regulators. A hospital in Texas was cited by state inspectors for concealing key facts about a patient abduction and a suicide. Regulators in Virginia uncovered what they called an organized scheme to cover up violence, suicide attempts and medication errors at a Charlottesville facility for juveniles.

* Some of the PSI hospitals most under fire from authorities are those the chain has owned longest. The Justice Department has opened an investigation into alleged patient-care problems at one of PSI's first acquisitions, Riveredge Hospital near Chicago, issuing subpoenas for records earlier this year.

Nationwide since 2006, health officials have pulled children out of one PSI facility and have moved five times to revoke the state licenses of others. They have withheld or ordered the company to repay more than $2 million in government funding for providing substandard care.

In addition to thousands of pages of inspection reports by individual states and the U.S. Centers for Medicare and Medicaid Services, ProPublica's investigation was based on hospital and court records and interviews with about two dozen former employees.

PSI executives say they are filling a desperate need in a tough business.

"Everyone at Psychiatric Solutions works hard every day to achieve excellence in patient care, often under extremely difficult circumstances to serve a patient population that includes extremely acute and complex diagnoses," Chief Executive Joey Jacobs said in a written statement.

Chad Thompson, who worked in the admissions office at Sierra Vista when PSI took over, has a different view. He felt the chain put intense pressure on him to keep every bed full, with less emphasis on assuring that each patient got high-quality care.

"It's a pattern of behavior driven totally by the almighty dollar," said Thompson, now the director of a nonprofit that provides therapy to the uninsured and chairman of Sacramento County's Mental Health Board, which advises the county Board of Supervisors.

"It's not a client-centered approach. It's a money-centered approach."

Psychiatrist arrested on the probability that he inappropriately touched one of his patients.

From the Sentinel newspaper out of Nouth Brunswick, New Jerseyu

A psychiatrist at a behavioral health center in Edison was arrested on Oct. 17 on the belief that he inappropriately touched one of his patients.

The suspect, Chowdhury M. Azam, a 54-year-old Monmouth Junction resident, was charged with criminal sexual contact, a fourth-degree crime. Criminal sexual contact is described in the state legal code as "intentional touching by the victim or actor, either directly or through clothing, of the victim's or actor's intimate parts for the purpose of degrading or humiliating the victim or sexually arousing or sexually gratifying the actor."

The arrest was made the same day the alleged victim filed a report with the Edison Police Department. Following the filing, the Middlesex County Prosecutor's Office Sex Crime/Child Abuse Unit and the Edison Police Department embarked on a joint investigation, eventually leading to Azam's arrest.

Azam has been a licensed psychiatrist with Compass Behavioral Health, located on Pierson Avenue. According to authorities, it is alleged that the psychiatrist inappropriately touched one of his patients on one occasion. The New Jersey State Board of Medical Examiners, the regulatory agency that licenses medical professionals, was informed of Azam's arrest.

According to police, Azam has been released on $50,000 bail set by Municipal Court Judge Craig Coughlin.

Authorities have not released details regarding the alleged victim's age or gender.

Authorities are currently seeking more information about the matter. Anyone with information regarding this investigation, or incidents similar in nature, is encouraged to contact Investigator Raj Chopra of the Middlesex County Prosecutor's Office Sex Crimes/Child Abuse Unit at 732-745-3600, or Detective Michael Michalski of the Edison Police Department at 732-248-7525 anytime day or night.

Family therapist charged with domestic battery

A report from TampaBay.com

Michael Anthony Holder is a family therapist who conducts at-home "Dynamic Parenting Courses" to correct negative patterns in children's behaviors.

But he's in jail now, after Hillsborough County Sheriff's Deputies charged him with two counts of domestic battery, including the battery by strangulation of his 15-year-old stepson.

An arrest report says that during a domestic argument, Holder, 39, grabbed the boy by his neck, restricting his airflow, and that he inflicted several lacerations to the boy's arms and face and left a contusion on his left arm.

The report states that Holder denied strangling the boy, but admitted to having touched him in an attempt to get his stepson out of his living quarters.

The report lists Holder's place of employment as ACTS, a non-profit agency that provides services from help with substance abuse to mental illness to child protection.

Holder is being held at Orient Road Jail with no bond.

Psychiatric Radio Host Had Undisclosed Drug Company Ties, Conflict of Interest Means His Show to Be Pulled From Air

From a Report in the NY Times

An influential psychiatrist who was the host of the popular NPR program “The Infinite Mind” earned at least $1.3 million from 2000 to 2007 giving marketing lectures for drugmakers, income not mentioned on the program.

The psychiatrist and radio host, Dr. Frederick K. Goodwin, is the latest in a series of doctors and researchers whose ties to drugmakers have been uncovered by Senator Charles E. Grassley, Republican of Iowa. Dr. Goodwin, a former director of the National Institute of Mental Health, is the first news media figure to be investigated.

Dr. Goodwin’s weekly radio programs have often touched on subjects important to the commercial interests of the companies for which he consults. In a program broadcast on Sept. 20, 2005, he warned that children with bipolar disorder who were left untreated could suffer brain damage, a controversial view.

“But as we’ll be hearing today,” Dr. Goodwin told his audience, “modern treatments — mood stabilizers in particular — have been proven both safe and effective in bipolar children.”

That same day, GlaxoSmithKline paid Dr. Goodwin $2,500 to give a promotional lecture for its mood stabilizer drug, Lamictal, at the Ritz Carlton Golf Resort in Naples, Fla. In all, GlaxoSmithKline paid him more than $329,000 that year for promoting Lamictal, records given to Congressional investigators show.

In an interview, Dr. Goodwin said that Bill Lichtenstein, the program’s producer, knew of his consulting but that neither thought “getting money from drug companies could be an issue.”

“In retrospect, that should have been disclosed,” he said.

But Mr. Lichtenstein said that he was unaware of Dr. Goodwin’s financial ties to drugmakers and that, after an article in the online magazine Slate this year pointed out that guests on his program had undisclosed affiliations with drugmakers, he called Dr. Goodwin “and asked him point-blank if he was receiving funding from pharmaceutical companies, directly or indirectly, and the answer was, ‘No.’ ”

Asked about the contradiction, Dr. Goodwin and Mr. Lichtenstein each stood by their versions of events.

“The fact that he was out on the stump for pharmaceutical companies was not something we were aware of,” Mr. Lichtenstein said in an interview. “It would have violated our agreements.”

Margaret Low Smith, vice president of National Public Radio, said NPR would remove “The Infinite Mind” from its satellite radio service next week, the earliest date possible. Ms. Smith said that had NPR been aware of Dr. Goodwin’s financial interests, it would not have broadcast the program.

Sarah Alspach, a spokeswoman for GlaxoSmithKline, said, “We continue to believe that healthcare professionals are responsible for making disclosures to their employers and other entities, in this case National Public Radio and its listeners.”

[...]

Mr. Grassley is systematically asking some of the nation’s leading researchers and doctors to provide their conflict-of-interest disclosures, and he is comparing those documents with records of actual payments from drug companies. The records often conflict, sometimes starkly.

In October, Mr. Grassley revealed that Dr. Charles B. Nemeroff of Emory University, an influential psychiatric researcher, earned more than $2.8 million in consulting arrangements with drugmakers from 2000 to 2007, failed to report at least $1.2 million of that income to his university and violated federal research rules. As a result, the National Institutes of Health suspended a $9.3 million research grant to Emory, and Dr. Nemeroff gave up his chairmanship of Emory’s psychiatry department.

In June, the senator revealed that Dr. Joseph Biederman of Harvard, whose work has fueled an explosion in the use of powerful antipsychotic medicines in children, had earned at least $1.6 million from drugmakers from 2000 to 2007, and failed to report most of this income to Harvard.

Mr. Grassley’s investigation demonstrates how deeply pharmaceutical commercial interests reach into academic medicine, and it has shown that universities are all but incapable of policing these arrangements. As a result, almost every major medical school and medical society is reassessing its relationships with makers of drugs and devices.

“We know the drug companies are throwing huge amounts of money at medical researchers, and there’s no clear-cut way to know how much and exactly where,” Mr. Grassley said. “Now it looks like the same thing is happening in journalism.”

Mr. Grassley has proposed legislation that would require drugmakers to disclose all payments of $500 or more to doctors. Eli Lilly and Merck have promised to begin doing so next year.

[...]

Former psychiatrist guilty of raping patients

From ABC News in Australia

An 80-year-old former Perth psychiatrist has been found guility of molesting and raping two of his patients more than 30 years ago.

Alan John Stubley had been on trial for the past week accused of forcing the two women to have sex with him during psychotherapy sessions between 1975 and 1978.

After six hours of deliberations, a Supreme Court jury found him guility of ten charges, but acquitted him of four others.

Stubley, who has senile dementia, has been remanded in custody and will be sentenced in January.

Sacramento judge castigates psychiatrist who vouched for killer

A Report from the Sacramento Bee

Napa State Hospital's attempt to release a killer into community treatment in Sacramento was based on the "horrifying" testimony of a psychiatrist who "clearly committed perjury in this court," a judge said Monday.

Sacramento Superior Court Judge Kevin J. McCormick made his comments about the Napa psychiatrist, Dr. Nathan Thuma, when he ruled from the bench that Ronald Benjamin Toppila is not fit for outpatient treatment and must remain in the mental hospital for killing his mother four years ago.

In a decision that will keep Toppila confined indefinitely on a jury's verdict that he was not guilty by reason of insanity, McCormick lashed Thuma for recommending in March that the defendant be released into community treatment even though at that time the psychiatrist had examined the client for barely a half hour.

McCormick said Thuma "could not have had enough information" to make the recommendation and that it was "beyond belief" the doctor could have reviewed Toppila's medical records in the short time he'd been on staff at Napa.

Thuma demonstrated "a total lack of independence and judgment" by concluding that Toppila did not present a danger because, in quoting the psychiatrist, "we all trust Mr. Toppila," McCormick said. The judge said Thuma's "demeanor and manner" in court "could only be described as horrifying."

"He clearly committed perjury in this court," McCormick said of Thuma. "He testified inconsistently at varying times. He showed a complete lack of any insight whatsoever into Mr. Toppila's history."

Thuma did not return a telephone call for comment Monday. A spokeswoman for the state Department of Mental Health said agency director Stephen Mayberg plans to review the judge's comments about Thuma.

"He would take it very seriously and look into it," the spokesman, Nancy Kincaid, said.

"If the judge expressed concern over someone's testimony or professional performance, that would be looked into both by the director of the department and by the executive director at the hospital."

McCormick did not specifically identify areas of Thuma's testimony where he thinks the psychiatrist lied under oath. In Thuma's testimony on Oct. 27, however, he wound up on both sides of a question on whether he thought Toppila had "malingered" to sway the therapists who were evaluating him. There were also inconsistencies in Thuma's testimony over whether he was aware of evaluations done on Toppila before the Oct. 7, 2004, beating death of his 86-year-old mother, Hilma Tone.

Deputy District Attorney Dawn Bladet hailed the judge's ruling, saying in an e-mail: "Toppila's continued confinement in Napa State Hospital is necessary to protect the public safety interest."

Toppila's lawyer, Robert J. Saria, said Toppila and his client's family were disappointed by the ruling. Saria said Toppila "is committed to returning to Napa and pursuing his treatment plan and engaging in all the treatment he is required to."

Toppila, 68, a long-time licensed clinical social worker, stabbed his mother 52 times and also bludgeoned her in the fatal attack in her South Land Park apartment.

Judge McCormick said he was also disturbed by the testimony of Antonio Alocer, an official from the Central Valley Conditional Release Program, which would have coordinated Toppila's community placement if he was released from Napa. McCormick said no treatment plan had been determined for Toppila in the event of his release. The judge said Alocer "could not tell me" where Toppila would be placed.

Alocer could not be reached for comment Monday.

"I cannot state with any degree of certainty based on the evidence that I heard in this courtroom that Mr. Toppila no longer poses a danger to the health and safety of others," McCormick said.

Psychiatrist guilty of misconduct after freeing dangerous patient

From a Report out of Plymouth, England

A Plymouth psychiatrist who released a dangerous schizophrenic from a mental health ward hours before he tried to kill his mother was today found guilty of 'recklessly' putting the public at risk.

Dr Andrea Tocca described the 39-year-old as 'no danger to himself or others' and discharged him from Derriford Hospital in Plymouth, Devon, a day after he assaulted a female patient.

Soon after arriving home, the man, referred to as GA, told his mother: 'I know what I have to do to you' and battered her repeatedly over the head with a spade.

Dr Tocca was found guilty of misconduct after the GMC panel decided that he had 'recklessly put the public at risk' in releasing GA from the ward.

Panel chair Ralph Bergmann said: 'This panel is particularly concerned by your decision to discharge GA on April 25, 2006.

'You had been responsible for the care and treatment of GA for some three months prior to discharging him.'

Mr Bergmann said during this time he had been informed by the patient's previous doctor in Torquay that 'if GA became acutely psychotic, his mother may be at risk.

'He (the doctor) had also informed you that GA had made two very serious suicide attempts.

'The panel accepts the proposition put forward by your counsel that your conduct in discharging GA amounted to a single episode of significant error.

'However, you had access to GA's medical history, you had become very familiar with his condition and you ought to have been very alert to the risks and potential consequences of discharging him.

'Your decision to do so leaves the panel in no doubt that this was serious misconduct on your part.

'As the consultant psychiatrist responsible foe the care and treatment of a vulnerable patient, you behaved irresponsibly and recklessly in allowing GA to be returned to the community.

'You thereby put at risk not only the patient but also his mother and the public.

'Taking all these matters into account, the panel has determined that your fitness to practise is impaired because of your misconduct.'

The GMC panel will now consider whether to kick Dr Tocca out of the medical profession.

The hearing was told that Dr Tocca did not read GA's medical notes and decided to 'make up his own mind' about the patient.

On April 24, GA assaulted a female patient on the unit by holding her in a headlock and punching her.

His medical records show that he had also threatened other patients and believed that the staff on the unit were trying to kill him.

Marios Lambis, for the GMC, said: 'At 9.55am on April 25, Dr Tocca made an entry in GA's notes stating that in his view, that assault on the female patient was not a product of his mental state but rather a result of the high level of stress he was experiencing on the unit.

'He recorded that once the police had completed their investigation into the assault, he would discharge GA, and twenty minutes later he recorded: ''In my clinical opinion, GA is not detainable under the Mental Health Act and he is not really a danger to himself or to others.'''

In a statement read to the panel GA's mother, referred to as Mrs A, told the hearing that Dr Tocca telephoned on April 25 to say her son had assaulted a patient but he was sending him home.

[...]

The GMC heard that GA had developed brain damage after falling from a tree swing at the age of 12 and became 'passive and apathetic.'

In 1991, at the age of 22, he was admitted to hospital in Manchester with paranoid psychotic symptoms, the hearing was told.

Mr Lambis said: 'He would not let anyone into his flat, his furniture was broken and he was talking in an incomprehensible manner.

'He had become suspicious and withdrawn.'

In 1993, he was diagnosed with paranoid schizophrenia and was admitted to acute mental health units nine times over the following three years.

Two years later he made threats to kill his grandmother.

GA took an overdose in 2003 and was later sectioned.

On August 8 2005, he set fire to his mattress five times before lying on it and burning himself in a suicide attempt.

He spent 11 weeks in the burns unit at Frenchay Hospital in Bristol.

Dr Tocca admitted being told by GA's doctor that he became acutely psychotic his mother may be at risk.

He also admitted that he ought to have known that GA had made threats to kill his grandmother and had shown previous incidents of violence, and he discharged GH when he ought to have known he should not have been discharged.

Psychiatrist pays for misconduct

A report from the Hamilton Spectator, near Toronto, Canada

A Hamilton psychiatrist has been handed an expensive penalty after a disciplinary panel accepted his admission of professional misconduct.

Dr. Brian Kirsh, medical director of the chronic pain management unit for Hamilton Health Sciences at Chedoke Hospital, appeared before the College of Physicians and Surgeons of Ontario yesterday.

A friend of Kirsh's alleged in 2007 the doctor failed to indicate the friendly, rather than professional, nature of a meeting where the man and his wife sought marital advice.

The panellists said Kirsh had blurred professional boundaries and they expected he would not make the same mistake again.

He was told to pay the $3,650 hearing cost, to take a $1,200 professional boundaries course and to make results of the hearing public online.

Before coming to Hamilton in 2003, Kirsch ran a family medical practice in Thornhill. He was friends with the couple for 18 years. The wife asked if he would meet with her and her husband. All three were members of the same religious community, and Kirsh and the woman worked together in that community. They met at his Thornhill practice in March 2007.

Kirsh asked the woman for her OHIP card at the beginning of the meeting, during which he advised them to seek a professional marriage counsellor for the troubles in their relationship.

The woman later told the college she understood Kirsh met with them as a family friend. The man, however, thought it was as a professional.

The woman asked to meet with Kirsh again that year. The two met at his office, where Kirsh told her he had feelings for her. She told him she was ending her marriage for reasons unrelated to him. The couple separated soon after.

Before the husband filed his complaint, Kirsh e-mailed him to apologize for any confusion and said he had seen the couple in a "spirit of friendship."

An agreed statement of facts says Kirsh admits to professional misconduct by taking the woman's OHIP card before the first meeting, by seeing them in his former medical office and by failing to "communicate clearly (to the man) that he was not seeing the couple in his professional capacity."

Woman describes alleged abuse by psychiatrist

From a Report in the West Australian

A 62-year-old woman has described freezing with fear as her psychiatrist sexually abused her during a session for post-natal depression in the 1970s.

Former psychiatrist Alan John Stubley, 80, is on trial in Perth Supreme Court accused of forcing sex offences against two of his female patients in the mid-late 1970s.

One of the alleged victims today told the jury the doctor had abused her on her first face-to-face session after being discharged from a psychiatric hospital where Dr Stubley had treated her for post-natal depression.

She said she had been shocked when the doctor told her to sit on his knee.

“It was just a terrible silence and then he repeated it (in a tone that) was very authoritative, quite demanding,” she said.

“He put his hand on my leg and he rubbed his hand up my leg and between my legs.

“I just froze, I was just so afraid. I was afraid of him and what he might do to me.

“I said I didn’t want to do this.”

Prosecutor Alan Troy said Dr Stubley had abused his position by taking advantage of his patient’s vulnerability in the pursuit of his own sexual gratification.

He said the two women submitted to the sexual contact because they had felt intimidated.

Mr Troy said one of the victims, who continued seeing the doctor for decades, had feared that no-one would believe her if she spoke out at the time about the alleged abuse.

“She had recently been in a psychiatric hospital and she didn’t think anyone would believe her,” Mr Troy said.

Mr Troy said she also feared she would be put in an institution if she did not continue to see him.

Defence lawyer Mark Trowell said the sex between his client and the women was consensual and there had been no intimidation.

“This is not a court of morals…he may well have acted unprofessionally as a doctor but that doesn’t make him guilty of criminal charges,” Mr Trowell said.

People with a bizarre disorder that makes them crave having a limb removed should be allowed amputations, according to Psychiatrist Christopher Ryan

Of course, curing them of the condition is something that the simply do not know how to do. As seen on News.Com Australia

To most people, the thought of amputating a perfectly healthy limb is unimaginable.

But for at least three Australians, possibly dozens more, cutting off their leg has felt perfectly normal.

These so-called "amputee wannabes" have a very rare condition in which they feel one of their limbs is not truly their own, and they become obsessed with cutting it off.

And people suffering from the bizarre body image disorder should be able to opt for amputation, a Sydney psychiatrist says.

Christopher Ryan, a psychiatrist at the University of Sydney, says there is a good argument for allowing patients with body integrity identity disorder (BIID) to have their unwanted limb removed.

"I am not saying we should unthinkingly cut off people's legs," Dr Ryan said.

"I realise that the idea strikes almost everyone as lunatic when they first hear it. However, there are a small number of people who see themselves, and have always seen themselves, as amputees," he said.

"They are often miserable their whole lives because of their 'extra limb', and we know that at least some of them feel much better if it is removed."

Dr Ryan has examined the ethics of the issue in the international philosophy journal Neuroethics and says doctors have a moral duty to amputate for the health and safety of the patient.

He said one 30-year-old patient of his lived his whole life feeling he was truly an amputee, but was so ashamed of how he felt he did not tell anyone.

"Eventually he took the only step he thought he had open to him and placed his leg in a bucket of dry ice until it died and had to be removed," Dr Ryan said.

"Now, a year later, he is living happily as an amputee and getting on with his life."

The paper said the operations should be likened to plastic surgery, with elective amputation offered to BIID sufferers only.

"Unless these patients know that doctors will take their concerns seriously, and at least consider their requests, more people will risk their lives trying to remove their own limbs," he said.

The disorder hit news headlines in 2000 when it was revealed that a surgeon in Scotland had amputated a healthy leg from two patients with the disorder.

At the time, appalled Scottish politicians called the procedure "obscene" and tried to ban such operations.