Health Practitioners Disciplinary Tribunal, 1269/Chiro22/540D, (20 September 2022)
The Director of Proceedings (the Director) filed a charge of professional misconduct against chiropractor William Donaldson (Dr Donaldson) in the Health Practitioners Disciplinary Tribunal (the Tribunal). The charge, which included three particulars, alleged that over a period of two years, Dr Donaldson engaged in a sexual relationship with a patient while also providing ongoing and regular chiropractic treatment to her and her child.
The patient’s first consultation in January 2016 was for treating a nerve irritation in her throat. The patient attended appointments with Dr Donaldson approximately every two weeks until October 2018, which included chiropractic spinal corrections, muscle balancing techniques, kinesiology, and Total Body Modification. At first, the treatments provided were those of a normal provider–consumer relationship. However, after several months, an attraction formed between Dr Donaldson and the patient that was personal and sexual in nature.
Although Dr Donaldson and the patient did not agree as to who initiated the attraction or when, Dr Donaldson agreed that the discussion about entering into an intimate relationship took place in October 2016. Dr Donaldson admitted that he engaged in a sexual relationship with the patient over the two-year period between November 2016 and October 2018. They met up multiple times during the week, and also exchanged text messages of a personal nature. The relationship ended in late October 2018, and the patient’s last appointment with Dr Donaldson was that same month.
The Tribunal acknowledged that by engaging in a sexual relationship with his patient, Dr Donaldson failed to set and maintain professional boundaries, as required by the Chiropractic Board.
As noted above, Dr Donaldson and the patient began their sexual relationship in November 2016. Soon after commencing their relationship, Dr Donaldson began providing chiropractic treatment to the patient’s child in December 2016. Although Dr Donaldson’s relationship with the patient ended in late October 2018, he continued to care for the patient’s child until November 2018.
The Director submitted that the additional provision of chiropractic treatment to the patient’s child was a further deepening of the clinical relationship and therefore a further breach of professional boundaries. The Tribunal accepted this position but noted that this was an aggravating feature of Dr Donaldson’s conduct rather than a separate or further breach of professional boundaries.
The Tribunal accepted the Director’s submission that Dr Donaldson’s sexual relationship with his patient was not a one-off momentary lapse in judgement, but rather a sustained breach of professional ethics over two years.
The Tribunal found that Dr Donaldson’s conduct in respect of all three particulars cumulatively amounted to malpractice and turned to consider the appropriate penalty.
The Tribunal considered the following aggravating factors: the sexual relationship arose out of the clinical relationship; the inherent power imbalance that existed as the patient was particularly vulnerable during the period of their relationship; the relationship could not be described as a ‘one-off’ lapse of judgement; and that Dr Donaldson continued to treat the patient’s child.
In mitigation, Dr Donaldson complied with the recommendation of HDC and offered a voluntary undertaking to the Chiropractic Board, and appropriately admitted to the charge and that his actions amounted to professional conduct warranting sanctions. A significant feature in this case was the rehabilitative steps that Dr Donaldson had already taken to address his breach of professional boundaries.
Having regard to the aggravating and mitigating factors, the seriousness of the professional misconduct, and the penalty imposed in similar cases, the Tribunal was satisfied that suspension from practice reflected the seriousness of the offending and would act as a deterrent to other practitioners. The Tribunal also considered that it was appropriate to reduce the term of the suspension from 12 to 8 months to reflect that Dr Donaldson had already taken considerable steps towards his rehabilitation.
Dr Donaldson was also provided conditions on return to practice (which included undergoing professional supervision and notifying any relevant parties of the Tribunal’s decision), and he was censured and ordered to pay costs.
The Tribunal’s decision can be found at:
https://www.hpdt.org.nz/portals/0/1269Chiro22540D%20-%20Decision.pdf