This is a story about medical ethics. But
unlike most stories of this kind, there are no
deaths, no embryos thawed out or thrown away, no life support systems switched off.
In fact, there was no one actually harmed, at least to the best of our knowledge, except perhaps a doctor who was put through a long and distressing trial. The so-called "victims" in the case have not complained about any pain from their unnecessary treatment, perhaps because they are mentally disabled.

There are no heroes or villains in this story, either, as there often are in similar cases. The doctor who was on trial is by all accounts a superb physician; the medical student who blew the whistle on what she considered unethical conduct would just as soon forget the whole thing; nearly everyone involved feels apologetic about the incident and has taken steps that it will not occur again.

But there is a victor, a winner in the case of Her Majesty The Queen vs. Doctor Ruth Wiens, which concluded before His Honour R.B. Batten at the Provincial Court House, City of Kingston, Province of Ontario, on the 22nd day of June 1984, in the forenoon --
quite a few winners, in fact. This is a victory for all the mentally and physically disabled of Canada, for everyone who ever steps foot into a hospital, for everyone who lives in Canada, even doctors.

The cast of characters is simple; the case is not like one of those windy Russian novels of the last century where you need a list of draniatis personae. There is the doctor in the dock, Ruth Wiens; her lawyer, D.K. Laidlaw, Q.C.; the prosecuting lawyer, David Newman; the medical student, Laura Muldoon, who'd prefer not to be mentioned, since this has all been dreadful PR for Queen's University Medical School.

There are lesser characters, of course: Robert Seaby, the Executive Director of Ongwanada Hospital, where the assaults took place; Dr. Boston, the Chief of Pediatrics
at Queen's; Elaine Newman, a lawyer with The Advocacy Resource Centre for the Handicapped in Toronto (ARCH); a few others. We can't list the names of the teenaged boys on whom the examinations/assaults were done/committed, however, since no one ever managed to find out what they are and that is one of the points of this law case.

The chronology of events and the events themselves are also straightforward, even if
the questions which have arisen from them are not. For we are discussing here nothing
less than the education of medical students and their need to be taught. These are the
future doctors who will ease your pain, operate on your spouse, cure your child. Call it a case of ends and means with a necessary trade-off somewhere in between the doctor's need to know and the patient's right to say "no."'

Here is what happened before the case came to trial:

On November 4, 1982, Dr. Ruth Wiens, a lecturer in the pediatrics department at
Queen's University since the late '70s and a member of the Medical Advisory Committee of Ongwanada Hospital since 1979, toured the facility with 10 students from the second-year class of Queen's University Medical School.

Ongwanada is a temporary building from the Second World War, built as the barracks
for Alcan female munitions workers. After the war, it became the Kingston home for the Department of Veterans' Affairs; then it became a TB sanitarium. By the late'60s TB had been mostly eradicated; in 1967 the Ontario Ministry of Health decided to move disabled children into Ongwanada. By 1970, there were 100 mentally and physically disabled youths in the building; today, there are around 85, since some have recently moved to group homes. In 1977, Ongwanada merged with the Penrose Centre, "a 19th century monstrosity," to quote the parent of a mentally disabled child, making the place the
home for over three dozen chronically ill adults, as well.

November of 1982 marked the third consecutive year that Dr. Wiens had taken her students -- there are about 75 in the second year -- to visit the disabled children and youths, to sensitize them to the physical and mental problems of the disabled, and to study their conditions. "It's hard to be depressed when you're in Ongwanada with Ruth Wiens," says one medical student who, like nearly all, wishes to remain anonymous. "Dr. Wiens is
a wonderful person! She'd pick up kids who are drooling, and kiss them all the while
she'd talk to us. She is truly warm."

Wiens would show the students how this child had Tay-Sachs, this one was hydrocephalic -- noting the head and how it was filled with water. "We did knee reflexes," recalls the student; "we looked into the eyes of many, which is a reasonable thing to do, if a kid is blind. A lot of kids there are blind. But at no time was there ever a hint of any rectal exams."

But there was in Laura Muldoon's group, in November, 1982, as there had been in groups of two previous years. All second-year students at Queen's Medical School practise what are called "clinical skills," in which a different part of the body is studied each week; one week it will be the ear/nose/throat area, the next week the cardiovascular system, and so on. Patients at Kingston hospitals are asked if they mind if a medical student taps their chest or looks down their throat; most say yes.

Muldoon and two other students were troubled that their trip to Ongwanada coincided with the week they were to do their examination of the abdomen and a rectal. They spoke with their teacher about their concern, and Dr. Wiens apparently assumed they were being squeamish about handling genitalia.

On the day Muldoon and nine fellow medical students visited Ongwanada, "Dr. Wiens handled the children there with care, love, compassion and concern. She was a good doctor," says Muldoon, now 24. But after watching her teacher perform the first rectal,
the three students left the room, refusing to participate, and Dr. Wiens accepted their
decision.

Few medical schools in Canada have compulsory courses in ethics, but a growing number, like Queen's, let students run their own. By coincidence, Laura Muldoon had been placed in charge of a symposium on "The Voiceless patient" -- patients such as children an the mentally disabled -- and a panel discussion was held on March 10, 1983. The fifth case
was the Ongwanada incident.

Dr. Georgina Harris of London, Ontario, was at the discussion as a clinical psychologist who works at University Hospital at the University of Western Ontario and as the mother of a mentally disabled child. "I didn't know what Ongwanada was," she recalls. Dr. Wiens was invited to describe what she had done, and those on the panel to comment. One doctor on the panel thought it was all right to use mentally disabled children in teaching medical students. All the others thought it was wrong.

Nick Bala, an associate professor on the faculty of law at Queen's, declared it was "assault," and said that Dr. Wiens and the students could be tried in a court of law. (A group of medical students approached Bala after the symposium and were overheard asking him, "Can we say that we were just following the orders of our teacher?" The law professor reminded them of the Nuremberg trials.)

"Dr. Wiens never once said, 'Oh my God!' or 'I never thought of that!"' recalls Dr. Harris about the symposium. "She seemed to wonder what all the fuss was about. But to say that a physician doesn't know that she didn't need consent is unbelievable to me! And what was so bad was that not only was there no consent to do these non-therapeutic exams but these children had no possibility of refusing!"

Harris recalls Wiens saying that parents who have children in institutions expect that they will be used in this way. At that point, Laura Muldoon asked Dr. Harris if, as a parent of a mentally disabled child, she thought that was true. "I said 'certainly not!' And that as far as I was concerned, no other parent would feel that way, either!" The psychiatrist on the panel agreed that he would be astonished if parents expected non-therapeutic examinations.

Someone at the symposium stood up and said that rectals should be learned in the proper fashion, with experts, at which point another student cried out, "Come on! You know
what goes on with people coming out of surgery!" Then another doctor on the panel
asked, "Why don't you medical students practise on each other?"

There was a great roar of laughter.

Professor Bernard Dickens, of the University of Toronto Law School, who lectures and writes extensively on the question of consent and medical ethics, comments: "The reason why those medical students would not examine each other is precisely why they should
not do it on retarded adolescents! One does not use a vulnerable population when a nonvulnerable population can be used just as well."

"The penny dropped," as Dr. Wiens would later put it in court. The word got out from
the symposium and was soon in hundreds of newspapers and broadcasts: QUEEN'S
UNIVERSITY STUDENTS USE RETARDED YOUTHS FOR MEDICAL EXAMINATIONS! The response, as one can well imagine, was universally negative.

"I don't think it happens every day," says Dr. Arthur Schafer, a professor in the department of philosophy at the University of Manitoba and a lecturer on bio-medical ethics in the faculty of medicine, "but it's not as infrequent as it should be." Schafer recalls being told
by medical students at the University of Manitoba that they had been invited to perform rectals on unconscious patients. When the students began the examinations, patients groaned in pain, and one student refused to continue. "The teacher became belligerent
and insulting and said that it showed how badly they did it, and made them feel stupid." Through discussions with his students, Dr. Schafer has gotten them to agree that "to do
any sort of procedure on unconscious patients without previous consent is first of all battery, and more importantly, immoral." Students may learn medical history or technique from such procedures, but they are also learning "that it's legitimate to use patients for
one's own convenience."

Echoes Nick Bala, the Kingston lawyer on that fateful symposium panel discussion, "It
was not necessary to have mentally retarded children as the subjects. It was a question
of convenience." The parents of the mentally disabled are even more troubled by the convenience of it all. "The fact that they didn't know who the children were!"exclaims Muriel Clarke-Beechey of Kingston, who was on the board of Ongwanada from 1972
to 1982, and whose son Rob lived there from 1968 to 1972. "That means that they
walked in and said `We'll take you, and you, and you,' like meat in a grocery store.
And they chose multihandicapped children, who couldn't push them away. They
maintain that it didn't hurt them, but you don't know if it hurts them or not. Some only
make little sounds and faces, and only if you know the do you understand. I'm sick to
my stomach when I think of this incident."

Other parents reacted with more than revulsion. Some laid charges against Dr. Wiens and Ongwanada. Or at least, they tried to. A great deal happened between the symposium
and the time the case came to trial in the spring of 1984, but in brief, the facts are these:

Elizabeth Hilhorst, the mother of a mentally disabled youth at Ongwanada, read of the incident in the papers and was concerned that her son Glen, now 18, had been involved. She contacted the Ontario Association for the Mentally Retarded (OAMR), the Kingston Association and eventually the Canadian Association for the Mentally Retarded (CAMR, which has recently changed its name to the Canadian Association for Community Living) and retained Elaine Newman of ARCH to defend her. "Glen is at the level of a one-year-
old," she later told the court. "He doesn't cry easily for pain. He once was burned through his skin and only sniffed; you have to know him. Dr. Wiens said, 'none were in any discomfort' from the rectals, but how could she know?"

Newman wrote to the attorney general of Ontario, then Roy McMurtry, to investigate the matter, on March 30, 1983. An investigation followed by Officer Pellisaro of the Ontario Provincial Police, who had difficulty discovering the names of the mentally disabled youths, and even the names of the medical students. He recommended that no charges be laid.
(On the stand, during the trial, the prosecuting attorney asked the officer whether, if he
had been able to find credible evidence and witnesses, he would have recommended
that it go to court. "No," he replied.)

The attorney general decided that "the public interest would not be served by a criminal prosecution in this case although it is quite possible that a technical assault took place."

On May 4, 1983, Elaine Newman wrote to the attorney general: "We are dealing with completely helpless and totally vulnerable people -- people who can neither call out for
help nor complain. Does the attorney general conclude that a crime committed against a voiceless victim is no crime at all? .... It is the helpless and the vulnerable segment of our community that most requires the protection of the criminal justice system. To deny them that protection in so clear a case as this has certainly served to bring the administration
of justice in this province into ridicule and disrepute."

On the last day of the six-month period during which charges could be laid, May 3, 1983, a private informant, John Osborne of the Kingston Association for the Mentally Retarded, swore out a complaint against Dr. Wiens before Justice of the Peace E.B. Hare of Kingston. Hare refused to pursue the criminal charges, forcing the three associations to
file notice with the Ontario Supreme Court and asking them to issue a writ of mandemus requiring the justice to deal with the case. "On every front we have been roadblocked," declared Jim Montgomery of the OAMR at the time. "We are frankly appalled by the wall of inaction we have run into," added Dr. Hugh Lafave of the CAMR. "An important issue is at stake here. Does the justice system of this province with all its power protect the rights of mentally handicapped people as vigilantly as those of other citizens?"

Finally, on October 6, 1983, another justice of the peace, Peter Philp, decided that there was sufficient evidence against Dr. Wiens, allowing the associations to abandon the writ action. On November 23, it was announced that Dr. Ruth Wiens would be tried in provincial court the following April 12, on five charges of assault.

The Ontario Health Insurance Program building in King\ston, Ontario is spanking
new, officially opened by William G. Davis, former premier of the province, on October 24, 1983, shortly after his attorney general had told the various associations for the
mentally disabled of Canada to forget about pursuing that Wiens affair. Just
inside the sparkling white building is an abstract mural incorporating the words:

When health is absent wisdom cannot reveal itself art cannot become manifest strength cannot fight
wealth becomes useless and intelligence cannot be applied
The health of the nations is more important than the wealth of the nations
Life is an adventure in forgiveness
Any life however long is too short if the mind is bereft of splendor!
Our awareness of what goes on within ourselves is the most illuminating of all our experiences
The greater the ignorance the greater the dogmatism

On the trip from Toronto to Kingston for the opening of the trial, the two prosecuting attorneys expressed their hopes and concerns for the case. "They want to quash it
because of abuse of process," said Michael Code, the young co-counsel. "But I think
our case is so strong, they'll have real trouble."

"I'm not so sure," said co-counsel David Newman, the older of the two lawyers. "I've defended six doctors, and never had one convicted. They're just a touch below Jesus Christ. People talk of doctors in hushed tones, even at cocktail parties." "You know,
it's unusual for someone as big as Laidlaw, a two grand-a-day man, to get involved in a provincial court trial." "It's devastating, hurtful, what those students did!" exploded Code. "No dignity! Totally demeaning! And those institutions use consent forms to take the kids to a picnic! If they need permission for a trip, then surely they need it for anal exams!"

At the courthouse, the regular judge was away for some reason, and Provincial Judge R. B. Batten came into the courtroom, which has wood panels everywhere and a big, glassed-in area for the court artists ("Be careful; his right side is best!" the secretary kibbitzes with them). The seal of the province of Ontario hangs on the wall: A Mari Usque Ad Mare.

Doug Laidlaw, at the time one of Canada's most prominent lawyers -- shortly after the conclusion of these proceedings he was killed in a Toronto traffic accident -- rose and
took control. Tall, handsome, stately, his hair thinning, his thumbs often sliding into his
pants gun-slinger fashion, Laidlaw moved to stay the proceedings on "abuse of process." He argued that the prosecution was using the courts wrongly, that it was attempting to punish a fine doctor when the problem had already been corrected, and was only interested in publicizing the CAMR and OAMR's attitudes toward the mentally disabled.

If Laidlaw succeeded in getting the case thrown out at this point, his client, Dr. Ruth
Wiens, would never have to go through a full trial. But in order to prove his abuse of process argument, he'd have to call witnesses, including Dr. Wiens, which for all intents
and purposes would make the motion a trial, in which most of the arguments and
concerns would get aired.

Dr. Boston, of Queen's Medical School, argued that a new, "very careful set of guidelines between Queen's and Ongwanada would insure that any teaching henceforth at the hospital would be beneficial and at no time harmful." Under cross-examination by David Newman (the lights of the room reflected off the lawyer's balding, head, making his sharply-angled face look disconcertingly like Pierre Trudeau's), the uncomfortable Dr. Boston declared: "Dr. Wiens said that the patients had no objection to the examinations." "But they couldn't give consent because they couldn't talk," shoots back Newman. "No further questions."
The problem of consent in medical care is hardly limited to the mentally disabled, of course. "I've heard far worse horror stories than the Wiens case," says one medical student at Queen's. "Tales of women under anesthetic, and five people come in and do pelvic exams." "There's a lot of anecdotal evidence of pelvic exams being done without consent," echoes Bernard Dickens of the University of Toronto law school. A Toronto nurse tells of non-therapeutic spinal taps being done on premature infants without their parents' knowledge, and the story is echoed by the mother of such a child.

Other people question just how informed consent can be when one is in a hospital and so very grateful to the doctors. "We never asked patients who were really sick," recalls Dr. Peter Rempel, a recent graduate of Queen's. "The majority of patients would say `yes.' Patients are flattered if they are paid attention to by doctors!" Nick Bala agrees: "There
are a large group of people who are more or less coerced, although a voluntariness is theoretically there. It's difficult for people who are less sophisticated and less educated
to refuse their doctor."

Most doctors and lawyers are concerned about this, and have gone out of their way to avoid gentle persuasion. "We make sure that the family doctor is not the one who requests that the child be checked by students," says Dickens, "so there is no sense of manipulation. At the Hospital for Sick Children, we are working to make sure that the vulnerability of parents is not exploited." Dr. Heshy Sturm, a general pediatrician at that hospital, concurs: "I ask parents, 'in order to benefit other doctors, it would be helpful if your child was seen. But don't hesitate to say no. If you're not comfortable with it, tell me. It will in no way
affect your child's medical care.'" Sturm claims that only "one in 10 parents says no."

Robert Seaby, a pleasant-looking, bespectacled young man, was called as a witness by Laidlaw. He agreed with the defense attorney's statement that "this prosecution is harmful to Ongwanada," of which he is executive director. Newman later read a quotation of Seaby's to The Globe and Mail in which he said: "The doctor carried out the examinations with care and compassion. It was an error in her judgment not to have obtained consents from the parents but I don't feel there was any malicious intent on her part or the students.
At no time do we condone teaching procedures without obtaining consent. We'll take every step to ensure that it never happens again."

Dr. Ruth Wiens was then called to testify. She is an attractive woman of 50, with severe, short-cropped brown hair, and was handsome in her grey suit.

Her lawyer examined her: "At that point in time [when the question was raised at the symposium], what was your opinion as to the ethical consideration involved?"

Wiens answered, "Ethically I had no problems with it because it was in no way, as I could see it, an abuse of the children. They were not distressed or disturbed or hurt..... Certainly the legalities of the whole thing had not intruded themselves on my mind at all until -- until that ethics seminar, I guess, is when the penny dropped."

In cross-examination, Newman referred to the exams themselves and asked Wiens, "Do you know from the course of your medical practice that ... there is a large segment of the population that finds a certain discomfort from receiving a rectal examination?"

"If there is an abnormality or if they are very tense," Wiens replied.

Dr. Harris, who lectures about pain at the University of Western Ontario, commented
later: "It was clear that the children must have had cerebral palsy, which means great tension. And the more tension in the body, the more pain you feel."

Later, Newman's voice grew harder. "Do the students ever, for instance, in clinical studies, practice on themselves, on one another? In examining each other's glands or..." "Yes," said Wiens.

"But you wouldn't think of having them examine each other rectally, would you?" Newman pressed.

"We encourage them to do whatever they can to improve their skills," said Wiens.

"Yes, but do you recall ever inviting the class to examine one another rectally?"

"No, I have not."

"It wouldn't be received in a -- I wouldn't think -- by the students in a very receptive manner?"

"I can't say."

"Come, Doctor, surely you could say. You can anticipate what it would be if you told the class, 'Well, I want half of you to lie down on the examination table and the other half of you are going to perform rectal examinations on your lab partner here.' You can well imagine what the response would be, can't you?"

"I would assume that there would be some who would object, certainly; maybe most."

"Yes. Most probably would. Thank you."

The unpleasant aspects of the case -- the fact that these were rectal exams, performed
on mentally disabled children who lacked the capacity to refuse the act were certainly important to both sides. "People seem to think a rectal exam is such a terrible fucking thing!" complained Doug Laidlaw after the case was complete. "And the prosecution tried to turn it into a horror scene! Sure it's an invasion of privacy! So is an electrocardiogram!"

Laidlaw is correct, of course; any act of touching another person without his or her consent is assault, under our criminal code. And had it been only an ear examination, it may never have seen the light of day, much less the light of courtroom. But the image of the mentally disabled being used is what cuts deeper. "That people who can't fend for themselves are used as guinea pigs by the medical profession -- it's diabolical!" says Nicola Schaefer of Winnipeg, the author of the best-selling biography of her severely disabled daughter, Catherine, Does She Know She's There. "Medical students should meet the handicapped in homes, not in institutions. I was able to say 'fuck off!' to doctors in the hospital; my daughter could not."

"Technically, Ongwanada is their home," echoes Kathleen Ruff, the human rights advocate for the CAMR, and former host of CBC TV's Onibudsman. "It is only called Ongwanada Hospital because of the few dozen chronically ill elderly who live there." (Ironically, Ongwanada comes from an eastern Canadian Indian dialect, meaning "Our Home.") "You don't learn about the mentally handicapped in an institution; if you want to know native people, you don't go to a prison! There is a danger that in an institutional setting it is very easy for people to become dehumanized."

Two weeks later, on April 26, the two lawyers were still arguing on the abuse of process motion. In his closing argument, David Newman, for the Crown, tried to tie the numerous strings together: "Good motives do not explicate someone from criminal liability. Dr. Wiens' intentions were good intentions. She said that she didn't realize at the time that it was an offense. How many doctors are there like Dr. Wiens? The penny hasn't dropped for them. The news will travel fast, and they will not commit this offense. The victims could not speak or walk. They could not find for themselves a justice of the peace. Ongwanada is the home of these children! Into their home came a well-meaning doctor who performed rectal exams. If it were my child, and my home, I know what my reaction would be. The Bill of Rights still exists. We are here to protect the liberty and security of people, even if they cannot protect themselves."

In his conclusion, Doug Laidlaw was equally passionate: "If this were assault with a deadly weapon, or assault with attempt to cause bodily harm, then be concerned. But when we deal with a very trivial, technical offence, then you ask yourself, why move the machinery of law here? ... Why punish a doctor? They want you to say, 'Medical profession, you will be guilty of an assault every time you touch a patient without his consent!' They want a trumpet blast from the court to frighten the medical profession. You would be saying to doctors, 'practise at your peril!' It would be destructive to the medical profession in this province....

"The prosecution used words like 'victims' and not 'patients.' They never mentioned that a medical school and teaching was involved. They want to tell doctors, 'Practise at your fear!' The confidence that people have in doctors is that they do their very best to practise their profession."

At this point, Laidlaw drew an analogy which left the people in the crowded courtroom open-mouthed. "Suppose a husband and wife are alone at night and get into an argument. The husband slaps his wife. They are contrite, and make up. Outside the window, a neighbor looks in, from a private interest group for women. Without the wife's agreement, the husband is dragged before our courts. A husband and wife must be left alone to solve their problems! To insert a criminal procedure would damage that relationship. The parallel is precisely the same! It's exactly parallel! The medical profession has a very sensitive relationship with its patients."

The court was adjourned until June 22, at which time Judge Batten was to rule on the abuse of process motion.

"The elitist approach of Laidlaw was evident in the submission he made," said Elaine Newman of ARCH after the proceedings. "This is a man who does not have insight into
the present and possible future abuse pf the mentally handicapped. He sees the same
about women: He argued that a battered wife should not have status in the courts. It's
the Bay Street view of rights. It's a second-citizenship notion. And he's not the only one
in the world who feels that way."

Newman's feelings towards Laidlaw were mutual. Although the Advocacy Resource Centre for the Handicapped was praised in Judge Rosalie S. Abella's 1983 study, Access to Legal Services of the Disabled ("ARCH deserves to be strengthened and encouraged in its work"), Laidlaw wrote a withering letter on May 10, 1984, to the Legal Aid Committee of the Law Society of Upper Canada, urging them to "take whatever steps
are necessary to terminate the services of such organizations insofar as they go outside
the appropriate boundaries of proper legal aid." This was six weeks before the case concluded.

On June 22, 1984, Judge R.B. Batten ruled on the motion to stay. Reviewing the various argument of both lawyers, he quoted from Elaine Newman, who was on the stand on the first day of testimonies: "Certainly it was hoped that the criminal process would deter this individual from repeating the offence, [and that] it would deter this institution from repeating the practice. But, on a more general level, [it was hoped] that a general deterrent effect could be achieved through the criminal process.... It makes a statement to the community about appropriate and inappropriate conduct."

The judge denied Laidlaw's application to have the case thrown out. David Newman asked Dr. Wiens to be arraigned on the first count. The clerk of the court read the information pertaining to that charge: ". . . that Doctor Ruth Wiens on or about the 4th day of November, 1982, did at Ongwanada Hospital, in the said city, commit a common assault upon a male person, referred to as John Doe 41, whose name is presently unknown to the informant but who, on November 4, 1982, was a patient at Ongwanada Hospital, contrary to Section 245(I) of the Criminal Code of Canada. Dr. Ruth Wiens, how do you plead?" Douglas Laidlaw leapt up and said "Guilty."

Laidlaw, Wiens and the medical profession seemed to have lost. Laidlaw argued for Wiens' character and urged an unconditional discharge. Newman agreed, but "tempered" Laidlaw's remarks: "The act itself," Newman said, "as opposed to the actor, is not, I would suggest to the Court, as flighty and insignificant as my friend has characterized. The act is an evil act although the doer is not an evil person. The act contravenes a very important principle that has been upheld in our courts. And that is that the body of every individual in our society is inviolate, subject, of course, to various consents.... The Court must be certain that the dignity of all individuals, dignity particularly in this case of mentally retarded persons and handicapped persons, can never be sacrificed for whatever purpose. It can't be sacrificed at the altar of academia, no matter how noble teaching is, and how noble that profession is, and how important it is; the right of the individual and the maintenance of
their dignity supercedes all that."

The judge agreed with both lawyers, giving Dr. Wiens an absolute discharge while making a finding of guilty.

What of the trade-off? How will our future doctors learn their profession? Doug Laidlaw was completely unrepentant: "There's been no lesson taught, except to terrify a few doctors, and steer them away from working with the retarded. Don't you think that that sort of thing will continue, except that now paper will be neatly stapled? It's not going to change! Won't rounds still be continued? Won't doctors still have to improve training?
The message of the case is do your paperwork. That's all."

Maybe so, but other commentators are more circumspect. "To educate our medical students effectively will sometimes conflict with patient care," admits Dr. Schafer of Winnipeg, "but patient care is more important than promoting student education. I think
that they can win patient cooperation by showing that the patient will gain. Students have the time. They can offer the patient the opportunity to ask questions. They can offer sympathetic understanding." Adds Professor Dickens of the University of Toronto law school, "We acknowledge as a community that the teaching of medical students is an important priority. But we should minimize the inconvenience. At Ongwanada, they
were using and abusing the children for teaching material. But there comes a point of needing hands-on with patients."

Has any good come from the Crown vs. Wiens? "This case has done much good for the medical community," declares Dr. Margaret Somerville, a full professor in both the faculties of medicine and law at McGill who teaches compulsory classes on medical ethics to first and fourth year medical students. "Doctors will be forced to learn how to teach ethically." Somerville is the author of the study Consent to Medical Care, which was prepared for the Law Reform Commission of Canada. In the 186-page book, Somerville writes on "Institutionalized Children": "These children deserve special mention and special protection, which means they should never be subjected to non-therapeutic medical interventions or used in non-therapeutic medical research. . . ." The chairman of the commission at the
time Somerville wrote her report was Francis C. Muldoon, Q.C., the father of Laura,
who made the penny drop.

"The fact that it went to court and a guilty verdict was rendered is a good thing," agrees
Dr. Schafer. "I am enormously heartened that some medical students, to the threat of their careers, were willing to protest. Increasingly they do protest, and educate their teachers."
"I think teaching hospitals have gained instruction from this case," adds Bernard Dickens. "It was time for it. The attitude toward doctors as holy is being eroded. It's a shame, though, that we have to learn from cases where doctors are pilloried."

True. But as Elaine Newman of ARCH comments, "This case deals head-on with our revered relationship with our doctors. And we respect the needs and aims of the medical profession. But Laidlaw tried to establish that that relationship is beyond the purvue of criminal law, and somewhere along the line, someone has to say 'No!'"

In June, 1984, a provincial court judge looked at one of the top lawyers in Canada, and
at the medical profession, and said "No."