Expert says 'bold' action needed on B.C. doctors and nurses accused of anti-vaccine misinformation

More than a year after a B.C. doctor began circulating a letter declaring the COVID-19 pandemic "over" and speaking at rallies against masks and vaccines, there's still no resolution to the numerous complaints filed against him.

Dr. Stephen Malthouse, now the subject of further investigation for his alleged involvement with a business offering phoney mask and vaccine exemption 'certificates,' is currently a fully licensed doctor with no limits on his medical practice, according to the College of Physicians and Surgeons.

That comes as a shock to Harry Cayton, an international expert on professional regulation who completed a review of B.C.'s health colleges in 2019.

"If you are standing up in public and saying I'm a doctor and I'm going to say things which are contrary to good medical practice, then you are, I think, in breach of standards and you should be challenged by the regulator," Cayton told CBC News.

"That is very different from saying in the privacy of your own home to your spouse, 'I'm not keen on this vaccination lark.'"

Several health professional colleges in B.C. have had to confront concerns about licensed medical professionals discouraging COVID-19 vaccination and spreading unproven claims about the virus. 

Just this week, the College of Nurses and Midwives issued a warning in response to public statements from unvaccinated nurses calling themselves 'NURZ's and declaring they are "divorcing" from the college because of B.C.'s vaccine requirement for health-care workers.

These cases highlight a struggle Cayton says regulators around the world are dealing with as they attempt to draw a line between the importance of respecting personal opinion and encouraging scientific debate on the one hand, and keeping the public safe from COVID-19 on the other.

It also calls attention to the different approaches that Canadian provinces are taking when dealing with health professionals accused of spreading misinformation.

"If necessary, government has to step in and clarify the law around these things," Cayton said.

"We have to say that it's not in the public interest in the present circumstances for people to be discouraging other people from protecting themselves from the virus."

Ontario taking doctors to court

According to a petition filed by Malthouse in B.C. Supreme Court in June, the college has informed him of its intention to reprimand him and ban him from speaking about COVID-19 in response to complaints from at least 10 other physicians.

Malthouse has argued that's an infringement of his right to free speech and is asking for the courts to step in, claiming in his petition that his statements on the pandemic are "backed and supported by sound scientific and medical peer-reviewed literature and evidence."

The college says it is unable to comment on the proposed disciplinary action or the next step in that case.

In Ontario, on the other hand, three doctors have been banned from issuing mask and vaccine exemptions in recent weeks. That province's college has also filed court applications asking for a judge to compel four doctors to comply with investigations into their conduct related to COVID-19.

One of the doctors targeted by both measures, Dr. Rochagne Kilian, recently had her licence suspended as well. 

There is no evidence of similar actions in B.C., despite clear similarities in the situation.

The Ontario college's application concerning Kilian, who previously practised in B.C., says the college "has received confirmation that she provides medical exemptions through Enable Air, a website which facilitates the purchase of vaccination exemptions."

EnableAir.com is based in Kelowna. Though it has largely been taken offline, the website "indicated that if an individual applied for an exemption through the site, 'it is next to impossible that the physician would reject it,'" the college's application says.

Malthouse is also under investigation in B.C. in connection with that website, following a complaint about a four-page "declaration certificate of medical exemption including psychosocial conditions" that he purportedly signed. 

The certificate says it was produced by Enable Air, and the contact information on it matches the business and personal information of Dr. Gwyllyn Goddard, whose medical licence is temporarily inactive. 

'Regulators should not be hiding behind caution'

Neither Malthouse nor Goddard has responded to questions about any involvement with the site, and nothing has been made public about possible action by the college.

Earlier this week, a college spokesperson said no official complaint had been filed related to Enable Air, and investigators had not seen a copy of a certificate produced through the website.

However, CBC News has reviewed emails confirming that a complaint was filed on Oct. 5, including a certificate purportedly signed by Malthouse and created on EnableAir.com.

Asked to clarify the situation, the college spokesperson said she couldn't comment publicly on complaints or investigations because of privacy legislation.

The college has said that it's possible to restrict B.C. doctors from writing mask and vaccine exemptions if the evidence suggests they are providing fraudulent exemptions. However, a spokesperson said B.C. law would not allow a regulator to follow Ontario's example and take someone to court to force cooperation with investigators.

Cayton says if that's true, it's a problem.

"The professional must cooperate with the regulator, otherwise they're not regulated, to put it quite bluntly," he said.

He's calling on regulators to be "bold and take action" on professionals who are suspected of spreading false information and discouraging patients from being vaccinated.

"In these kinds of circumstances, regulators should not be hiding behind caution ... They should be saying the public interest is first and foremost, and let's test whether our legislation will allow us to take action," Cayton said.