You are on page 1of 6

Berlin The Practice of Radiology • Malpractice Issues in Radiology

Sexual
Harassment
Downloaded from www.ajronline.org by 49.151.175.205 on 02/25/18 from IP address 49.151.175.205. Copyright ARRS. For personal use only; all rights reserved

A C E N T U
R Y O F

MEDICAL IMAGING
Sexual Harassment
Leonard Berlin1 The Case “had work and studying to do.” She also de-
It was in her second year of training that the clined all of his invitations for dining or movies.
Berlin L radiology resident began experiencing ha- The resident discussed these encounters
rassment of a sexual nature. During her first with a colleague, a woman who was in her
year of residency, the radiology subspecialty fourth year of residency. The colleague told
areas through which she rotated and her day- the resident that “rumors were prevalent” that
to-day activities had not allowed her much the residency director was a “ladies’ man”
opportunity to have personal contact with the and had the reputation of always being “on
director of the residency program, a male ra- the make.” When asked about whether anyone
diologist. Her second year, however, was the had ever lodged a formal complaint against
period in her training when the resident was to the residency director, the older colleague re-
spend considerable time in the section where plied that to the best of her knowledge, no
the director himself was the head. complaint had ever been filed.
As documented in a written grievance pre- Because the resident felt extremely uncom-
pared later by the resident and her attorney, the fortable and intimidated by the conduct of the
harassment began with the residency director residency director, she requested a private
telling her with increasing frequency that she meeting with the department chair. At this
was “the prettiest resident that we’ve ever had.” meeting she related to the chair her experi-
Sometimes the verbal phraseology was ences with the residency director, and she
changed to “the sexiest resident we’ve ever complained that his conduct was not only in-
had.” Over the next 2 months whenever the res- appropriate but also interfering with her resi-
ident was assigned after-hours duty in the radi- dency duties and education. The chair replied
ology department, the radiology director that he had not received any prior complaints
would “suddenly appear” saying that he, too, of this nature about the director but that he
Keywords: malpractice, medical–legal issues, sexual had “work to do” that required his presence in would look into the matter.
harassment the department at night. On many of these oc- For the next 2 months, the residency director
casions the director would sit down and chat avoided conversation and other contact with
DOI:10.2214/AJR.06.0272
with the resident about topics that made the the resident. However, the resident observed
Case summaries are based on actual events and lawsuits, resident feel “very uncomfortable.” At times that the director began favoring other residents
although certain facts have been omitted or modified by the the director would tell the resident that he had with regard to rotation and on-call assign-
author. All opinions expressed herein are those of the an “unhappy marriage” and that often his wife ments. When the resident saw the director in
author and do not necessarily reflect those of the American
Journal of Roentgenology or the American Roentgen Ray
was “too busy” or “simply disinterested” in the radiology department’s lecture room, li-
Society. meeting “his needs.” At other times the direc- brary, or hallway, he would ignore her and, in
tor would ask the resident whether she had, or fact, would not respond to her greeting of
Received February 22, 2006; accepted without revision had had, a “boyfriend,” sometimes rephrasing “hello.” Disturbed by what she felt was dis-
February 27, 2006.
the wording by asking whether she had had criminatory treatment from the residency di-
1Department of Radiology, Rush North Shore Medical
“any love affairs.” On four separate occasions rector, the resident went to the director’s office
Center, 9600 Gross Point Rd., Skokie, IL 60076, and the director invited the resident to join him for to discuss the matter with him. In a one-on-one
Department of Radiology, Rush Medical College, Chicago, dinner, “so that we can talk more privately,” or conversation, the residency director denied
IL. Address correspondence to L. Berlin (lberlin@rsh.net). to accompany him to a movie. that he was treating the resident differently
AJR 2006; 187:288–293
On all of these occasions the resident told the from her colleagues, but then added that if she
director that she did not “want to hear or talk thought he was, she “would just have to get
0361–803X/06/1872–288
about personal things,” and that she “didn’t used to it.” He then asked her if she was famil-
© American Roentgen Ray Society have the time to spend with him” because she iar with an old World War II slogan that stated,

288 AJR:187, August 2006


Sexual Harassment

“Loose lips sink ships.” “Not really, but what is nia, received national media attention when reporting would not be kept confidential and
that supposed to mean?” asked the resident. “It she resigned her positions in protest of the might result in retribution or punishment.
means whatever you think it means. You figure proposed appointment as chair of neurosur- A more recent study [5] among psychiatry,
it out,” replied the residency director. gery of an individual whom she charged was internal medicine, and obstetrics–gynecology
After that encounter, the resident continued guilty of sexual harassment. As a result of her residents also disclosed that sexual harass-
to be subjected to discriminatory behavior on highly publicized action, the appointment of ment and abuse are prevalent in medical train-
Downloaded from www.ajronline.org by 49.151.175.205 on 02/25/18 from IP address 49.151.175.205. Copyright ARRS. For personal use only; all rights reserved

the part of the residency director. Eventually the individual was later rescinded. The sec- ing programs. Thirty-two percent reported
the resident consulted an attorney specializ- ond event occurred shortly thereafter: At con- that their physician supervisors told them in-
ing in sexual harassment, who advised her to gressional hearings related to the appoint- appropriate details of their private lives, 24%
prepare a detailed document that carefully de- ment of Clarence Thomas to the U.S. asked about details of the residents’ private
scribed all conversations and contacts that Supreme Court, accusations of sexual harass- lives that made them feel uncomfortable, 12%
had occurred between her and the residency ment were made against Thomas by Anita touched them inappropriately, and nearly 8%
director. When completed, the document pro- Hill. The hearings were covered extensively asked them directly for a date. More than 31%
vided the foundation on which the resident by the news media. At the end of her com- of the residents reported that a supervisor un-
would be charging the residency program di- mentary about the RSNA focus session, Con- fairly favored another trainee because of a
rector and the administration of the hospital ley observed that “The occupational environ- personal relationship with that trainee, and
with sexual harassment and discrimination, ment that has been established by the old 25% of the trainees reported that a supervisor
resulting in “substantial interference” with guard is an exclusive good old boys club, had dated a fellow trainee. Sexual harassment
her “ability to derive the benefits of the radi- where elements of sexual harassment along of residents is not limited to training pro-
ology residency program.” with sex and racial discrimination remain and grams in the United States. A survey of Ar-
Over the next 2 months, a number of meet- are accepted part of the status quo.” gentinean residents disclosed that 10% were
ings among the resident and her attorney and She then presented a challenge to the medical subjected to sexual harassment; attending
various representatives of the hospital, in- community: “The next round of leadership physicians were the perpetrators of this ha-
cluding the hospital’s president and legal for medicine must be carefully chosen from rassment in 14% of the cases [6].
counsel, were held. After considerable nego- among the enlightened, not from those who In yet another study, 93% of women and
tiation, an agreement between the parties was are locked in a time warp of male supremacy.” 83% of men reported encountering sexual ha-
reached. Details of the agreement were kept As described later, enlightened medical rassment during their residencies [7]. This
confidential, but it is known that although no leadership accepted that challenge, and over study also examined the role of sex discrimina-
formal lawsuit was actually filed and no hos- the next decade they made substantial inroads tion and sexual harassment in medical stu-
pital personnel admitted wrongdoing, none- toward achieving the ultimate goal of elimi- dents’ choice of specialty and residency pro-
theless the staff radiologist was relieved of his nating sexual harassment and discrimination. grams. It found that across all specialties, more
position as residency director, and a financial women than men experienced sex discrimina-
settlement of an undisclosed amount was paid Prevalence of Sexual Harassment tion and sexual harassment during residency
to the resident. Furthermore, the hospital in Medical Training selection, with one exception: A higher per-
promptly instituted a sexual harassment pol- Sexual harassment occurs in residency pro- centage of men than women choosing obstet-
icy and grievance procedure that was circu- grams with alarming frequency. One survey rics–gynecology experienced such behavior.
lated to all employees and personnel. revealed that 75% of residents in anesthesiol- A survey of female orthopedic residents re-
Several months later, the staff radiologist ogy, family medicine, internal medicine, ob- vealed that 46% experienced sexual harass-
resigned from the hospital and joined a pri- stetrics–gynecology, pediatrics, psychiatry, ment, 65% experienced sex discrimination,
vate radiology group in another city. Follow- and surgery reported having experienced dis- and 68% believed they were ignored or re-
ing the end of her second year of residency, crimination on the basis of sex [4]. The most ceived less encouragement than did their male
the resident transferred to another program in common forms of sexual harassment experi- colleagues during residency training [8].
a different state. enced by female residents included the telling Sexual harassment among medical students
of sexist jokes, compliments on body or fig- also occurs, although to a lesser extent. Accord-
Discussion ure, and flirtation. Unwanted sexual contact ing to one survey, 15% of graduating U.S. med-
Sexual harassment has received little atten- was experienced by 13% and explicit sexual ical students experienced sexual harassment
tion in the radiology literature. However, propositions by 6.5%. Most of the responding [9]. Three percent of students claimed that they
three side-to-side articles published in 1994 female residents indicated that the sexual ha- were denied training opportunities because of
[1–3] summarized a special focus session ti- rassment was generated from a supervising sex rather than performance, and 2% reported
tled, “Sex Bias and Sexual Harassment in Ra- physician. Fifty percent of residents experi- experiencing unwanted sexual advances from
diology—Does It Exist?” that was held at the encing sexual harassment stated that they told school personnel. In still another survey of
1993 annual meeting of the Radiological So- someone about it, most often another resident medical students [10], 64% of female students
ciety of North America (RSNA). Interest in or friend. Only 23% of these residents re- and 21% of male students reported having ex-
this subject had been generated by two events. ported it to a supervising physician, and none perienced sexual harassment. Finally, a study of
First, in May 1991, Frances Conley, professor reported it to the sexual harassment officer. medical students in Japan disclosed that 54% of
of neurosurgery at Stanford University and Fourteen percent were afraid to report sexual female students and 15% of male students ex-
chief of neurosurgery at the Veterans Admin- harassment because it would adversely affect perienced sexual harassment [11]. Only 8% re-
istration Medical Center in Palo Alto, Califor- their evaluations, and 13% believed that such ported the abuse to authorities.

AJR:187, August 2006 289


Berlin

A survey of radiologic technology students harassers can be fellow students or employ- leges of employment. In 1972, Title IX of the
conducted by a group of Texas researchers ees, teachers, principals, or other supervisors Act was modified to provide its citizens equal
[12] found that 50% of first-year students and or coworkers [16]. access to educational experiences without re-
87% of second-year students experienced A more detailed commentary on what sex- gard to sex [22]. More specifically, that section
mistreatment ranging from verbal to sexual. ual harassment is and is not has been given by provided that “No person in the United States
Thirty-seven percent of first-year students the U.S. Supreme Court [17]: shall, on the basis of sex, be excluded from par-
Downloaded from www.ajronline.org by 49.151.175.205 on 02/25/18 from IP address 49.151.175.205. Copyright ARRS. For personal use only; all rights reserved

and 49% of second-year students identified ticipation in, be denied the benefits of, or be
radiologists as the source of abuse. The Sexual harassment must be more than subjected to discrimination under any educa-
American Nurses Association has reported episodic; it must be sufficiently continu- tional program or activity receiving federal fi-
that 60% of nurses surveyed experienced sex- ous and concerted to be deemed perva- nancial assistance” [23].
ual harassment at work [13]. In most of these sive…. It must be both objectively and Congress later amended the law to permit
cases, the harassment stopped before legal subjectively offensive, one that a reason- victims of sexual harassment to recover not
charges were filed. able person would find hostile or abu- only compensatory damages but punitive dam-
The prevalence of sexual harassment sive, and one that the victim did in fact ages as well [24]. Enforcement functions were
among college students is similar. An Ameri- perceive to be so…. Courts [must] look originally implemented by the U.S. Depart-
can Association of University Women survey at all the circumstances, including the ment of Labor but were transferred to the
published in January 2006 revealed that 62% frequency of the discriminatory con- Equal Employment Opportunity Commission
of students at American colleges and univer- duct; its severity; whether it is physi- (EEOC) in 1978 [25]. One of the missions of
sities were subjected to sexual harassment cally threatening or humiliating, or a the EEOC is to conduct litigation to obtain re-
[14]. Less than 10% of them reported the ha- mere offensive utterance; and whether it lief for victims of employment discrimination.
rassment to a school official. unreasonably interferes with an em- In 1988, a federal appeals court issued a
ployee’s work performance…. [The ground-breaking opinion that held that sex-
Sexual Harassment Defined law] does not prohibit genuine but in- ual harassment of a physician participating
Sexual harassment has been defined as nocuous differences in the ways men in a medical residency program is a pro-
“unwelcome sexual advances, requests for and women routinely interact with tected right under the Civil Rights Act. The
sexual favors, and other verbal or physical members of the same sex and of the op- case dealt with a female physician who, after
conduct that unreasonably interferes with an posite sex…. Simple teasing, offhand being dismissed from a surgical residency
individual’s work or study performance or comments, and isolated incidents (un- program at the University of Puerto Rico,
creates an intimidating, hostile, or offensive less extremely serious) will not amount filed a lawsuit claiming she had been sexu-
working environment” [15]. There are two to [sexual] discrimination. ally harassed [26]. A litany of examples of
kinds of sexual harassment: quid pro quo and sexual harassment was documented in the
hostile environment [16]. More detailed descriptions of sexual ha- record. One attending surgeon assigned the
Quid pro quo harassment (loosely trans- rassment in both the workplace and the edu- plaintiff menial tasks by asserting that
lated as “something for something”) occurs cational environment can be found in two fed- women should not be surgeons because they
when an employee is required to choose be- eral government publications referenced at could not be relied on while they were men-
tween submitting to sexual advances and los- the end of this article [18, 19]. struating or, as he put it, “in heat.” Another
ing a tangible job or educational benefit. This told the plaintiff that women should not go
kind of harassment usually occurs between a Sexual Harassment and the Law into surgery because they needed “too much
supervisor and subordinate. In 1803, Chief Justice John Marshall [20] time to bathe, to go to the bathroom, to apply
Hostile environment harassment is unwel- of the U.S. Supreme Court observed that our makeup, and to get dressed.” Another of her
come conduct that is so severe or pervasive, it government: “has been emphatically termed a supervising staff surgeons made repeated
changes the conditions of the claimant’s em- government of laws and not of men. It will sexual advances to the plaintiff, which, on
ployment or educational situation and creates certainly cease to deserve this high appella- every occasion, she rejected.
an intimidating, hostile, or offensive work en- tion if the laws furnish no remedy for the vi- Male residents in the program “plastered
vironment. Hostile work environment harass- olation of a vested legal right. It is an indis- the walls” of the residents’ lounge with Play-
ment is not limited to sexual advances and in- putable rule that where there is a legal right, boy centerfolds. They composed a list con-
cludes sex-based actions such as display of there is also a legal remedy by suit or action taining sexually charged nicknames for all of
sexually explicit materials, posters, pinups, of law, whenever that right is invaded.” the female residents and posted that list on the
and magazines. The nation had to wait 161 years, however, bulletin board. The plaintiff’s nickname was
Sexual harassment can be verbal—such as for the law that gave its citizens the right to be “Selastraga,” a Spanish word translated liter-
comments about one’s body, spreading sexual free of sexual harassment. The Civil Rights ally to mean “she swallows them.” Male resi-
rumors, sexual remarks or accusations, dirty Act, enacted in 1964, for the first time made it dents also posted on the wall a sexually ex-
jokes or stories; it can be physical—such as illegal in the United States to discriminate on plicit drawing of the plaintiff’s body. The
grabbing, rubbing, touching, or pinching in a the basis of race, color, religion, age, national only offers to alleviate the plaintiff’s harass-
sexual way; or vit can be isual—such as a dis- origin, or sex [21]. Title VII of this act specifi- ment came from residents who told her that if
play of pictures of naked persons or sex-re- cally prohibited employers from discriminat- she had sexual relations with them, they
lated objects, or obscene gestures. Sexual ha- ing or harassing on the basis of sex with respect would protect her throughout the residency.
rassment can happen to men and women, and to compensation, terms, conditions, or privi- When the plaintiff complained to the chief

290 AJR:187, August 2006


Sexual Harassment

resident about this harassment, he responded invested by the school board with supervisory ment…. The law imposes liability where
that it was “characteristic for a low level power over the offending employee actually the employee’s purpose, however mis-
woman to keep a relationship with a high knew of the abuse, had the power to end the guided, is wholly or in part to further the
level resident or an attending to ease her way abuse, and failed to do so.” The case was then master’s business…. An employer is
through the residency program.” appealed to the U.S. Supreme Court. subject to vicarious liability to a victim-
Numerous complaints to the chief resident In a 5–4 split decision, the Supreme Court, ized employee for a hostile environment
Downloaded from www.ajronline.org by 49.151.175.205 on 02/25/18 from IP address 49.151.175.205. Copyright ARRS. For personal use only; all rights reserved

and the chair of the department did not curtail with Justices O’Connor, Rehnquist, Scalia, created by a supervisor with immediate
the harassment and, if anything, resulted in Kennedy, and Thomas joining in the majority authority over the employee.
increasing it. Eventually the director of the decision, upheld the lower courts’ dismissal
residency program retaliated by filing a com- of the case [27]. Four justices, Stevens, Justices Thomas and Scalia dissented [28]:
plaint against the plaintiff, accusing her of Souter, Ginsburg, and Breyer, dissented. Em- “The Court’s holding does guarantee one re-
“sowing friction, arguments, discord and jeal- phasizing that one of the purposes of the Civil sult: there will be more and more litigation to
ousy” among the residents. This eventually Rights Act and its subsequent amendments is clarify applicable legal rules in an area in
led to the plaintiff’s dismissal from the resi- “to induce school boards to adopt and enforce which both practitioners and the courts have
dency program. practices that will minimize the danger that long been begging for guidance. It thus truly
The resident filed a lawsuit alleging sexual vulnerable students will be exposed to such boggles the mind that the Court can claim that
harassment and discrimination. The local fed- odious behavior,” the dissenting justices ve- its holding will affect Congress’ intention to
eral trial court judge dismissed the action, rul- hemently disagreed with the majority. The promote conciliation rather than litigation.”
ing that evidence of sexual discrimination stage was set for the Supreme Court to ex- The U.S. Supreme Court took another step
was insufficient and furthermore implying pand, rather than contract, an employer’s lia- in the direction of expansion of liability in
that the plaintiff, “self-described as an out- bility in sexual harassment cases. 1999 when it ruled that a school board can be
spoken woman,” had exaggerated or fabri- In 1998, the Supreme Court once again fo- held responsible for student-on-student sexual
cated altogether the events described in her cused on sexual harassment, this time ruling harassment. A fifth-grade girl was victimized
complaint. The resident then appealed to the on a case involving a female salesperson who by a prolonged pattern of sexual harassment by
federal appellate court. It reversed the lower was subjected to constant sexual harassment one of her classmates. The girl reported each of
court’s decision, holding that the plaintiff res- by one of her supervisors, a midlevel manager these incidents to her mother and to her class-
ident clearly presented evidence of sexual ha- who had the authority to hire and promote room teacher, who in turn contacted the school
rassment and discrimination sufficient to employees. The supervisor threatened the principal. Eventually the offending student
bring the matter to a trial. In an unusual re- employee with denial of tangible job benefits was charged with sexual battery and miscon-
buke to the lower court judge, the appeals if she did not comply with his demands for a duct. The victimized student then sued the
court ordered that the matter be transferred to sexual relationship. The woman rejected the school board, claiming that as a result of the
another judge. supervisor’s demands but told no one about months of sexual harassment, her previously
the harassment. The woman later quit as a re- high grades had dropped because she became
Liability for Sexual sult of this harassment, and she eventually unable to concentrate on her studies. The lower
Harassment Expands filed a sexual discrimination lawsuit against court dismissed the lawsuit, holding that nei-
Within the past decade, the U.S. Supreme the company. Here again, the woman had ther the board nor any of its employees had any
Court has resolved three separate lawsuits never informed anyone in authority about the role in the harassment. In a split decision, the
that have set in motion a trend toward sub- supervisor’s conduct, despite knowing that Supreme Court reversed the lower court’s rul-
stantial expansion of liability for sexual ha- the company had a policy against sexual ha- ing [29], holding that the school’s
rassment. The first of these cases concerned a rassment. Notwithstanding the supervisor’s
female high school student who had sexual numerous threats to retaliate against the …power over public school children is
intercourse on a number of occasions with a woman if she rejected his sexual advances, custodial and tutelary, permitting a de-
male teacher. The student did not report the the threats were not performed. Pointing out gree of supervision and control that could
relationship to any school official. Eventually that the woman neither suffered any concrete not be exercised over free adults…. [The
this relationship was discovered by the par- adverse tangible job consequence nor had school] is properly held liable in damages
ents. The teacher was arrested and his em- ever informed company management of the where it is deliberately indifferent to sex-
ployment at the school terminated. The stu- sexual harassment, the lower court dismissed ual harassment, of which it has actual
dent and her parents then filed a lawsuit the lawsuit. The U.S. Supreme Court, with knowledge, that is so severe, pervasive,
against the school district, seeking compensa- Justices Kennedy, Rehnquist, Stevens, and objectively offensive that it can be
tory and punitive damages on the theory that O’Connor, Souter, and Breyer joining in the said to deprive the victims of access to the
the district was responsible for the miscon- majority opinion, reversed the lower courts’ educational opportunities or benefits pro-
duct of the teacher. The lower court rejected decision and reinstated the lawsuit even vided by the school.
the claim, ruling that the district could not be though company management knew nothing
held liable if it had not been apprised of the about the harassment, stating [28]: The Court added, “Damages are not avail-
activity. A federal appeals court upheld the able for simple acts of teasing and name-
dismissal of the lawsuit, stating, “school dis- A master is subject to liability for the calling among school children, however,
tricts are not liable for teacher-student sexual torts of his servants committed while even where these comments target differ-
harassment unless an employee who has been acting in the scope of their employ- ences in sex.”

AJR:187, August 2006 291


Berlin

Justices Kennedy, Rehnquist, Scalia, and New York second-grader was suspended for ter the settlement was reached, the woman’s
Thomas strongly dissented [29]: kissing a girl and ripping a button off her skirt, attorney said, “The high punitive damage
and a North Carolina 6-year-old was sepa- award should stand as a warning: If you’re a
The Nation’s school children will learn rated from his class after kissing a classmate good corporate citizen and take time to train
their first lessons about federalism in on the cheek. your employees and act on complaints, this
classrooms where the Federal Govern- won’t happen to you” [33]. Universities and
Downloaded from www.ajronline.org by 49.151.175.205 on 02/25/18 from IP address 49.151.175.205. Copyright ARRS. For personal use only; all rights reserved

ment is the ever-present regulator. The Sexual Harassment Litigation hospitals are not immune to this warning.
Federal Government will have insinu- With the passage and increasingly strin- Clearly, the U.S. government has maintained
ated itself not only into one of the most gent enforcement of sexual harassment legis- and continues to maintain an extremely ag-
traditional areas of state concern, but lation, myriad lawsuits alleging harassment gressive stance in initiating litigation with the
also into one of the most sensitive areas have frequently resulted in large jury verdicts purpose of holding accountable businesses,
of human affairs…. Defining the appro- or out-of-court settlements. One highly publi- educational institutions, and health care facil-
priate role of schools in teaching and su- cized case involved Mitsubishi Motors. In ities for acts of sexual harassment or discrim-
pervising children who are beginning to 1998, Mitsubishi settled a harassment suit, ination occurring within their organizations.
explore their own sexuality and learning agreeing to pay $34 million in compensation
how to express it to others is one of the to 350 women who were subjected to sexual Summary and Risk Management
most complex…. and sensitive issues harassment while employed in an Illinois Notwithstanding the fact that myriad court
our schools face. Such decisions are best plant. As part of the settlement, Mitsubishi af- decisions dealing with sexual harassment and
made by parents and by teachers and firmed a “Statement of Zero-Tolerance” pol- the highly visible media attention given to
school administrators who can counsel icy “to swiftly and firmly respond to any acts them have increased the public’s awareness of
with them. The delicacy and immense of sexual harassment and implement a disci- sexual harassment substantially, such conduct
significance of teaching children about plinary system to strongly deter sexual ha- still exists in the workplace and educational
sexuality should cause the Court to act rassment” [31]. institutions, including health care facilities
with great restraint before it displaces In 2004, the EEOC prosecuted more than and medical schools. Radiology facilities,
state and local governments…. We can 400 lawsuits alleging employee discrimina- whether they are free-standing imaging cen-
conceive of few interventions more in- tion, of which half were related to sexual ha- ters or radiology departments in hospitals or
trusive on the delicate and vital relations rassment [25]. A $10 million settlement was university medical centers, are not immune to
between teacher and student, between reached with the Dial Corporation, against the presence of such activity. The following
student and student, and between the which the government had alleged that women risk management pointers will assist medical
state and its citizens, than the one the employees were subjected daily by male co- facilities and individual men or women who
Court creates today by its own hand…. workers and supervisory personnel to sexually may be victimized by or be perpetrators of
The Court clears the way for the Federal offensive conduct, including groping, sexual sexual harassment in reducing the incidence
Government to claim center stage in propositions, circulation of pornography, and of such harassment, in lessening the likeli-
America’s classrooms. Today’s decision stalking. Of the lawsuits charging employee hood of incurring a lawsuit alleging such ha-
mandates to teachers instructing and su- discrimination filed by the EEOC, 95% re- rassment, and in maximizing the chances for
pervising their students the dubious as- sulted in compensation payments. a successful defense if such a lawsuit is filed.
sistance of Federal Court plaintiffs and Two other well-publicized sexual harass- • All medical and educational facilities
their lawyers and makes the Federal ment lawsuits were resolved in early 2006, should have a written sexual harassment
Courts the final arbiters of school policy one by settlement, the other by jury verdict. policy in place. The policy should be made
and of almost every disagreement be- Pepsi Americas settled a sexual harassment known to all personnel and affirm that the
tween students…. After today, Johnny lawsuit filed by a former female dispatcher for facility will not tolerate sexual harassment,
will find that the routine problems of ad- $400,000 [32]. Although denying any wrong- will promote an environment free of such
olescence are to be resolved by invoking doing, the record showed that a supervisor had harassment, and will take disciplinary ac-
a federal right to demand assignment to told the woman she would “just have to get used tion when such harassment is discovered.
a desk two rows away. to it” when she complained about male employ- The policy should also include a definition
ees making sexual advances and degrading re- of sexual harassment, preferably including
The dissenting justices’ admonition that marks. The harassment had escalated into examples of behavior that does or does not
federal law regarding sexual harassment men’s room graffiti depicting her engaged in constitute sexual harassment. A suggested
among students may be intruding too far into sex acts. The government attorney stated that sexual harassment policy prepared by the
the classroom warrants consideration. In Feb- the settlement “sends a message to companies American Association of University Pro-
ruary 2006, in a case characterized by a child that they have to take complaints seriously and fessors [34] and representative policies
psychiatrist as an “overzealous attempt to en- they cannot retaliate.” from three different universities [35–37]
sure students feel safe in school after years in A Missouri jury awarded $50,000 in actual are referenced at the end of this article.
which society was not attentive enough,” a damages and $6.7 million in punitive dam- • The facility should establish a procedure for
Massachusetts first-grade boy was suspended ages to a woman employee of a company who the reporting of incidents of sexual harass-
from school for 3 days for sexual harassment charged her supervisor with making lewd ment or discrimination, and it should desig-
after he put two fingers inside a female class- comments to her and once hitting her buttocks nate an individual or group of individuals to
mate’s waistband [30]. Some years earlier, a with a belt in front of another supervisor. Af- assume the role of sexual harassment or

292 AJR:187, August 2006


Sexual Harassment

grievance officer, whose duty will be to re- abuse, discrimination and sexual harassment during www.ed.gov/print/about/offices/list/ocr/docs/
ceive and act on complaints alleging such residency training. McMaster University Residency sexhar01.html. Accessed February 20, 2006
harassment. Radiologists, other physicians, Training Programs. Can Med Assoc J 1996; 20. Marbury v Madison, 5 US 137 (1803)
house staff, and all professional and ancil- 154:1657–1665 21. Civil Rights Act of 1964, 42 USC 2000(a) (1)
lary personnel should be advised how, and 5. Recupero PR, Cooney MC, Rayner C, Heru AM, Price 22. Education Amendments of 1972, 20 USC
to whom, incidents of sexual harassment or M. Supervisor–trainee relationship boundaries in 1681–1688
Downloaded from www.ajronline.org by 49.151.175.205 on 02/25/18 from IP address 49.151.175.205. Copyright ARRS. For personal use only; all rights reserved

discrimination should be reported. medical education. Med Teacher 2005; 27:484–488 23. Murray v New York University College of Dentistry,
• Persons who believe they are being sub- 6. Mejia R, Diego A, Aleman M, Maliandi MR, Lasala 57 F3d 242 (US App 2nd Cir 1995)
jected to sexual harassment should have F. Perception of mistreatment during medical resi- 24. Roberts BS, Mann RA. Sexual harassment in the
several options to pursue, ranging from dency training [in Spanish]. Medicina (B Aires) workplace: a primer. Akron Law Review 1996;
firmly telling the individual to refrain from 2005; 65:295–301 29:269–290
such behavior to filing a formal complaint 7. Stratton TD, McLaughlin MA, Witte FM, Fosson 25. Office of General Counsel FY 2004 annual re-
with the institution’s designated sexual ha- SE, Nora LM. Does students’ exposure to gender di- port—summary of accomplishments. U.S. Equal
rassment officer. They should also be ad- scrimination and sexual harassment in medical Employment Opportunity Commission Web site.
vised that they have the option of bypass- school affect specialty choice and residency pro- Available at: www.eeoc.gov/litigation/04annrpt/
ing the facility’s process and filing a gram selection? Acad Med 2005; 80:400–408 index.html. Accessed February 20, 2006
complaint directly with an outside state or 8. Walker JL, Janssen H, Hubbard D. Gender differ- 26. Lipsett v University of Puerto Rico, 864 F2d 881
federal agency. ences in attrition from orthopedic surgery residency. (US App 1st Cir 1988)
• Persons accused of sexual harassment J Am Med Womens Assoc 1993; 48:182–184 27. Gebser v Lago Vista Independent School District,
should immediately refrain from conduct 9. Recupero PR, Heru AM, Price M, Alves J. Sexual 524 US 274 (1998)
that may be construed as such. The accused harassment in medical education: liability and pro- 28. Burlington Industries, Inc. v Ellerth, 524 US 742
individual might consider discussing the tection. Acad Med 2004; 79:817–824 (1998)
matter with the facility’s sexual harassment 10. Lubitz RM, Nguyen DD. Medical student abuse 29. Davis v Monroe County Board of Education, 526
officer, seeking assistance from a legal or during third-year clerkships. JAMA 1996; US 629 (1999)
professional adviser, or both. The accused 275:414–416 30. Lindsay J. Sexual harassment at age 6? Chicago Tri-
individual should not in any way retaliate 11. Nagata-Kobayashi S, Sekimoto M, Koyama H, et bune, February 10, 2006:4(News section)
against the accuser. al. Medical student abuse during clinical clerkships 31. Mitsubishi settles sexual harassment suit. Court
• Department chairpersons, staff radiolo- in Japan. J Gen Intern Med 2006; 21:212–218 TV Legal Documents (1998). Available at:
gists, and other supervisory personnel are 12. Moreno M, White ED III, Flores ME, Riethmayer www.courttv.com/archive/legaldocs/rights/
responsible for maintaining an environ- J. Student perceptions of clinical mistreatment. Ra- mitsubishi.html. Accessed February 20, 2006
ment free of sexual harassment and should diol Technol 2001; 73:18–24 32. Rose B. Firm settles harassment suit. Chicago Tri-
be aware that they could be held liable for 13. U.S. nurses regularly face sexual harassment. Ari- bune, January 21, 2006:2(Business section)
not doing so. If they become aware either zona Daily Star, December 16, 2005. Available at: 33. Lambe J. $6.8 million awarded in sex harassment
through their own observation or by being azstarnet.com/sn/printds/107208. Accessed Janu- case. Kansas City Star. Available at: Kansas-
informed by another person that sexual ary 24, 2006 City.com. Posted January 19, 2005
harassment or discrimination is occurring, 14. Kinzie S. Sexual harassment routine, college stu- 34. Sexual harassment: suggested policy and procedure
they should report the matter to the appro- dents in poll say. Washington Post, January 25, for handling complaints. American Association of
priate authority in accordance with the fa- 2006:A02 University Professors Web site. Available at:
cility’s policy. 15. Rubin PN. Civil rights and criminal justice: primer www.aaup.org/statements/Redbook/rbsexha.ht
on sexual harassment. National Institute of Justice, m. Accessed February 20, 2006
October 1995 35. Prohibiting sexual harassment. University of
References 16. Sexual harassment at school: know your rights. Illinois, Executive Notice 96-1. Available at:
1. Alazraki NP, Ferris EJ, Huckman BB, Conley FK. Equal Rights Advocates. Available at: www.equal www.uic.edu/depts/oae/harassment.htm. Ac-
Gender bias and sexual harassment in radiology: rights.org/publications/kyr/shschool.asp. Ac- cessed February 20, 2006
does it exist? Radiology 1994; 192:325–326 cessed February 20, 2006 36. Sexual harassment policy & grievance procedures.
2. Huckman BB. An institutional approach to the 17. Faragher v City of Boca Raton, 524 U.S. 775, 1998 George Mason University, 1998. Available at:
prevention of harassment. Radiology 1994; 18. Policy guidance on current issues of sexual harass- www.gmu.edu/facstaff/policy/sexa.html. Ac-
192:327–328 ment, The U.S. Equal Employment Opportunity cessed February 20, 2006
3. Conley FK. Issues in gender bias and sexual harass- Commission. Available at: www.eeoc.gov/policy/ 37. University of California policy on sexual harass-
ment. Radiology 1994; 192:329–331 docs/currentissues.html. Accessed February 20, ment. Available at: www.ucop.edu/ucophome/
4. Cook DJ, Liutkus JF, Risdon CL, Griffith LE, 2006 coordrev/policy/PP121404policy.pdf. Accessed
Guyatt GH, Walter SD. Residents’ experiences of 19. Sexual harassment guidance 1997. Available at: February 20, 2006

AJR:187, August 2006 293