The Persecution of a Doctor

“In the public interest”, in August 2019, the registration of a Melbourne Christian doctor, Jereth Kok, was suspended by the Medical Board of Victoria. His appeal was rejected by the Victorian Civil and Administrative Tribunal (VCAT) in February 2020[1]. He awaits further deliberation, humiliated, unemployed, and with a wife and three children to support.

No criminal charges have been made against Kok. Nor is he physically or mentally unwell. Nor has he failed to keep up to date and practise accordingly. Nor have there been complaints from patients or the LGBT community. To the contrary, his alleged danger to the public interest lies in some of his little-read postings on social media, brought to the attention of the board and its investigating arm, the Australian Health Practitioners’ Regulatory Agency (AHPRA) by two anonymous complainants.

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AHPRA exists to protect the public from dangerous or incompetent doctors, nurses and other health practitioners. That is a valuable service. The question raised by the Kok case is one of justice and proportionality: Why do AHPRA and the board suspend a GP for over a year for social media posts that break no law while allowing doctors charged with grave crimes to continue working?

Comparative cases

We can usefully compare and contrast the Kok case with other decisions of the Medical Board.

The first[2], in August 2018, involved Dr Seyyed Farshchi, charged in January 2018 with alleged breaches of the Crimes Legislation Amendment Act 2013. Farshchi was alleged to have forced a fellow Iranian, a refugee, to work long hours for little pay under the threat that Farshchi’s “connections in the Department of Immigration” could have the man returned to Iran. Further, Farshchi threatened to tell the Iranian government the refugee and his family had converted to Christianity, adding fear of the death penalty for apostasy. The Victorian Medical Board decided not to suspend Farshchi’s registration while awaiting the conclusion of criminal charges, on the basis that his continued registration would not undermine public confidence in the medical profession and, therefore, suspension was not “in the public interest”. Nevertheless, “concerns raised” would be allayed only if “the most onerous of conditions” were imposed. What were these onerous conditions? Farshchi was merely obliged to work under supervision. VCAT upheld the decision.

The second case was heard in February 2019 and concerned CJE[3], a doctor alleged to have raped a male colleague by anal penetration without a condom. CJE was suspended when charges were laid in November 2018, but VCAT overturned the Board’s decision. CJE had been suspended for three months when he returned to work. He later received an Order of Australia award.

The third[4], and perhaps most comparable case, was heard in March 2019, concerning Dr Kwan Lee, accused of professional misconduct for his statements on social media. His posts included: “This kind will NEVER learn. She needs to be abandoned in India and repeatedly raped in order for her to wake up her idea”; “With her suicide, nothing of value would be lost”; “If my marriage fell apart it would not end in divorce. It would end in murder”. With regard to murder of a victim after rape, Lee commented, “what do you expect them to do, if the victim has seen their faces”. In January 2018, Lee described himself as “a mongrel doctor who claims to know all manner of shit on earth … It is rumored [sic] that his hospital in Australia has the highest casualties in the world due to him not attending to his dying patients …”

Finding Lee guilty of misconduct, the Board declared “the respondent be reprimanded, suspended for a period of six weeks and undergo education on ethical behaviour and communications, particularly in the use of social media”.

In summary: a doctor charged with slavery offences is not suspended at all; a doctor charged with rape is suspended for just three months; a doctor who urged rape and threatened murder online is suspended for just six weeks.

What heinous crimes, then, must Dr Jereth Kok have committed to be summarily suspended and still unable to practise more than a year later?

The Kok case

Kok’s offences lie solely in the field of social media. The first of two anonymous complaints from the general public appeared in December 2017, when a member of the public identifying as a “family member not a patient” criticised Kok’s disdain for the attribution of the motivation for the man who had ploughed his car into civilians near Flinders Street Station to mental illness rather than ideology.

Investigations progressed slowly and silently and, one year later, in December 2018, an investigator from AHPRA turned up unannounced at Kok’s surgery to examine his electronic files. In March 2019, AHPRA informed Kok “it had confirmed issues for investigation” (presumably revealed in his social media accounts) including provision of sub-standard care to LGBT people, failing to comply with the Abortion Law Reform Act, breaching privacy of patients with mental health issues and failing to adhere to the Medical Board’s codes, guidelines and policies.

In May 2019, the Board received a second complaint, accusing Kok (right) of inappropriate use of the word retardation in one of his posts. In response, AHPRA conflated the two complaints but, in the process, because of “lack of substantiation”, withdrew “earlier concerns regarding mental health of patients, mistreatment of LGBT people and failure of compliance with the Abortion Law”. Concerns regarding his social media posts had, however, grown and they were now considered a risk to “public interest”.

In a previous encounter with AHPRA, in 2012, Kok had been cautioned for declaring unwillingness to comply with a legal obligation to refer patients for abortion. His views were forwarded to the Medical Board by a fellow doctor who had been privy to a social media discussion but Kok had been told the Board did not concern itself with his personal opinions.

The Board’s ongoing concerns included:

# “denigrating, demeaning and slurring medical practitioners” who practise abortion, treat gender dysphoria in accordance with “accepted medical practice” and who recognise “transgender” people “are not suffering from a mental health condition”.

# “sentiments of violence”: endorsing “genocide towards racial and religious groups” and “capital punishment” to practitioners of abortion.

# views on “LGBTI persons” that have “no clinical basis, [are] contrary to accepted medical practice and [are] demeaning”.

These concerns were supposedly so threatening to public safety they demanded “immediate” suspension of Kok’s registration in August 2019. His appeal to VCAT was rejected in March 2020 on the basis that his “conduct compromises the confidence held by the public that they can seek and receive treatment safely not only from him, but potentially from other members of the medical profession”. Kok remains suspended, in the dark.

The complaints

It is worth looking more closely at the complaints the Medical Board chose to take so seriously. Regarding the Flinders Street atrocity, Kok had wielded what appears to be his favourite manner of expression, hyperbole: unrealistic exaggeration that is not meant to be taken literally. He proclaimed people with “mental health issues … are clearly very dangerous and we should promptly lock them all up for the safety of society”. Declaring “we can’t be too careful”, Kok announced he was “going to do a search of our clinic’s database” and would forward the names of “everyone with a mental health plan” to the Australian Federal Police.

Interpreting the text literally, the “family member” asserted it revealed an “abuse of power and breaking of doctor-patient confidentiality”, concluding “patients with mental illness will not receive the best treatment from this doctor”.

The second complainant also sought “disciplinary action”, this time for Kok’s reply, “Australia and Melbourne—leading the world in retardation” to the newspaper headlines, “Australian school renames Mother’s Day. Principal States, “We No Longer Subscribe to a Binary World’”. The complainant claimed the use of the word retardation was “discriminatory, derogatory and offensive against people with an intellectual disability” and revealed such “lack of understanding and sensitivity” it “could cause harm to any intellectually disabled person who attends his practice”. Being a “mental health researcher” apparently qualified the complainant to suggest Kok suffered from “mental health issues such as untreated psychosis or personality disorder”.

What AHPRA unearthed

From ten years of postings to Kok’s small circle of contacts on social media, AHPRA’s researchers uncovered a selection whose content allegedly justified Kok’s suspension.

On abortion. In May 2010, responding to graphic details of late-term abortions, Kok suggested to the author “you should … replace the word ‘doctor’ with ‘butcher’. Sickening.” A lady’s comment confirmed the gruesome content: “I can’t really write anything because I am crying.”

Commenting in October 2017 on a video in which a “teen with Down Syndrome challenges, stuns Chancellor Angela Merkel on abortion”, Kok mused, “What is it with German Chancellors and exterminating people?” Also in October, Kok concluded, “Having endorsed the industrial-scale massacre of babies by doctors, under the guise of ‘health care’ there is no principled basis upon which we as a society can object to doctor-assisted suicide.” Elsewhere, he had described the Royal Women’s Hospital in Melbourne as a “baby killing factory”.

In December 2018, Kok reposted another’s comments on advocacy for infanticide of disabled babies by a US governor. The comments traced the progression from justification of early term abortion: “it’s just a clump of cells” to “OK, it looks like a baby but it’s not really alive” to “OK, it’s alive but can’t feel pain” to “OK, it can feel pain but it is a foetus not a baby” to “OK, it is a baby but it is not murder because it’s the mother’s choice” to “OK, but you can’t criticise us unless you are willing to adopt all the unwanted children”, to “OK, now we want to kill babies after they are born … and we don’t care who knows it”.

On genocide. In July 2012, in discussion on Western aid money funding abortions in poor countries, Kok again wielded hyperbole: “Thanks to ‘family planning’ developed nations … are facing an impending financial and economic crisis that comes with an aged population”, concluding “soon … the Earth will be overrun by Black people. The solution is clear: we must take ‘family planning’ to poor countries and exterminate them before it is too late.”

On the Flinders Street atrocity, the Medical Board decided that evidence of Kok’s approval for genocide could be found in a convoluted online discussion on the minimisation of the ideology of jihad. One person had proclaimed, “Now they will say it is everyone else’s fault for all being racist, bigots and Nazis.” To this, Kok flicked an “approval”. A third person added, “I am so sick of that accusation. I’m ordering Zyklon B from Amazon, building some showers in the backyard and inviting the inferior races over for a wash. What are they gonna do? Call me a double Nazi?” Kok’s failure to react to this banal reference to Zyklon B was reckoned by AHPRA to confirm his support for genocide!

Racism. Kok’s racism was supposedly confirmed in the posting of another “like” to a News Limited cartoon lampooning the Victorian government’s claim for law and order. In the cartoon, a government minister declared “No problem here” against a backdrop of rioting stick-figures. AHPRA’s keen eye spotted racism: the stick figures were black!

Sexism. The board detected sexism in Kok’s conviction that the physiology and psychology of women rendered them best fitted for motherhood. Further evidence of racism and sexism was detected in a comment of Kok regarding the campaign by some supporters of the “Yes” vote for same-sex marriage for the deregistration of an ethnically Chinese lady doctor who had appeared in a television advertisement for the “No” vote. In September 2017, Kok lunged into battle with histrionic hyperbole: “Please sign GetUp petition against stupid pig ignorant ching chong slanty-eye bigot homophobic woman doctor. Go back to your own backwards country, your kind don’t belong in tolerant and diverse Australia.” In fact, Kok’s forebears came from China, and his eyes bear a confirmatory slant. But AHPRA remained committed to its fundamentalist interpretation of the written word.

LGBTI. In June 2019, in reflection on the headline, “Vic govt births bill allows gender choice”, Kok warned that “Surgeons (despite being God and all) cannot change your sex. A man who has the surgery does not become a woman, he becomes a surgically mutilated man. So in this regard, the new law will just underline the foolishness of this whole ideology … it is possible that making it this easy [to change sex] will, paradoxically, result in LESS people seeking mutilative surgery and this, at least, would be a good thing.” Judging by its condemnation of this post, it would appear AHPRA finds “no clinical basis” for the implication that chromosomes are determinative.

In July 2015, Kok had stepped beyond social media to write an article in a mainstream Christian magazine. In refutation of AHPRA’s repeated claim that Kok lacked the “compassion” required of a medical practitioner, Kok declared in reasonable, respectful speech, without hyperbole or satire, that the “church must not neglect to show empathy … our engagement must be a careful, educated one, not blunt or dismissive”. Unfortunately, (from AHPRA’s point of view) he went on to reflect on the “overwhelming and deep-seated belief” of some people that they “truly belong to the wrong sex and are trapped in the wrong body”. Kok explained his “impression” that the “identities and life styles” of a “great many” transgender people are “determined by voluntary choices and cultural winds” to a “significantly greater extent than by irresistible internal impulses”. In any case, “our maleness and femaleness goes all the way down to the level of our individual cells” and “the technology does not exist … to change a man into a woman and vice-versa”. Thus, despite the “very best plastic surgery money can buy … [to a man recently transgendered into a woman] we are proclaiming untruth … sustaining him in a pathological, delusional belief”. The duty of “professionals, care-givers and friends is to firmly challenge those beliefs so the patient might heal”. Notably, at that time, the International Classification of Diseases still defined “the desire to live and be accepted as a member of the opposite sex” as a disorder.

Public interest without prejudice

Dr Kok’s professional banishment since August 2019 is justified by AHPRA as being necessary “in the public interest”. The question is, Why are the “crimes” of Jereth Kok deemed so threatening to “public interest” compared to slavery, rape and medical incompetence?

Created only ten years ago, AHPRA has already been subject to ministerial inquiries which have raised the problems of timeliness, communication and consistency that have, in fact, characterised its handling of Jereth Kok. Such criticisms of AHPRA continue.[5] Indeed, given “the public interest is a protean concept”, according to a barrister in Kok’s case, how is consistency of judging “the public interest” to be achieved, without protean prejudice affecting the outcome? How can standards be set and justice applied to offences allegedly committed against a concept defined as “readily assuming different forms or characters; exceedingly variable”[6]? And how can it be done by investigators of varying persuasions?

The question of consistency becomes even more poignant if we look at some other judgments by Heather Lambrick, Deputy President of the Victorian tribunal which rejected Kok’s appeal against suspension. In October 2016[7], Lambrick presided over the appeal of a serial sex offender against a Working with Children Assessment Notice. The offender was proved to have exposed himself in 1982, 1995 and 1997, and had probably offended on many more occasions and in varying ways. The man had begun offending as a teenager and continued until he was thirty-four, incurring various punishments, but Lambrick concluded that he “longer poses a threat to children”, and “it is in the public interest” for him to be given an Assessment Notice to enable employment in the family day-care business.

In January 2018[8], Lambrick approved an Assessment Notice for a man guilty of a prior indecent act with his fourteen-year-old stepsister but, though suffering major depressive and post-traumatic stress disorder, desired access to “schools and young people” for employment purposes. Lambrick found no evidence that he was “sexually attracted to children”.

In April 2018[9], she approved a Notice for a man who had been involved in the “horrendous aggravated [gang] rape and robbery” of another man, incurring a jail sentence of three years. The offender now sought a Notice to enable work in his family’s business. Ms Lambrick considered the risk to children to be very low and that “there is a public interest in the rehabilitation of offenders”.

The question is not whether these men should have received Notices. Indeed, rehabilitation is in the public interest. The question is why their potential for harm to the “public interest” is considered less than Kok’s?

Under the presidency of Lambrick, VCAT rejected Kok’s appeal against his suspension, declaring that his social media posts “have the real potential to undermine public confidence … There is a real likelihood that the maintenance of standards of the medical profession will be undermined …” Perhaps an explanation for all the inconsistencies in the treatment of Kok is revealed in clause 42 of the account of his appeal to Lambrick. The transcription reveals an emphasis: Kok “has clear conservative leanings”.

Dr John Whitehall is Professor of Paediatrics at a Sydney University

[1] Kok vs Medical Board of Australia. (Review and Regulation) VCAT 405. 27 March 2020)

[2] Farshchi v Medical Board of Australia (Review and Regulation) VCAT 1619 (18 October 2018)

[3] CJE v Medical Board of Australia (Review and Regulation) VCAT 178 (26 February 2019)

[4] Medical Board of Australia v Dr Christopher Kwan Chen Lee TASHPT 3 (16 April 2019)

[5] Walton M, Kelly PJ, Chiarella EM and Carney T. Management and outcomes of health practitioner complaints in Australia: a comparison of the national and New South Wales systems. Aust Health Review. 2020, 44:180-189.

[6] Macquarie Dictionary.

[7] VCAT 1769 (24 October, 2016)

[8] VCAT. 24. (8 January, 2018)

[9] VCAT 862 (5 June, 2018)