A rape victim who was refused treatment at a clinic because of aggressive behaviour caused by her suffering from post-traumatic stress disorder has been awarded €10,000 in compensation.
The Workplace Relations Commission ruled that the woman has been discriminated against by the clinic under the Equal Status Act on grounds of her disability.
Although WRC adjudicator, Catherine Byrne, said she could not condone the use of expletives by the woman in a phone call to a doctor, she claimed the clinic’s decision to terminate her treatment was “a cruel and excessive response".
The unnamed patient, who was seeking to have her embryos frozen until the symptoms of her post-traumatic stress disorder (PTSD) had improved, had accused the clinic of failing to inform themselves about her medical history and her reason for seeking treatment.
She told a hearing of the WRC that her treatment was cancelled prior to an appointment with her husband to discuss the appropriate management of her PTSD on February 1st, 2022.
She claimed it was cancelled because of the “manner” in which she had dealt with a doctor in a phone call two weeks earlier when she had been triggered by the circulation of information about her among its staff.
The woman claimed the clinic was oblivious to the fact that her conduct was a trauma-triggered response.
The woman explained she had been referred to the clinic by a reproductive endocrinologist after she had been raped by an unknown assailant in January 2020.
She claimed she had informed the clinic about the rape and that she had been diagnosed with PTSD and was experiencing symptoms of the condition.
Trauma response
The woman argued that people with PTSD can experience a trauma-triggered response which can have a profound effect on their emotions over which they have no control.
The WRC heard she had notified the clinic that she did not want an appointment around the anniversary of the rape as she found it was a natural trigger, while medical appointments themselves were also a particularly strong trigger.
She claimed the clinic did not observe the trigger warnings in her case which resulted in her experiencing severe responses during her treatment.
The woman acknowledged that she responded to triggers with uncontrollable crying, becoming extremely angry and screaming at people and telling them to “f**k off".
The patient complained she was treated less favourably by the clinic because she had PTSD and that it had failed to provide reasonable accommodation for her disability.
She also pointed out that the behaviour of someone in the middle of an epileptic seizure would never be described as violent, unsafe or unacceptable.
She observed that it would be unthinkable to expose a person with epilepsy to a known trigger like strobe lighting given its associated risk of causing a seizure.
The woman said the discrimination she had experienced based on her disability had resulted in further discrimination on grounds of her family status as there was an unjustified interference with her reproductive rights.
She said her treatment was cancelled three months before her 40th birthday when her chances of successful egg-harvesting and embryo transplant were significantly reduced.
The woman said she had no words to convey the devastating consequences of her situation because of the increased risk she might not become pregnant.
Lawyers for the clinic claimed the woman had used inappropriate and aggressive language to a member of its staff in a phone call on January 18th, 2022, while she had ended a follow-up call a week later by hanging up.
The WRC heard the clinic’s management had been informed about the call and that it had made the reluctant decision not to provide her with further treatment after reviewing the incident and previous communications with her.
The clinic maintained its decision was based on the duty of care it had to ensure its staff were treated with respect.
Counsel for the clinic, Andrew Whelan BL, claimed it was within its rights to decline to provide treatment to patients who behaved inappropriately or aggressively towards its staff.
Mr Whelan said it was entitled to refuse to provide treatment on the basis that further aggressive and inappropriate communication from the complainant could cause harm to the clinic’s staff.
He claimed the abusive manner of the woman during the phone call was unacceptable and that her case was “misconceived".
Letter
The WRC heard she had also used profane language in a letter written to the clinic in response to its decision to terminate her treatment as well as in separate correspondence when she was seeking the return of her medical files.
Mr Whelan claimed the clinic’s policy on the treatment of its staff was fair, proportionate and responsible, while the patient had provided no evidence that she was suffering from PTSD.
In her ruling, Ms Byrne said the woman had established a prima facie case of discrimination as she was satisfied that she suffered from PTSD and that it constituted a disability under the legislation.
Duty of care
Ms Byrne also acknowledged that the clinic had a duty of care to its staff and accepted that its staff had experienced “unpleasant and perhaps stressful encounters” with the complainant.
However, she observed that most ambulance personnel and medical staff in hospital emergency departments are exposed to aggression and assault but that patients who behave in such a manner are not denied treatment.
Ms Byrne said she had read a transcript of the woman’s call to the doctor on January 18th, 2022 and said she had not found her abusive but adamant in her objection to some medication.
She noted the patient had remarked four times: “I’m not f**king taking it.”
Ms Byrne said she believed a few simple interventions by the clinic, like having a dedicated contact person, could have resulted in a different outcome.
She added the clinic had a responsibility to intervene and offer her support so that treatment could be administered without it triggering a traumatic response.
The WRC ruled that she had been discriminated against as she was sent away from the clinic because of her disability.
While Ms Byrne agreed that the woman’s reproductive rights were infringed, she said the patient was not discriminated against on grounds of family status.
Ordering the clinic to pay €10,000 in compensation, the WRC adjudicator said she believed the clinic had the capacity and resources to accommodate the woman’s disability.
Ms Byrne acknowledged that the effect of withdrawing its services was “devastating” for the patient.
If you have been affected by any of the issues raised in this article, you can call the national 24-hour Rape Crisis Helpline at 1800-77 8888, access text service and webchat options at drcc.ie/services/helpline/, or visit Rape Crisis Help.
