First, do not speak: Errant doctors, sexual abuse, and institutional silence

Abstract

This dissertation looks at the power of silence, uncovering the repressed history of physicians who sexually abuse their patients. This research is an effort to understand how institutional practices create and sustain an atmosphere of silence in which such abuses can continue unchecked, if not completely unnoticed.

The silence tied to physicians' sexual abuse of patients has a complex history involving the growing, then waning institutional authority of medicine; the treatment of gender and class issues both within and outside the medical community; and the history of sexuality and its medical constructions.

This dissertation "reads" recent media and institutional exposure of this history backward, uncovering the silence that preceded and helped produce it. Silence works as a tool of domination in institutions. The media--both medical and mainstream--have sometimes helped construct and maintain this silence in complex ways.

While I closely examine medicine for its silences, I suggest that this perspective can be applied to other institutions. Recent theory centers on discourse as the consolidating point of power. What tends to be elided in these accounts is the power of silence and the silence of power. The silenced victim has been theorized in these accounts, as well as the process by which someone or something is silenced. But the third prong in what might call a "trilogy of silence"--the silence of the powerful--is less well understood.

This dissertation draws upon work in feminism, sociology, anthropology, institutional studies, communications, cultural studies, and ethics to understand the power of silence in institutions. It also draws upon my own experience as a reporter, as well as drawing upon hundreds of legal cases, medical articles, mainstream news articles, and interviews.

This dissertation shifts the focus away from the "silenced" themselves, and examines those who do the silencing, and who are also silent by choice, not by oppression.