College of Physicians and Surgeons of Alberta QB1803-01472 Written BRIEF of Applicant

COURT FILE NUMBER 1803 01472 Clerk’s Stamp
COURT QUEEN’S BENCH OF ALBERTA
JUDICIAL CENTRE EDMONTON
APPLICANT(S) DR.VILIAM MAKIS
RESPONDENT(S) COLLEGE OF PHYSICIANS AND SURGEONS OF

ALBERTA (COMPLAINT REVIEW COMMITTEE)
ADDRESS FOR SERVICE Attention: Dr.Viliam Makis

AND CONTACT 5970 Mullen Way, #36560
INFORMATION OF PERSON Edmonton, AB, T6R 0T4
FILING THIS DOCUMENT Phone: (780) 937-8745
Email: makisw79@yahoo.com
BRIEF OF THE PLANTIFF/APPLICANT, DR.VILIAM MAKIS FOR A JUDICIAL REVIEW to be

heard in Special Chambers, on February 15, 2019 at 10:00am.
____________________________________________________________________________
ADDRESS FOR SERVICE AND 5970 Mullen Way, #36560

CONTACT INFORMATION OF EDMONTON, AB, T6R 0T4
PLAINTIFF/APPLICANT Attention: Dr.Viliam Makis
Phone: (780) 937-8745
Email: makisw79@yahoo.com
ADDRESS FOR SERVICE AND Shores Jardine LLP

CONTACT INFORMATION OF Barristers and Solicitors
DEFENDANT/RESPONDENT Suite 2250, 10104 – 103 Avenue
COLLEGE OF PHYSICIANS Edmonton, AB, T5J 0H8
AND SURGEONS OF ALBERTA Attention: Craig D. Boyer
(COMPLAINT REVIEW Ph: (780) 448-9275,
COMMITTEE) Fax: (780) 423-0163
Email: craig@shoresjardine.com
TABLE OF CONTENTS
I. INTRODUCTION………………………………………………………………………………..1
II. FACTS……………………………………………………………………………………………1
III. ISSUES…..……………………………………………………………………………………….6
IV. LAW AND ARGUMENT…………………………………………….…………………………..7
a. Standard of Review applicable to CRC Decision – Reasonableness…….....7
i. Legal obligations of CPSA and CPSA Officials…………….……………....8
ii. Legal obligations of Applicant Dr.Makis……………………………………10
iii. Legal obligations of CPSA Complaints Director and CRC………..….…11
b. Was the CRC Decision unreasonable?.............................……………..…….13
i. Unreasonable conduct of CPSA Officials that led to CRC Review…….13
ii. CRC Decision is unreasonable – Documents reviewed……………..….18
iii. CRC Decision is unreasonable – Misrepresented Background………..20
iv. CRC Decision is unreasonable – Decision………………………………..21
c. Did the CRC Breach the Duty of Procedural Fairness?..................…...…...36
i. Nature of CRC Decision and process followed………...……………..….37
ii. Nature of statutory scheme and terms of the statute……………………39
iii. The importance of the Decision to the individual affected……………..40
iv. The legitimate expectations of the person challenging decision……..44
v. The choices of procedure made by the agency itself…………………...46
V. RELIEF SOUGHT….…………………………………………………………………………49
VI. TABLE OF AUTHORITIES….………………………………………………………………50

I. INTRODUCTION
1. The Applicant, Dr.Viliam Makis (“Dr.Makis”), seeks a Judicial Review of the Decision of the
College of Physicians and Surgeons of Alberta (“CPSA”) Complaint Review Committee
(“CRC”), which conducted a Review (the “CRC Review”) pursuant to section 68 of the
Health Professions Act, R.S.A. 2000 c.H-7 (“HPA”) of the CPSA Complaints Director
Dr.Michael Caffaro’s dismissal of a CPSA Complaint No.160618 regarding serious
allegations of physically and verbally abusive, unprofessional, unlawful and unethical
conduct of a regulated member of the CPSA and Alberta Health Services (“AHS”) Medical
Administrative Leader and Site Chief of Diagnostic Imaging at Cross Cancer Institute
(“CCI”), Dr.Robert MacEwan (“Dr.MacEwan”).
2. Dr.Makis applies for an Order in the nature of certiorari, setting aside the CPSA CRC
Decision to dismiss the entire 160618 complaint (the “CRC Decision”).
3. Dr.Makis also applies for an Order in the nature of mandamus, directing that the CPSA
refer the Applicant’s CPSA complaints No.160350 and 160618 for an Independent
Investigation and for a public Hearing pursuant to sections 61 to 79 (inclusive) of the HPA.
4. Dr.Makis applies for an Order declaring that the CPSA, CPSA Complaints Director
Dr.Michael Caffaro, and CPSA CRC Review Panel chaired by Dr.Randy Naiker, failed or
refused to uphold their legal duties and obligations pursuant to the HPA, and breached the
duty of procedural fairness owed to Dr.Makis.
II. FACTS
5. The relevant facts in this matter are set out in Affidavits of Dr.Makis, filed on January 26,
2018, and January 24, 2019.
6. Dr.Makis is a Nuclear Medicine physician who provided medical services at CCI in
Edmonton, AB, from August 5, 2013 until October 31, 2016.
Affidavit of Dr.Makis filed Jan.26, 2018 at para. 2-3.
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7. Commencing in or about August 2014, upon raising patient care concerns in the
Diagnostic Imaging Department of CCI, Dr.Makis became a victim of repeated workplace
harassment, verbal abuse and job threats committed by his direct AHS supervisor,
Dr.MacEwan. After filing a harassment complaint against Dr.MacEwan in August 2014,
Dr.Makis was retaliated against throughout 2015 and was repeatedly defamed by
Dr.MacEwan to senior AHS Officials, including Dr.MacEwan’s supervisor and AHS
Medical Director of CCI Dr.Matthew Parliament. Starting in or about August 2015 Dr.Makis
was subjected to a pre-meditated campaign of career sabotage by Dr.MacEwan who
wanted to see Dr.Makis fired from CCI by means of solicited complaints against Dr.Makis
that would be coerced from Dr.Makis’ healthcare colleagues by Dr.MacEwan and his AHS
dyad Director partner Quinn West. On June 1, 2016, Dr.Makis formally reported
Dr.MacEwan’s unlawful, unprofessional and unethical conduct to the CPSA pursuant to
section 54 of the HPA, which became CPSA File No.160350.

Health Professions Act (“HPA”), R.S.A. 2000 c.H-7, s.54 [TAB 1]
8. CPSA Complaints Director Dr.Michael Caffaro (“Dr.Caffaro”) dismissed the entire 160350
complaint on July 8, 2016 and refused to initiate a CPSA Investigation pursuant to section
55 of the HPA, of all serious allegations including physical assaults, harassment, verbal
abuse, intimidation, job threats, coercion, soliciting complaints, defamation and medical
career sabotage committed by Dr.MacEwan against Dr.Makis and Dr.Makis’ healthcare
colleagues.The Applicant submits that Dr.Caffaro did so in bad faith and with the malicious
intent of covering-up the allegations.

HPA, supra, s.55 [TAB 1]
9. By way of a letter dated July 29, 2016, AHS informed Dr.Makis that it would not be
extending Dr.Makis’ AHS Contract called the “Medical Services Agreement” (“MSA”) and
did not provide any reasons for doing so. The MSA renewal was the responsibility of
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Dr.MacEwan’s direct supervisor Dr.Matthew Parliament (see MSA page 10). The Applicant
submits that the nonrenewal of Dr.Makis’ MSA was an act of retaliation against Dr.Makis
by Dr.MacEwan and Dr.Parliament for Dr.Makis’ filing of CPSA 160350. The Applicant
also submits that Dr.Caffaro’s dismissal of 160350 contributed to the July 29, 2016
nonrenewal of Dr.Makis’ MSA and the subsequent damages that were inflicted on
Dr.Makis’ medical career by both CPSA and AHS Officials, Administrators and Employees.
CPSA Certified Record of Proceedings filed Feb.9, 2018, signed by David Kay, at page 107.
Affidavit of Dr.Makis filed Jan.24, 2019, at para. 4, see Exhibit A “MSA”.
10. Dr.Makis filed an Appeal of the 160350 Dismissal on August 8, 2016. In a letter dated
Aug.17, 2016, CPSA Hearings Director Dr.Kate Reed claimed the 160350 Appeal was
received 24 hours outside the 30-day time frame which the Applicant denies (see CPSA
Certified Record of Proceedings page 906). Dr.Kate Reed claimed Dr.Caffaro’s July 8,
2016 dismissal letter was delivered to the Applicant also so July 8, 2016 by registered mail
which the applicant denies and which, according to Canada Post, is not possible because
Canada Post Registered Mail does not offer a “same day” delivery service. The Applicant
submits that CPSA falsely claimed Dr.Makis’ 160350 Appeal was received just 24 hours
outside the 30-day time frame in bad faith and with the malicious intent of dismissing and
covering-up both Dr.Makis’ 160350 complaint and the 160350 Appeal. The Applicant
submits that Dr.Makis’ 160350 Appeal was received within the 30-day Appeal limit.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.6; see Exhibit C.

CPSA Certified Record of Proceedings, supra, at page 841-905, Aug.17, 2016 letter p.906.
11. On October 14, 2016, Dr.Makis filed a new CPSA Complaint No.160618 in regards to new
allegations of unprofessional conduct of Dr.MacEwan. On November 15, 2016, Dr.Caffaro
dismissed the 160618 complaint on grounds that Allegations 1-4 and 6-10 in 160618 were
identical to those previously submitted in 160350 and therefore could be dismissed without
any further consideration, and Allegation 5 did not warrant any Investigation by CPSA.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.7-8, Exhibits D and E.
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12. On October 27, 2016, Dr.Makis filed a lawsuit at the Court of Queen’s Bench of Alberta
QB1603-18935 for $13.5 million in damages inflicted on Dr.Makis’ medical career by
Dr.MacEwan and his supervisor Dr.Parliament and their AHS Administrative Team.
CPSA Certified Record of Proceedings, supra, at pages 203-220.
13. On November 24, 2016, Dr.Makis wrote to CPSA Registrar Dr.Trevor Theman, expressing
an intention to appeal Dr.Caffaro’s 160618 Dismissal and shared the following concerns:
I remain deeply concerned about the safety of Cross Cancer Institute healthcare staff
who continue to be abused. I also remain deeply concerned about the safety of CCI
patients, whose care continues to be compromised as described in the above
mentioned files. Finally, I am gravely concerned about the adverse impact of the
improper dismissal of these complaints on the integrity of the medical profession in
Alberta, on public safety and on the safe and proper practice of medicine. It appears
the Complaints Director, Dr.Caffaro, is protecting the AHS Officials who conspired to
sabotage and destroy my medical practice (Dr.Mador, Dr.Parliament, Dr.MacEwan,
Dr.McEwan) and who are the subjects of a lawsuit filed on Oct.27, 2016 for the
severe damages they deliberately inflicted on my medical practice, by not holding
them to the same standards as all other Alberta physicians in regards to their
violations of CPSA Code of Ethics and Standards of Practice, to the detriment of
patients and healthcare staff alike.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.9-10, see Exhibit F, Nov.24, 2016 letter.
CPSA Registrar Dr.Theman failed or refused to reply to this letter or address any of the
safety concerns expressed therein. The Applicant submits that Dr.Theman failed or
refused to respond to these concerns in bad faith and with the malicious intent of covering-
up these concerns of healthcare staff abuse, to protect the AHS Administrative Team of
Dr.MacEwan and Dr.Parliament, which reported directly to AHS Chief Medical Officer and
AHS Vice President Dr.Francois Belanger, and to protect AHS’ reputation at the expense
of the safety of CCI healthcare staff and patients. Dr.Theman’s bad faith behaviour was
consistent with that of Dr.Caffaro and Dr.Reed in the mishandling of 160350 and 160618.
CPSA Certified Record of Proceedings, supra, at page 127.
14. On December 14, 2016, Dr.Makis filed an Appeal of Dr.Caffaro’s dismissal of 160618 with
the CPSA CRC, pursuant to section 68 of the HPA.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.11, see Exhibit G.

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15. On December 28, 2016, Dr.David Williams resigned his job at CCI as a direct result of
being physically assaulted by Dr.MacEwan on Nov.26, 2015, having his job threatened by
Dr.MacEwan and Dr.Parliament in December 2015, and Dr.Caffaro’s Dismissals of these
incidents of unprofessional conduct by dismissing 160350 and 160618. Dr.Williams
documented Dr.MacEwan’s physically and verbally abusive conduct toward CCI
healthcare staff with Alberta Human Rights Commission by a letter dated June 25, 2017.
Affidavit of Dr.Makis filed Jan.24, 2019, at para. 7, see Exhibit D, June 25, 2017 letter.
16. By way of letter dated January 17, 2017, CPSA Hearings Director Mr.David Kay informed
Dr.Makis that he had appointed a CRC pursuant to sections 16 and 68 of the HPA to
review 160618 and invited Dr.Makis to provide a written submission only, for the upcoming
CRC Review of 160618, which Dr.Makis provided on January 24, 2017. The Applicant
submits that the CPSA did not offer Dr.Makis the opportunity to provide oral submissions
or to call witnesses in support of 160618, notwithstanding that section 68(4) of the HPA
offers this option.
Affidavit of Dr.Makis filed Jan.24, 2019, at para. 5, see Exhibit B, Jan.17, 2017 letter.
CPSA Certified Record of Proceedings, supra, at page 164-165.
HPA, supra, s.16, s.68 [TAB 1]
17. By way of letter dated March 28, 2017, CPSA Hearings Director Mr.Kay informed Dr.Makis
that Dr.MacEwan did not provide any written submission or response to 160618, despite
Dr.MacEwan receiving the same January 17, 2017 invitation from CPSA to provide written
submissions to the CRC that was also extended to Dr.Makis. Mr.Kay also stated: “Neither
Dr.MacEwan nor you were invited to the review meeting; all submissions were asked for in
written format re my letter of January 17, 2017”. The Applicant submits that this March 28,
2017 CPSA letter confirming that Dr.MacEwan did not respond to and also did not deny
the allegations in 160350 and 160618, is absent from the 906-page CPSA Certified
Record of Proceedings signed by Mr.Kay, and thus was not considered in the CRC
Review or CRC Decision breaching the duty of procedural fairness and violating the
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principles of natural justice. The Applicant also submits that Mr.Kay confirmed in writing
that the CPSA denied both Dr.Makis and Dr.MacEwan the opportunity to provide oral
submissions and the opportunity to attend the CRC Review and call witnesses, also
breaching the duty of procedural fairness and violating the principles of natural justice.
Affidavit of Dr.Makis filed Jan.24, 2019, at para. 6, see Exhibit C, March 28, 2017 letter.
18. On April 3, 2017, the CRC convened and reviewed Dr.Makis’ Appeal of Dr.Caffaro’s
160618 Dismissal and issued the CRC Decision on July 20, 2017. The CRC Decision,
signed on behalf of the CRC Review Panel by its Chair Dr.Randy Naiker, upheld
Dr.Caffaro’s Dismissals of 160618 and 160350, and concluded there was insufficient
evidence of unprofessional conduct to warrant a CPSA Investigation or Hearing.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, see Exhibit H.
19. On December 11, 2017, Dr.Makis filed an Amended Statement of Claim for the $13.5
million lawsuit QB1603-18935 against AHS, and included CPSA as a co-defendant of AHS
on the basis of Dr.Caffaro’s involvement in the sabotage of Dr.Makis’ medical career via
tampering with and maliciously manipulating CPSA Complaints, and covering up abuses
of healthcare staff committed by Dr.MacEwan.
Affidavit of Dr.Makis filed Jan.24, 2019, at para. 8, see Exhibit E.
20. On February 7, 2018, CPSA Registrar Dr.Scott McLeod launched an investigation of
Dr.Michael Caffaro’s professional misconduct regarding Dr.Caffaro’s role in the sabotage
of Dr.Makis’ and Dr.Williams’ medical careers via unlawful tampering with and malicious
manipulating of CPSA Complaint processes. The Investigation of Dr.Caffaro was launched
pursuant to section 55 of the HPA and is ongoing.
Affidavit of Dr.Makis filed Jan.24, 2019, at para. 9, see Exhibit F.

III. ISSUES
21. Was the CPSA CRC Decision unreasonable?
22. Did the CPSA CRC Breach the Duty of Procedural Fairness?
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IV. LAW AND ARGUMENT
a. Standard of Review applicable to CRC Decision - Reasonableness
23. Regarding the Standard of Review applicable to the CRC Decision, in Farhat v CPSA
Justice Pentelechuk noted (para 21)
I note that there is a presumption that the reasonableness standard applies to a

tribunal’s interpretation of its own statute: Dunsmuir at para 54; Alberta (Information
and Privacy Commissioner) v Alberta Teacher’s Association, 2011 SCC 61 at para
30.
Farhat v College of Physicians and Surgeons of Alberta, 2014 ABQB 731, at para 21 [TAB 2].
24. In Farhat v CPSA, Justice Pentelechuk also noted (para 24):
The Review Panel is a body or tribunal established by the Council of the College,
pursuant to the provisions of the HPA, s.32. The College acts through the Council, its
governing body: HPA ss 5,6. The College has a duty to “carry out its activities and
govern its regulated members in a manner that protects and serves the public
interest”: HPA, s 3(1). The Review Panel is clearly an expert tribunal in the context of
the HPA. The relevant issue involves a question of law and the interpretation of a
provision of the HPA, the Review Panel’s home statute. All of these factors point to a
reasonableness standard.
Farhat v CPSA, supra, at para 24 [TAB 2].
25. CPSA acts through the Council of the College, its governing body, pursuant to sections 5
and 6 of HPA. A CPSA Hearings Director is appointed by the Council of the College
pursuant to section 14 of the HPA and has the authority to establish a CRC pursuant to
section 16 of the HPA. CRC is a body or tribunal that reviews Complaints Director
dismissals of CPSA Complaints, pursuant to sections 17 and 68 of the HPA. The Applicant
submits that the CRC as a CPSA Body or Tribunal, has legal duties and obligations
pursuant to the HPA to carry out its activities in an honest and fair manner that serves the
public interest, pursuant to section 3 of the HPA and the HPA as a whole.
HPA, supra, s.3, s.5, s.6, s.14, s.16, s.17, s.68 [TAB 1]
26. The Applicant submits that, in light of the above, the Standard of Review applicable to the
CRC Review and CRC Decision in this Judicial Review is the reasonableness standard.
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27. In Dunsmuir v. New Brunswick, at para 47, the majority of the Supreme Court of Canada
explain the standard in the judicial review context as:
Tribunals have a margin of appreciation within the range of acceptable and rational
solutions. A court conducting a review for reasonableness enquires into the qualities
that make the decision reasonable, referring both to the process of articulating the
reasons and to outcomes. In judicial review, reasonableness is concerned mostly
with the existence of justification, transparency and intelligibility within the decision-
making process. But it is also concerned with whether the decision falls within a
range of possible, acceptable outcomes which are defensible in respect of the facts
and law.
Dunsmuir v New Brunswick, [2008] 1 SCR 190, 2008 SCC 9, at para 47 [TAB 3]
28. The Applicant submits that it is against this standard that the CRC Review, CRC decision-
making process, and CRC Decision must be measured.
i. Legal Duties and Obligations of CPSA and CPSA Officials
29. The legal obligations, responsibilities and roles of CPSA, are defined pursuant to section 3
of the HPA:
3(1) A college
(a) Must carry out its activities and govern its regulated members in a manner that
protects and serves the public interest,
(b) Must provide direction to and regulate the practice of the regulated profession by its
regulated members,
(c) Must establish, maintain and enforce standards for registration and of continuing
competence and standards of practice of the regulated profession,
(d) Must establish, maintain and enforce a code of ethics,
(e) Carry on the activities of the college and perform other duties and functions by the
exercise of the powers conferred by this Act, and
(f) May approve programs of study and education courses for the purposes of
registrations requirements.
HPA, supra, (emphasis added), s.3 [TAB 1]
30. In Farhat v CPSA, Justice Pentelechuk observed (para 32):
This Court observes that a basic principle of interpretation is that an Act must be
read as a whole. Our Court of Appeal recently reiterated this principle stating that:
“The Court interpreting must not look only at the precise passage in question and the
rules of grammar. It must also use the context and the aim or scheme of the Act”:
Zakhary v College of Physicians and Surgeons of Alberta, 2013 ABCA 336 (CanLII)
at para 16, 561 AR 87.
Farhat v CPSA, supra, at para 32 [TAB 2]

Zakhary v CPSA, 2013 ABCA 336 at para 16, 561 AR 87 [TAB 4]
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The Applicant submits that the aim or scheme of the HPA as a whole is the safe practice
of medicine in the province of Alberta, which includes regulating not just the professional
conduct of physicians toward patients but also the professional conduct of physicians
towards their colleagues and co-workers. The Applicant submits that CPSA has legal
duties and obligations not only to abide by the individual provisions of the HPA, but also to
administer the HPA in keeping with the aim and scheme of the HPA as a whole.
31. The HPA is clear that all physicians licensed to practice medicine in the province of
Alberta and all regulated members of CPSA, including Dr.MacEwan, must comply with the
Code of Ethics and Standards of Practice adopted by the CPSA in accordance with
Section 133 of the HPA. The plaintiffs submit that Section 133 of HPA does not provide
any professional conduct exemptions for AHS Medical Administrators such as
Dr.MacEwan.
32. The CPSA Code of Conduct in the section “Scope of the Code of Conduct” states that :
The Code of Conduct applies in any environment where a physician interacts with
patients, colleagues, co-workers, learners and others in the healthcare workplace,
including physical workplace, telephone, videoconference and online.
The Code of Conduct is consistent with the Canadian Medical Association’s (“CMA”)
Code of Ethics and complements the CPSA Standards of Practice. Physicians are
expected to know and abide by these rules; any breach of processional behaviour
will be judged against all three of these foundation documents. While the Code
outlines expectations regarding professional behaviour, the College will consider the
following when inappropriate behaviour occurs: The well-being of the physician,
systemic issues within the healthcare system.
CPSA, CPSA Code of Conduct, Reissued: June 5, 2014, at page 2 (emphasis added) [TAB 5]
The Applicant submits that the CPSA Code of Conduct clearly applies to any environment
where any physician (regardless of their AHS or CPSA Administrative rank) interacts with
colleagues, co-workers and learners (residents, fellows). The Applicant submits that the
CPSA Code of Conduct does not provide any professional conduct exemptions for AHS
Administrators such as Dr.MacEwan, or CPSA Administrators such as the Registrar,
Hearings Director, Complaints Director or CRC Review Panel members or CRC Chair.
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33. All physicians licensed to practice medicine in Alberta must abide by the CPSA/CMA Code
of Ethics - Fundamental Responsibilities, which includes but is not limited to:
01. Consider first the well-being of the patient,

04. Consider the well-being of society in matters affecting health,
07. Resist any influence or interference that could undermine your professional
integrity,
09. Refuse to participate in or support practices that violate basic human rights,
14. Take all reasonable steps to prevent harm to patients,
44. Use health care resources prudently,
48. Avoid impugning the reputation of colleagues for personal motives; however
report to the appropriate authority any unprofessional conduct by colleagues,
52. Collaborate with other physicians and health professionals in the care of patients
and the functioning and improvement of health services. Treat your colleagues with
dignity and as persons worthy of respect.
CMA, CMA Code of Ethics, Update 2004 (emphasis added) [TAB 6]

The Applicant submits that the CPSA/CMA Code of Ethics clearly applies to any
environment where any physician (regardless of their AHS or CPSA Administrative rank)
interacts with colleagues, co-workers and learners. The Applicant submits that the
CPSA/CMA Code of Ethics does not provide any professional conduct exemptions for
AHS Administrators such as Dr.MacEwan, or CPSA Administrators such as the Registrar,
Hearings Director, Complaints Director, CRC Review Panel members or CRC Chair.
34. The Applicant submits that Dr.Makis had a reasonable expectation that CPSA, its
Administrators, Officials, Employees and its bodies and Tribunals (as constituted pursuant
to HPA), would uphold CPSA’s legal duties and obligations pursuant to the HPA as a
whole and pursuant to individual sections of HPA such as section 3: to maintain and
enforce standards of practice, maintain and enforce code of ethics and govern its
regulated members in a manner that protects and serves the public interest.
ii. Legal obligations of the Applicant Dr.Makis
35. The Applicant submits that Dr.Makis filed 160350 and 160618 in keeping with his legal and
professional obligations, duties and responsibilities pursuant to the CPSA Code of
Conduct, “Specific Expectations – Responsible Behavior” including but not limited to:
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(a) – ensure patient care and safety assume the highest priority in the clinical setting,
(n) – address breaches of professional conduct, scientific conduct or unskilled
practice by another healthcare professional by discussion directly with that person,
or, if necessary, by reporting to the appropriate authorities using established
procedures,
(o) – know and adhere to the CPSA Standards of Practice,
(q) – Respect the authority of the law and understand professional and ethical
obligations.
CPSA, CPSA Code of Conduct, supra, at page 4 (emphasis added) [TAB 5]
36. The Applicant submits that Dr.Makis filed 160350 and 160618 in keeping with the
mandatory legal requirement that Dr.Makis had as an Alberta physician, to report
unprofessional, unlawful and unethical conduct pursuant to the CPSA Standards of
Practice – Duty to Report a Colleague:
1. A physician must report another physician to the College when the first physician
believes, on reasonable grounds, that the conduct of the other physician places
patients at risk or is considered unprofessional conduct under the Health
Professions Act.
2. Knowledge of physician conduct that should be reported in subsection (1)
includes but is not limited to situations in which a physician:
(b) suffers from a physical, cognitive, mental or emotional condition that is
negatively impacting the work or is reasonably likely to negatively impact the
work of the physician,
(c) repeatedly or consistently fails to address his or her behaviour that interferes
with the delivery of care to patients, the ability of other physicians, learners or
healthcare workers to provide care to patients.
CPSA, CPSA Standards of Practice – Duty to Report a Colleague,
Reissued: September 1, 2012 [TAB 7]
37. The Applicant submits that Dr.Makis’ mandatory requirement to report unprofessional
conduct of Dr.MacEwan was governed by CPSA Standards of Practice – Terms used in
the Standards of Practice” where the term “must” is defined as follows:
“must” - refers to a mandatory requirement

CPSA, CPSA Standards of Practice – Duty to Report a Colleague, supra,
Terms used in the Standards of Practice [TAB 7]
iii. Legal obligations of the CPSA Complaints Director Dr.Caffaro and CRC
38. The plaintiffs submit that at all material times, the CRC, as a body or tribunal of the CPSA,
had a duty to uphold CPSA’s legal duties and obligations pursuant to the HPA as a whole
and to individual sections of HPA such as section 3: to maintain and enforce standards of
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practice, maintain and enforce code of ethics and govern its regulated members in a
manner that protected and served the public interest.
39. CPSA Complaints Director is appointed by the Council of the College pursuant to section
14 of the HPA and is entrusted by the public with a vital role in the administration of the
HPA as the gatekeeper to the quality control of Alberta’s healthcare system and must
uphold the absolute highest standard in the administration of his legal duties and
responsibilities pursuant to the HPA, to ensure that the integrity of the practice of medicine
in Alberta is maintained for the benefit of patients, healthcare workers and society.
40. If the CPSA Complaints Director is ethically compromised and abrogates his legal duties
and responsibilities pursuant to the HPA as a whole (and specifically section 3), as the
Applicant submits Dr.Caffaro has, this has extremely adverse effects not just on the
individuals involved in this CPSA 160618 complaint (in this case Dr.Viliam Makis, Dr.David
Williams, healthcare staff of Diagnostic Imaging of CCI, and Dr.Robert MacEwan), but on
all medical professionals, patients, the public and society.
41. The CRC reviews decisions made by the Complaints Director, pursuant to sections 17 and
68 of the HPA, and serves as a body or Tribunal of the CPSA that effectively conducts
quality control on the Complaints Director and his handling of CPSA Complaints.
42. If the CRC members, or the CRC Chair, are ethically compromised and if any of them
abrogate their legal duties and responsibilities pursuant to the HPA as a whole (and
specifically section 3) , this has extremely adverse impacts not just on the individuals
involved in this complaint but on all medical professionals, patients, the public and society.
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b. Was the CRC Decision unreasonable?
i. Unreasonable conduct of CPSA Officials that led to CRC Review
43. The Applicant submits that since the CRC Decision upheld all of the decisions of the
Complaints Director to dismiss 160350 and 160618 without any Investigation or Hearing, if
the Complaints Director’s decisions are found to have been very unreasonable, then by
extension, the CRC Decision was also very unreasonable.
44. CPSA complaint 160350 contained 11 allegations of unprofessional, unlawful and
unethical conduct committed by Dr.MacEwan, thoroughly documented in a 20-page
complaint and 222 pages of supporting documentation. The allegations are summarized:
1. Physical assaults: (victims: Dr.David Williams, Deb Haldorson)

2. Verbal Abuse of Dr.Francois-Alexandre Buteau
3. Harassment of Dr.Viliam Makis: Formal harassment complaint Aug.20, 2014
4. Request by 8 CCI radiologists to Dr.Matthew Parliament to remove Dr.Robert
MacEwan as Director of Diagnostic Imaging for ongoing unprofessional conduct.
5. Retaliation for Aug.2014 harassment complaint: interference in research activity
6. Retaliation: accusations of imaging mistakes to damage Dr.Makis’ career
7. Retaliation: advocating for Dr.Makis’ contract non-renewal, defamation, threats by
Dr.MacEwan and Quinn West
8. Retaliation: Dr.MacEwan conspiring with Quinn West to destroy Dr.Makis’ medical
career via harassment and coercion of staff, and soliciting fraudulent complaints
(a) harassment and coercion of nuclear medicine technologist Brittany Sammann
(b) harassment and coercion of nuclear medicine technologist Joanne Snydmiller
(c) AHS Director Quinn West makes false and defamatory statements
(d) defamation and soliciting fraudulent complaints
(e) planning for Dr.Makis’ removal/firing
(f) Dr.MacEwan conspiring with therapy nurses to file a fraudulent complaint
(g) violations of confidentiality
9. False accusations against other CCI MDs Dr.Sandy McEwan, Dr.David Williams
10. Adverse impacts on work related issues, patient care
11. Illegal reporting by Dr.MacEwan of cancer therapy studies done by Dr.Makis
Affidavit of Dr.Makis filed Jan.26, 2018 at para.4, Exhibit A.

The Applicant submits that any one of these allegations represents a serious violation of
the CPSA Code of Ethics and CPSA Standards of Practice and warrants an Investigation
and or Hearing in keeping with CPSA’s legal obligations and duties pursuant to section 3
of HPA. The Applicant submits that in Al-Ghamdi (Re) there is a precedent for CPSA
Investigating disruptive behaviour by a physician towards nursing staff and physician
Page 13 of 50
colleagues of the very similar type that was reported with Dr.MacEwan in 160350, and in
that precedent, there was not only a CPSA Investigation, CPSA Hearing and Penalty, but
there was also a practice permit suspension for a minimum of two years.
Al-Ghamdi (Re), 2017 CanLII 145468 (AB CPSDC) [TAB 8]
45. Dr.Caffaro’s July 8, 2016 analysis of 160350 is barely 2 pages long (pages 3-4). In this
analysis, Dr.Caffaro repeatedly misrepresents the CPSA Code of Conduct and the legal
obligations of the CPSA pursuant to section 3 HPA with statements such as:
with regards to the concern over physical assault allegations, please note that the
College is not the appropriate venue for the investigation of such a
matter…individuals who are reported to the victims of same should be advised to
approach the Edmonton Police Service with their concerns.
Affidavit of Dr.Makis filed Jan.26, 2018 (emphasis added), at para.5, Exhibit B.
The Applicant submits that a physician physically assaulting both a co-worker nurse and a
colleague physician is unprofessional conduct that is covered in CPSA Code of Ethics
(violation of Code 52 – treat your colleagues with dignity and as persons worthy of
respect) and CPSA Standards of Practice. Dr.Caffaro further misrepresented the legal
duties and obligations of the CPSA pursuant to the HPA, in the seventh paragraph:
You have provided no evidence that Dr.MacEwan’s concerns with your employment
are a direct result of, or specifically direct, an active campaign of harassment against
you. What you have provided are allegations which are best tested in the context of
the AHS structure, or in a civil court proceeding
Affidavit of Dr.Makis filed Jan.26, 2018 at para.5, Exhibit B, 160350.
The Applicant submits that the 160350 allegations of physical assaults, harassment,
verbal abuse, intimidation, threats, coercion, defamation, soliciting complaints, and
deliberate medical career sabotage are all violations of CPSA Code of Ethics and CPSA
Standards of Practice and all of them are types of behaviour that the CPSA has routinely
Investigated in the past, held Hearings for, and penalized as it did in Al-Ghamdi (Re).
Page 14 of 50
46. In addition to repeatedly misrepresenting the legal obligations of the CPSA pursuant to
HPA as a whole, Dr.Caffaro repeatedly misrepresented the allegations and supporting
documents and took such extremely biased positions in favour of Dr.MacEwan’s physically
and verbally abusive conduct, that he all but acted as Dr.MacEwan’s legal counsel,
excusing every single misconduct allegation in the absence of any CPSA Investigation.

47. Dr.Caffaro fabricated an excuse for Dr.MacEwan’s medical reporting of having
administered radioactive cancer treatments to Dr.Makis’ patients, that Dr.MacEwan didn’t
administer, to patients whom Dr.MacEwan had never seen, didn’t know, with whom he had
no doctor-patient relationship, but treatments that Dr.MacEwan reported and signed that
he administered and then supervised for secondary effects:
There is no documentation provided regarding the alleged reporting of the studies by

Dr.MacEwan. If these alleged reports are in fact in violation of trial protocol, then the
reporting of same should be to Health Canada
Dr.Caffaro showed no regard for the safety of hundreds of cancer patients who were
clinically treated at an AHS facility by Alberta physicians, and had their radioactive cancer
treatments (which were administered and overseen by Dr.Makis or members of Dr.Makis’
team) unlawfully and improperly reported and signed by Dr.MacEwan. The Applicant
submits that Dr.Caffaro’s suggestion that this was a Health Canada problem and not a
CPSA regulated member problem, was unreasonable and represented a full abrogation of
Dr.Caffaro’s legal duties and responsibilities pursuant to section 3 of the HPA.
48. The Applicant submits that Complaints Director Dr.Caffaro’s decision to dismiss every
single allegation in the 242 page 160350 complaint on the basis of “insufficient evidence”
was very unreasonable and not defensible in respect of the facts and the law.
Furthermore, it amounted to a full abrogation of Dr.Caffaro’s legal duties and
responsibilities under the HPA as a whole, not just to Dr.Makis and to the physically and
Page 15 of 50
verbally abused healthcare staff of CCI and cancer patients receiving radioactive
treatments at CCI, but also to other healthcare staff, patients, public and society.
49. The Applicant submits that Dr.Caffaro’s unreasonable dismissal of 160350 was just the
beginning of a deliberate cover-up by CPSA. Other CPSA Officials handling 160350 also
abrogated their legal duties and responsibilities pursuant to HPA: this includes the
Hearings Director Dr.Kate Reed who on August 17, 2016 dismissed Dr.Makis’ Appeal of
160350 on the basis of the false claim that it was 24 hours outside the 30-day Appeal limit,
when the documents confirm that Dr.Makis’ Appeal was within the 30-day Appeal limit.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.6, Exhibit C.
50. On October 14, 2016, Dr.Makis filed a second CPSA complaint against Dr.MacEwan
(160618), which was a 17-page complaint supported by 96 pages of supporting
documents. While four of the eleven allegations of 160350 were expanded upon in 160618
with new documents, Dr.Makis filed six new allegations with CPSA which were:
2. Sabotage of medical practice of Dr.David Williams following physical assault

3. Threats to the medical practice of Dr.David Williams.
5. Workplace violence – Verbal assault of Marlon Bonilla-Salazar
7. Conspiracy to destroy the medical practice of Dr.V.Makis via abuse of AHS and
CPSA complaint systems.
8. Conspiracy to provide coordinated, false and defamatory testimony to an AHS
Investigation to sabotage and destroy Dr.Makis’ medical practice.
9. Human rights abuses of CCI Staff
Affidavit of Dr.Makis filed Jan.26, 2018 at para.7, Exhibit D.
51. Dr.Caffaro dismissed the entire 160618 complaint on November 15, 2016, with a very
short “Analysis” comprising two small paragraphs covering less than half of one page.
Dr.Caffaro falsely claimed that all but one allegation were:
Considered previously and your resubmission of them represents simply repetition of

the previous complaint matter which was dismissed.
Regarding allegation 5 Dr.Caffaro claimed:
the one issue that is mentioned as a “new” matter, item five above, is at best a
secondhand, and at worst a third hand report of a matter…you have provided no
evidence supporting your allegation of a “verbal assault”….without evidence of
unprofessional conduct and given the hearsay provided, the CPSA will not pursue an
investigation
Page 16 of 50
Affidavit of Dr.Makis filed Jan.26, 2018 at para.8, Exhibit E.
The Applicant submits that Dr.Caffaro characterized the abuse victim’s direct witness
account which was documented in an email complaint sent to her AHS supervisor, as
“hearsay”, which was unreasonable and not defensible in respect of the facts and law.
52. The Applicant submits that Dr.Caffaro’s dismissal of 160618 on the basis of demonstrably
false claims that 160618 was identical to 160350 and thus could be dismissed out of hand
without any consideration, was unreasonable and not defensible in respect of the facts
and law. Dr.Caffaro again showed no regard for the safety of healthcare staff at CCI who
were reporting being physically and verbally abused by Dr.MacEwan, and Dr.Caffaro once
again fully abrogated his legal duties and responsibilities pursuant to HPA. The Applicant
submits that Dr.Caffaro falsely claimed that only one Allegation in 160618 was “new”,
while the Applicant claims that six Allegations in 160618 were “new”.

53. Dr.Makis expressed his concerns about healthcare staff safety and abuse in a letter to
CPSA Registrar Dr.Trevor Theman dated November 24, 2016, which Dr.Theman failed or
refused to respond to at all, consistent with Dr.Theman’s abrogation of his legal duties and
responsibilities pursuant to the HPA. Dr.Theman’s unreasonable behaviour was consistent
with what was now an active conspiracy by senior CPSA Officials (Hearings Director,
Complaints Director and Registrar) to cover-up all allegations and documentary evidence
of physical and verbal abuses committed by Dr.MacEwan against a number of Edmonton
healthcare staff.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.9-10

54. CPSA Hearings Director David Kay constituted the CRC on January 17, 2017 pursuant to
section 16 of the HPA, to review Dr.Caffaro’s dismissal of 160618. The Applicant submits
that since the most senior CPSA Officials (CPSA Registrar Dr.Theman, CSPA Hearings
Page 17 of 50
Directors Dr.Kate Reed and Mr.Kay and Complaints Director Dr.Caffaro) had already put
in a concerted effort to cover-up all allegations in 160350 and 160618 in violation of the
provisions of the HPA Act (section 3 – to maintain and enforce a Code of Conduct and
Standards of Practice which they failed or refused to do with Dr.MacEwan) and contrary to
HPA’s overall intent, aim and scheme (to protect patients and healthcare staff, which they
failed or refused to do with Dr.MacEwan), the formation of the CRC and its independence
and impartiality were significantly, if not fatally compromised.
ii. The CRC Review and Decision are unreasonable – Documents reviewed
55. The CRC Decision lists “Documents Reviewed by the CRC” on page 1. This list is notable
for missing four crucial CRC Review documents including:
• June 1, 2016 CPSA Complaint 160350

• July 8, 2016 CPSA Complaint 160350 Dismissal by Dr.Caffaro
• August 8, 2016 CPSA Complaint 160350 Appeal by Dr.Makis
• March 28, 2017 letter from CPSA Hearings Director David Kay indicating
Dr.MacEwan provided no written submissions and issued no denials of the
allegations in 160350 and 160618 to the CRC.
Affidavit of Dr.Makis filed Jan.26, 2018, at para 12, Exhibit H, CRC Decision page 1.
56. The Applicant submits that the CRC did not review 160350 complaint dated June 1, 2016,
Dr.Caffaro’s Decision to dismiss 160350 dated July 8, 2016, or Dr.Makis’ 160350 Appeal
dated Aug.8, 2016 and that this is why these documents are missing from the “Documents
Reviewed by the CRC” list in the CRC Decision. The CPSA Certified Record of
Proceedings signed by CPSA Hearings Director David Kay, Form 9, confirms that all
documents pertaining to 160350 were not reviewed by the CRC. In 1(b), the CPSA
Certified Record of Proceedings lists “the documents considered by the Complaint Review
Committee – Rule 3.18(2)(c) and (d)”; this list does not contain any of the 160350
documents or the Hearings Director March 28, 2017 letter.
CPSA Certified Record of Proceedings, supra, Form 9, Rule 3.19 signed by David Kay, at 1(b).
Page 18 of 50
57. The Applicant submits that the CRC Review of 160618, in the absence of any review of
160350 or Dr.Caffaro’s Decision to Dismiss 160350, renders the CRC Decision about
160618 very unreasonable and not defensible in respect of the facts and law, because the
review of 160618 relies almost entirely on the determination whether it was similar
enough to 160350 to be dismissed as Dr.Caffaro had dismissed it (falsely claiming that
160618 was merely a “resubmission” of 160350, which the Applicant denies).
Furthermore, if the CRC did not review 160350, then it could not have reasonably
compared 160350 to 160618, and in the absence of any comparison between 160350 and
160618, the CRC Decision is unreasonable and indefensible in respect of the facts and
law.
58. Further or in the alternative, Dr.Caffaro dismissed 160618 on the basis that Allegations 1-4
and 6-10 of 160618 were “identical” to those in 160350, and that since 160350 was
already “considered” by Dr.Caffaro and was dismissed in its entirety, accordingly
Dr.Caffaro could also dismiss 160618 in its entirety because it was merely a
“resubmission” of 160350. The applicant submits that CRC was constituted to review
Dr.Caffaro’s Decision to dismiss 160618 which means CRC was required to review
whether Allegations 1-4 and 6-10 of 160618 had already been submitted in 160350. This
required the CRC to review 160350 and Dr.Caffaro’s Dismissal of 160350. Because CRC
failed or refused to review any documents pertaining to 160350, the CRC could not have
made any reasonable and legally defensible Decision with regard to Dr.Caffaro’s decision
to dismiss 160618. Accordingly the CRC Decision is unreasonable and indefensible.
59. Additionally, the Applicant submits that the CPSA Certified Record of Proceedings
confirms the absence of the CPSA letter dated March 28, 2017 authored by the Hearings
Director David Kay, that indicated that Dr.MacEwan provided no written submission to the
Page 19 of 50
CRC in regards to 160350 or 160618, and did not deny any of the allegations in 160350 or
160618. This document is not listed in the July 20, 2017 CRC Decision “Documents
Reviewed by the CRC” section on page 1, and the March 28, 2017 document is also
absent from the CPSA Certified Record of Proceedings Form 9 signed by David Kay.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, Exhibit H – CRC Decision, page 1
CPSA Certified Record of Proceedings, supra, Form 9, Rule 3.19 signed by David Kay, p.1-2.
60. The Applicant submits that the CRC Panel did not have this crucial March 28, 2017
document, and the CRC Panel did not have the information contained within it, which was
that Dr.MacEwan had failed or refused to provide a response to 160350 or 160618, and
had not denied any of the allegations in 160350 or 160618. Accordingly, CRC could not
reach an honest, fair, balanced, reasonable and legally defensible Decision, because the
CRC Proceedings did not meet the level of fairness required by law. The Applicant
submits that it was the responsibility of the Hearings Director David Kay to provide all
necessary documentation to the CRC and David Kay failed or refused to do so, violating
the principles of natural justice and breaching the duty of procedural fairness.
CPSA Certified Record of Proceedings, supra, Form 9, Rule 3.19 signed by David Kay
iii. The CRC Review and Decision are unreasonable – Misrepresented background
61. The Applicant submits that there are “errors of fact” in the Background section of the CRC
Decision and that each of the following statements in the Background are false:
The complainant had concerns about the workflow in nuclear medicine. He had
several discussions with the Investigated Member and several follow-up emails were
sent to various other individuals complaining about the Investigated Member’s
alleged incompetent leadership. The ongoing relationship continued to erode
subsequently resulting in an Alberta Health Services Triggered Initial Assessment
investigation.
Central issue of both 160350 and 160618 was Dr.MacEwan’s physically and verbally
abusive conduct towards Dr.Makis and his colleagues. Not one allegation in 160350 or
160618 lists “workflow in nuclear medicine” or “incompetent leadership” as a concern. The
Applicant submits that these errors of fact are consistent with the CRC’s failure to review
Page 20 of 50
any documents pertaining to 160350, and strongly suggest that CRC did not review
160618 either.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.4,7, Exhibits A, D

62. The Applicant submits that there are additional errors of fact in the Background section of
the CRC Decision:
Without evidence of unprofessional conduct and given the nature of the

information provided, the Complaints Director dismissed the complaint without
investigation
Affidavit of Dr.Makis filed Jan.26, 2018 at para.8, Exhibit E – 160618 Decision Dr.Caffaro
The Applicant submits that this is an “error of fact”: “Without evidence of unprofessional
conduct” is a statement that claims Dr.Makis did not provide any evidence of
unprofessional conduct committed by Dr.MacEwan, to Dr.Caffaro. This is incorrect.
Dr.Makis filed 160350 with 246 pages of documentation in total and 160618 with 117
pages of documentation in total. The Applicant submits that Dr.Caffaro also did not make
the claim in his Decisions in 160350 or 160618 that Dr.Makis had not provided any
evidence of unprofessional conduct committed by Dr.MacEwan. Instead, Dr.Caffaro
concluded that there was “insufficient evidence of unprofessional conduct”. The Applicant
submits that these “errors in fact” may have played a role in the CRC reaching an
unreasonable CRC Decision.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.5, 8, Exhibit B, E – Decisions Dr.Caffaro
iv. The CRC Review and Decision are unreasonable – Decision (pages 3-5)
63. The CRC Decision spans barely 1.5 pages, from the last paragraph of page 3 to page 5.
The first paragraph reads as follows:
The CRC has reviewed all material and submissions and confirms that the complaint
is dismissed on the basis that there is insufficient evidence of unprofessional conduct
on the part of the Investigated Member.
This is a very unreasonable CRC Decision and is not in the range of possible or
acceptable outcomes defensible in respect of the facts and law. In respect of the facts, the
Page 21 of 50
CRC did not review the two documents whose review was unequivocally required to reach
a reasonable decision: namely 160350 and Dr.Caffaro’s decision on 160350. A review of
Dr.Makis’ Appeal of 160350 would also have been helpful to the CRC. The Applicant
submits that the statement “CRC has reviewed all material and submissions” is a
demonstrably false statement. The CPSA Certified Record of Proceedings Form 9 signed
by David Kay clearly lists documents in paragraph 1(d) which were not “documents
considered by the Complaint Review Committee” which are listed in paragraph 1(b).
Therefore “CRC has reviewed all material and submissions” is a false statement.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, Exhibit H:CRC Decision, page 1
CPSA Certified Record of Proceedings, supra, Form 9, 1(b) and 1(d).
64. Dr.Caffaro dismissed 160618 on the basis that Allegations 1-4 and 6-10 had already been
previously submitted in 160350, a claim that is denied by Dr.Makis, as already outlined in
the Applicant’s Brief. Dr.Makis has shown that 6 allegations were new in 160618, not one.
The CRC did not independently compare 160350 to 160618, and therefore there was no
reasonable way for the CRC to verify whether Dr.Caffaro’s comparison of 160350 or
160618 was appropriate, legitimate or reasonable. The CRC Decision, in the absence of
any CRC Review of 160350 or Caffaro’s Decision on 160350 is therefore unreasonable
and indefensible. The CRC could not reasonably uphold Dr.Caffaro’s Decision to dismiss
1601618 on the basis of similarity to 160350, if no review of 160350 was done by CRC.
65. The Applicant also submits that the CRC Decision is also unreasonable and not defensible
in respect of the facts given that the CRC appears to have not reviewed any of the 906
pages of CPSA Certified Record of Proceedings (other than the one page that it referred
to about Allegation 5 – page 31). This is supported by the list of documents that the CRC
didn’t review, which is in the CPSA Certified Record of Proceedings Form 9 signed by
Hearings Director David Kay in paragraph 1(d). Furthermore, in the list of Documents that
the CRC did claim to review, none of the remaining 905 pages of CPSA Certified Record
of Proceedings are referred to at all in the entire CRC Decision. There was no
Page 22 of 50
transparency in the decision-making process in regards to whether CRC reviewed any of
these 905 pages of documents or not, however the preponderance of evidence suggests
that the CRC did not review any of these 905 pages of documents. The Applicant submits
that the CRC decision-making process and document review process is unintelligible.
Accordingly the CRC Decision was also unreasonable in light of a failure or refusal to
review the documents that were available to the CRC.
CPSA Certified Record of Proceedings, supra, Form 9, at 1(b) and 1(d).

Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, Exhibit H – CRC Decision
66. Furthermore, given that the 906-page CPSA Certified Record of Proceedings also
contains documented first-hand accounts of physical assaults, harassment, verbal abuse,
intimidation, job threats, coercion, bullying, defamation, soliciting of complaints, medical
career sabotage, incidents which were experienced or witnessed by a number of Dr.Makis’
healthcare colleagues and alleged to have been committed by Dr.MacEwan, including the
following individuals:
Dr.David Williams (CCI Radiologist) – page 152-153, 160

Deborah Haldorson (CCI Radiology nurse) – page 31
Marlon Bonilla-Salazar (CCI Radiology Tech) – page 31
Brittany Sammann (CCI Nuclear Medicine tech) – pages 61-64, 155-157
Joanne Snydmiller (CCI Nuclear Medicine tech) – pages 157-158
Clayton Kozak, Joanne Snydmiller (CCI Nuclear Medicine techs) – page 66
Majority of CCI Radiologists – pages 114-119
and that the 906-page CPSA Certified Record of Proceedings page 147 also summarizes
and lists 25 Alberta healthcare workers who either reported directly being victims of
physical and or verbal abuse committed by Dr.MacEwan or were witnessed to be victims
of abuse, and that the CRC Decision makes no reference to any of these 25 alleged abuse
victims save for one (Allegation 5), also strongly suggests that CRC did not review these
905-pages of documents.
CPSA Certified Record of Proceedings, supra, pages 31, 61-64, 66, 114-119, 147, 152-160.
Page 23 of 50
67. The Applicant submits that the CRC Decision contains no analysis of any document
contained in the 906 page CPSA Certified Record of Proceedings ( save for page 31 for
Allegation 5). The Applicant further submits that in the CRC Decision, there was no
transparency regarding the review of Documents allegedly conducted by the CRC Panel.
Accordingly, the Applicant submits that it was very unreasonable for CRC to conclude that
there was “insufficient evidence of unprofessional conduct on the part of the Investigated
Member (Dr.MacEwan)”, if the CRC did not review any of the 905-pages in the CPSA
Certified Record of Proceedings. Furthermore, if the CRC claims that it did review these
documents, the Applicant submits that there was no transparency to the decision-making
process that would allow for any independent analysis of CRC’s alleged “Document
Review” and whether it was conducted properly, legitimately, thoroughly, with procedural
fairness and in accordance with principles of natural justice, or whether it was conducted
at all. Accordingly, the Applicant submits that the CRC Decision stating there was
“insufficient evidence of unprofessional conduct” is very unreasonable and does not fall
within a range of possible or acceptable outcomes that could be defensible in respect of
the facts and law.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, Exhibit H – CRC Decision.

CPSA Certified Record of Proceedings, supra, Form 9, at 1(a) to 1(d).
68. The CRC Decision repeatedly offers the same false allegations made by Complaints
Director Dr.Caffaro regarding 160618 being a “duplicate” of 160350:
CRC agrees with the Complaints Director that it is generally not permitted for
complainants in professional disciplinary regimes to make multiple complaints about
the same allegation of unprofessional conduct.
Once a matter has been considered, complainants are generally not permitted to
resubmit a complaint simply because a new piece of evidence is provided.
These statements are general and unreasonable, because the CRC did not review 160350
nor did it independently compare 160350 to 160618 to be able to make any determination
whether 160618 amounted to “multiple complaints about the same allegation”. Therefore
the CRC cannot simply “agree with the Complaints Director” if it cannot ascertain whether
Page 24 of 50
the Complaints Director was telling the truth about 160350 being similar to 160618 or not.
The CRC did not independently determine the veracity of the Complaints Director’s
Dismissal of 160618 (on the basis of being a “resubmission” of 160350). The CRC did not
conduct any independent analysis to compare 160350 to 160618 (which is what it was
constituted pursuant to section 16 of the HPA to do), and by failing or refusing to do so,
the CRC breached its duties and responsibilities pursuant to section 68 of HPA (the CRC
was constituted to independently review the Complaints Director’s Decisions, not to
regurgitate, repeat or “generally agree” with them). The Applicant also submits that for the
CRC to make claims about 160618 being similar to 160350 without having reviewed
160350 or the Complaints Director’s Decision on 160350 was a violation of the principles
of natural justice and a breach of duty of procedural fairness.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, Exhibit H – CRC Decision.
69. In the CRC Decision, in its review of 160618 Allegations 1-4, CRC states:
With respect to allegations 1-4…the CRC finds that, in fact, those matters (160618)
were considered in a previous complaint (160350), and were ultimately dismissed.
To the extent that the Complainant suggests in this review that the Complaints
Director did not appropriately consider the information available to him, this CRC is
not able to review that decision (160350), and any remedy in relation to that alleged
failure would have to be pursued in the previous complaints. The decision of the
Complaints Director on this issue was reasonable based on the information before
him and on the general legal principles noted above.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, Exhibit H – CRC Decision
(emphasis added), page 4.
The Applicant submits that these statements are irrational, mutually exclusive and very
unreasonable. CRC contradicts itself by claiming that CRC finds that “those matters”
(160618) were considered in a previous complaint (160350) and were ultimately
dismissed, but then immediately admits that CRC “is not able to review that decision”
(Dr.Caffaro’s Decision to dismiss 160350 and whether he reviewed all supporting
documents before making that decision). The Applicant submits that these two CRC
statements are mutually exclusive and only one of them can be correct and accurate.
Either CRC fully reviewed both 160618 and 160350 and concluded that the matters in
Page 25 of 50
160618 were already considered properly in 160350 and thus could be dismissed,
properly upholding the Complaints Director’s Decision, or the other possibility is that the
CRC did not review 160350, did not compare 160618 to 160350 and then improperly
concluded, in violation of principles of natural justice and procedural fairness, that 160618
was similar enough to 160350 to be dismissed, thereby upholding Dr.Caffaro’s decisions
to dismiss 160618 and 160350 without verifying whether these decisions were at all
reasonable, appropriate or legally defensible. The Applicant submits that since CRC
admitted in the CPSA Certified Record of Proceedings signed by David Kay (and on page
1 of the CRC Decision itself) that it did not review 160350 and it did not review
Dr.Caffaro’s decision on 160350, accordingly the CRC’s Decision on Allegations 1-4 of
160618, is very unreasonable, does not fall within a range of possible or acceptable
outcomes, and is indefensible in respect of the facts and the law. Furthermore, the
Applicant submits that CRC admits that it agrees with Dr.Caffaro’s Dismissal “on the
general legal principles noted above”, which further adds to the preponderance of
evidence that the CRC likely agreed with Dr.Caffaro on the general principles that once a
complaint was dismissed it cannot be resubmitted, but that CRC did not actually compare
160350 to 160618 and accordingly, the CRC failed or refused to review Dr.Caffaro’s
Decision to dismiss 160618, in violation of its duties pursuant to section 68 of HPA.
CPSA Certified Record of Proceedings, supra, Form 9, at 1(a) to 1(d).

Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, see Exhibit H – CRC Decision
70. Furthermore, there is an error in fact in the following CRC statement about Allegations 1-4:
With respect to allegations 1-4, the complainant does not deny that the same
allegations were made in the past.
This is a false statement and a fraudulent misrepresentation of Dr.Makis’ December 14,
2016 Appeal letter. The following allegations were new in 160618 (and were absent in
160350):
2. Sabotage of medical practice of Dr.David Williams following physical assault

3. Threats to the medical practice of Dr.David Williams.
Page 26 of 50
Affidavit of Dr.Makis filed Jan.26, 2018 at para.11, see Exhibit G.
71. In regards to CRC Decision, in its review of 160618 Allegations 6-10, the CRC states:
Concerning allegations 6-10, the CRC finds that the substance of the allegations
were made by the Complainant in his previous complaint (160350). For the reasons
stated above, it was reasonable for the Complaints Director to dismiss those
allegations, even if the Complainant provided additional information which (in his
view) buttressed the concerns.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, see Exhibit H – CRC Decision, page 5
72. The Applicant submits that for reasons already outlined in paragraphs 55 to 70 of the
Applicant’s Brief, the CRC Decision to dismiss Allegations 6-10 of 160618 was very
unreasonable, did not fall into the range of possible or acceptable outcomes, and was not
defensible in respect of the facts and law. For the CRC Decision to dismiss Allegations 6-
10 of 160618 because “the substance of the allegations were made by the complainant in
his previous complaint (160350)”, the CRC would have had to review the previous
complaint 160350 and Dr.Caffaro’s Decision on 160350 which, as already established in
the Applicant’s brief in paragraphs 55 to 70, the CRC did not perform, as confirmed in the
CPSA Certified Record of Proceedings Form 9, which lists the documents reviewed in
paragraph 1(b) and those not reviewed in paragraph 1(d). Accordingly, without any review
of documents pertaining to 160350, the CRC could not reasonably reach this conclusion
on Allegations 6-10 of 160618.
CPSA Certified Record of Proceedings, supra, Form 9, 1(a) to 1(d).

Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, see Exhibit H – CRC Decision.
73. Further, in regards to CRC Decision on Allegations 6-10 of 160618, the CRC states:
For the reasons stated above, it was reasonable for the Complaints Director to
dismiss those allegations, even if the Complainant provided additional information
which (in his view) buttressed the concerns.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, see Exhibit H – CRC Decision
The Applicant submits that with this statement, the CRC continued to make the fraudulent
misrepresentation that it had compared the information contained within 160350 with
160618 especially in regards to the “additional information which (in his view) buttressed
the concerns”. Once again, the CRC Decision is not transparent – the CRC does not
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explain or identify what this additional buttressing information is. Furthermore, CRC did not
review 160350, therefore it had no reasonable or legally defensible way of determining
which information was “additional information which buttressed the concerns”. The
Applicant submits that this CRC Decision statement strongly supports the Applicant’s
position, that the CRC Decision was not simply a failure of the CRC to abide by its legal
duties and responsibilities to properly review Dr.Caffaro’s Dismissal of 160618 pursuant to
section 68 of the HPA, but that the CRC deliberately engaged in a cover-up to uphold
Dr.Caffaro’s Decision to dismiss 160618 (and deliberately did not conduct any review of
160350) for the bad faith and malicious purpose of covering-up all allegations of physically
and verbally abusive conduct committed by Dr.MacEwan. The Applicant submits that the
CRC did this knowingly, willingly and with the full understanding that the CRC Decision
would cause harm to healthcare staff (including Dr.Makis) and to patients alike.
74. The Applicant submits that the CRC deliberately breached the principles of natural justice
and the duty of procedural fairness by dismissing allegations 6-10 of 160618 without
conducting any review of 160350 or Dr.Caffaro’s dismissal of 160350, and also
deliberately breached its legal duties and responsibilities pursuant to section 3 of HPA and
HPA as a whole.
75. Specifically in its review of 160618 Allegation 5, CRC Decision stated:
Although the nature of the allegation in the email suggests rude behavior by the
investigated member, there is insufficient evidence of the conduct which would
amount to “unprofessional conduct”
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, Exhibit H – CRC Decision, p.4
The Applicant submits that this CRC Decision is also very unreasonable in the absence of
any investigation of the allegation by the CPSA. This type of verbally abusive behaviour by
Dr.MacEwan toward a Diagnostic Imaging technologist was also documented in writing by
another Diagnostic Imaging Technologist Brittany Sammann who wrote to Dr.Makis on
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August 28, 2015, that if she was subjected to such verbal abuse by Dr.MacEwan again
she would quit her job (pages 61-64 of CPSA Certified Record of Proceedings). The CRC
cannot reasonably conclude, in a legally defensible manner, that there is “insufficient
evidence” of unprofessional conduct in Allegation 5, as the CRC itself admits:
It is abundantly clear that the original email sent by DH was her first-hand
observations of an alleged interaction between the Investigated Member and a third-
party. DH was reporting this information to an internal supervisor, not the
Complainant. The information was provided by the Complainant to the Complaints
Director. It was not the first-hand observations of the Complainant, or even the
supervisor who appears to have received the email.
The CRC does admit that Allegation 5 and its supporting document (page 31 of the CPSA
Certified Record of Proceedings, an email authored by “DH” to her manager Quinn West),
the only document of the entire 906-pages of CPSA Certified Record of Proceedings that
the CRC confirms it reviewed and referred to in its entire CRC Decision, is a first-hand
observation of an “alleged interaction” with the Investigated Member (Dr.MacEwan).
However, CRC casts an aspersion on this testimony of an abuse witness, by noting that
the abuse was not reported directly to the Complainant Dr.Makis, or that Dr.Makis did not
have “first-hand observations” of the abuse. In further lack of transparency of its decision-
making process, the CRC does not explain why it matters that Dr.Makis did not witness
the abuse or did not receive report of it directly.
CPSA Certified Record of Proceedings, supra, at p.31.
76. The Applicant submits that pursuant to section 56 of the HPA, CPSA has the authority to
investigate unprofessional conduct that is not reported directly by an abuse victim to the
CPSA formally, but that the CPSA becomes aware of in some manner (verbally or
otherwise). If the CPSA becomes aware of possible unprofessional conduct, it can open a
complaint and act as the “Complainant” pursuant to section 56 of the HPA and then launch
an Investigation and Hearing pursuant to section 55 of the HPA. The Applicant submits
that this course of action was available to the Complaints Director Dr.Caffaro, who
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deliberately chose not to Investigate this allegation of verbal abuse in the workplace
committed by Dr.MacEwan.
77. In regards to Allegation 5 of 160618, the Applicant argues that the documented witness
account of the verbal abuse, documented by Radiology nurse “DH”, was sufficient for the
CPSA to open a complaint pursuant to section 56 of the HPA and act on it by conducting
Investigation and or Hearing pursuant to section 55 of the HPA. There is a legal precedent
for CPSA taking action in this type of situation. In Makis (Re), a healthcare coworker made
unsubstantiated allegations against Dr.Makis over the phone to CPSA without filing a
formal complaint. CPSA (Dr.Caffaro) launched an Investigation of these informal and
unfiled verbal allegations pursuant to Section 56 acting as the Complainant, and pursued a
CPSA Hearing pursuant to HPA, notwithstanding that the CPSA Investigation showed no
evidence and no witnesses to substantiate the allegations against Dr.Makis.
Makis (Re), 2018 CanLII 127231 (AB CPSDC) [TAB 9]
78. The Applicant submits that CRC dismissing Allegation 5 of 160618 was unreasonable, not
within the range of possible or acceptable outcomes and was indefensible in respect of the
facts and law. Furthermore, it was consistent with Dr.Caffaro’s and CRC’s abrogation of
their legal duties and responsibilities pursuant to section 3 of HPA and HPA as a whole.
79. The CRC Decision then provided the following statement:
The CRC also notes that the Investigated Member serves as site director for the CCI,
and under his portfolio he is responsible for management of physician workforce.
Any critique of a physician in this role is not necessarily demonstrative of harassment
or abuse, let alone of unprofessional conduct.
The Applicant submits that this statement is biased and deliberately misrepresents the
Allegations in 160350 and 160618. The Applicant submits that none of the Allegations in
160350 or 160618 critiqued or were concerned with Dr.MacEwan’s role in “management of
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physician workforce” and that none of the allegations in 160350 and 160618 conflated
Dr.MacEwan’s AHS Administrative role in managing the Diagnostic Imaging Department at
CCI, with actual physical and or verbal abuse that was committed by Dr.MacEwan against
CCI healthcare staff including Dr.Makis, which was unprofessional conduct regardless of
whether Dr.MacEwan was simply a colleague or AHS Site Chief of Diagnostic Imaging.
The Applicant submits that this statement in the CRC Decision would be expected of
Dr.MacEwan’s legal counsel and not of an impartial, independent CPSA body or Tribunal.
80. Furthermore, the Applicant submits that CRC’s deliberate misrepresentation of the
Allegations in 160350 and 160618 further supports the Applicant’s position that the CRC
did not review any documents in the 906-page CPSA Certified Record of Proceedings
(save for Allegation 5, page 31), as none of the 906-pages of documents conflate
Dr.MacEwan’s “management of physician workforce” with incidents of physical abuse or
verbal abuse committed by Dr.MacEwan.
81. The final concluding paragraph of the CRC Decision on page 5 offers the following:
CRC believes that the decision made by the Complaints Director was reasonable;
The Applicant submits that this CRC Decision is also very unreasonable and does not fall
within the range of possible, acceptable outcomes defensible in respect of the facts and
law, due to all the reasons outlined in paragraphs 55 to 80 of this Brief, particularly the
failure to review 160350 and Dr.Caffaro’s 160350 dismissal. The Applicant submits that
the CRC failed to provide any justification for this Decision, beyond stating that it simply
agrees with the Complaints Director’s dismissal of 160618. The CRC’s decision-making
process lacked transparency, as, save for Allegation 5, the CRC did not explain how it
arrived at the conclusion that Dr.Caffaro’s dismissal of 160618 was “reasonable”.
Furthermore, the decision-making process also lacked transparency as 905 of the 906
pages of the CPSA Certified Record of Proceedings were not referred to at all in the CRC
Decision, there was no documented comparison between 160350 and 160618, there was
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no independent analysis of the allegations in either 160350 or 160618 and there was no
independent analysis of Dr.Caffaro’s Dismissal letters for either 160350 or 160618.
82. The Applicant submits that there was no intelligibility or transparency within CRC’s
decision-making process. The CRC Decision did not provide any intermediate steps that
could be followed or that led to the final CRC Decision.
83. Furthermore, the CRC Decision contained a number of general statements about
“definition of unprofessional conduct” and “limited jurisdiction” which were non-contributory
to the CRC Decision itself. Adding to the lack of intelligibility within the CRC’s decision-
making process, the CRC did not explain how it reached the conclusion that it agreed with
Dr.Caffaro’s dismissal of 160618, in regards to Allegations 1-4 and 6-10. In regards to
Allegations 1-4, CRC Decision states:
The decision of the Complaints Director on this issue was reasonable based on
the information before him and on the general legal principles noted above.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, Exhibit H – CRC Decision, p.4.
The Applicant submits that CRC did not explain or identify what these “general legal
principles” were and what they had to do with the Complaints Director’s decision to
dismiss 160618.
84. In regards to the following statement in the CRC Decision on page 5:
There is insufficient evidence of a violation of the relevant provisions of the Code of

Ethics, Standards of Practice, any other legislation which might apply to the
investigated member, or any conduct which would harm the integrity of the
profession to refer the matter for investigation or for a hearing.
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, Exhibit H – CRC Decision (emphasis added), p.5.
The Applicant submits that this CRC Decision is also very unreasonable and does not fall
within the range of possible or acceptable outcomes defensible in respect of the facts and
law. In respect of the facts, the CRC did not make the case that Dr.Makis falsely reported
being harassed, threatened in regards to his employment, intimidated, defamed, being a
victim of career sabotage, and having had his cancer treatments unlawfully reported and
signed by Dr.MacEwan. However the CRC Decision unequivocally took the position that
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Dr.Makis was not worthy of belief in regards to his testimony about being a victim of
Dr.MacEwan’s abusive and unprofessional conduct, however the CRC did not explain why
it took this position, and failed to be transparent and intelligible about it.
85. The CRC also did not make the case that Radiologist Dr.David Williams falsely reported
being physically assaulted when he authored a letter on pages 152-153 of the CPSA
Certified Record of Proceedings that stated: “Please find below a short timeline of events
leading up to a physical assault by Dr.R.MacEwan upon myself”. However the CRC
Decision unequivocally took the position that Dr.Williams was not worthy of belief in
regards to his testimony about being physically assaulted by Dr.MacEwan. The CRC did
not explain why it took this position in regards to Dr.Williams, and once again failed to be
transparent and intelligible about it.
CPSA Certified Record of Proceedings, supra, p.152-153.
86. The same argument can be made about every single document in the 906 pages of CPSA
Certified Record of Proceedings that documents incidents of physical abuse, verbal
abuse, harassment or other type of abuse committed against a total of 25 healthcare staff.
The CRC unequivocally took the position that none of the victims of abuse or witnesses of
abuse were worthy of belief. The CRC did not explain why it took this position and failed to
be transparent and intelligible about it. Furthermore, although Dr.MacEwan did not provide
a written response to any of the Allegations in 160350 and 160618 and also did not deny
any of these allegations, the CRC took the position that Dr.MacEwan was innocent of all
allegations and should not be subjected to an Investigation. The Applicants submit that the
CRC’s position with regards to the victims of abuse as described here in, finding all 25
victims of abuse (including Dr.Makis and Dr.Williams) not worthy of belief, is unreasonable
and indefensible in respect of the facts and law.
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87. In respect of the facts, the CRC cannot reasonably claim that 906 pages of CPSA Certified
Record of Proceedings constitutes “insufficient evidence”, especially in light of the fact that
the CRC failed or refused to refer to all 906-pages of these documents, save for one.
88. In respect of the law, the CRC cannot reasonably or successfully argue legally that
physical assault, harassment, verbal abuse, intimidation, threats, coercion, human rights
abuses, soliciting complaints, conspiracy, defamation, medical career sabotage, and even
improper reporting of cancer patient therapy work, do not constitute violations of the
relevant provisions of CPSA Code of Ethics and CPSA Standards of Practice as claimed
in the CRC Decision. In 160618, in respect to Allegations 1-10, Dr.Makis identified the
violations of the relevant and specific provisions of the CPSA Code of Ethics (Numbers 1,
3, 7, 9, 14, 15, 48, 51, 52), and CPSA Standards of Practice (Collaboration in patient care
2), which the CRC had available to them on pages 26-27 of the CPSA Certified Record of
Proceedings but which the CRC did not refer to in its CRC Decision at all.
CPSA Certified Record of Proceedings, supra, p.26-27.
89. The Applicant submits that the CRC Decision regarding 160618 Allegations 1-10 not
constituting violations of the relevant provisions of CPSA Code of Ethics and or CPSA
Standards of Practice, in the absence of any CSPA Investigation, and for the reasons
stated above, is very unreasonable and not within the range of possible or acceptable
outcomes which are defensible in respect of the facts and law.
90. The Applicant submits that the CRC Decision did not provide any justification for reaching
the conclusion that there is “insufficient evidence of violations of Code of Ethics and
Standards of Practice” and it failed or refused to address any of the supporting
documentation provided by abuse victims and abuse witnesses in the 906-page CPSA
Certified Record of Proceedings (other than Allegation 5 which the CRC attempted to
downplay and diminish by claiming that the abuse was not worthy of Investigation because
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it was not witnessed by or reported directly to Dr.Makis). Furthermore, this CRC Decision
and the decision-making process used to reach it also lacked transparency and
intelligibility.
91. In regards to the CRC Decision statement that there is “insufficient evidence…of conduct
which would harm the integrity of the profession to refer the matter for investigation or for a
hearing” the Applicant submits that this CRC Decision is also very unreasonable and not
within the range of possible or acceptable outcomes which are defensible in respect of the
facts and law. The CRC cannot reasonably argue that physical assault, harassment,
verbal abuse, intimidation, threats, coercion, human rights abuses, soliciting complaints,
conspiracy, defamation, medical career sabotage committed against healthcare staff by a
regulated member of CPSA, and even improper reporting of cancer patient therapy work
do not “harm the integrity of the profession”. There is a legal precedent in Al-Ghamdi (Re)
for the CPSA Investigating, sending to a Hearing and Reprimanding and penalizing exactly
the type of behaviour that AHS Administrator Dr.MacEwan engaged in:
The concerns arose form Dr.Al-Ghamdi’s interactions with healthcare colleagues

(physicians and nurses) and from AHS management.
92. The Applicant submits that the entire CRC Decision and the decision-making process
utilized by CRC, lacked transparency and intelligibility in regards to the individual
contributions of the three CRC Panel members (Dr.Randy Naiker - Chair, Dr.Brinda
Balachandra, and public member Ms.Nancy Brook). The CRC Decision did not identify
what the contributions of each CRC panel member were to the overall CRC Decision.
Since there were at least four individual CRC decisions (1. Dr.Caffaro acted reasonably in
dismissing 160618, 2. there was insufficient evidence of unprofessional conduct, 3. there
was insufficient evidence of violation of Code of Ethics or Standards of Practice, 4. there
was insufficient evidence of harm to integrity of profession to refer the matter for
investigation or hearing), each of these CRC Decisions required transparency and
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intelligibility as to the opinion and decision of each CRC panel member that subsequently
led to the overall alleged “unanimous” agreement of the three CRC panel members on the
final CRC Decision. This transparency was not provided in the CRC Decision and is, in
fact, entirely absent. The Applicant submits that this lack of transparency and intelligibility
of the contribution of each CRC panel member to each of the individual CRC Decisions
and the final CRC Decision as a whole, adds to the lack of credibility and lack of
reasonableness of the final CRC Decision.
c. Did the CPSA CRC Breach the Duty of Procedural Fairness?
93. The Applicant submits, that as in Farhat v CPSA, at para (26):
the Court is not required to conduct an assessment of the appropriate standard of

judicial review. Rather, procedural fairness is evaluated on the basis of whether or
not the procedures and safeguards adopted by a tribunal in a particular situation
have complied with the duty of fairness: Moreau-Bérubé v New Brunswick (Judicial
Council), 2002 SCC 11 (CanLII) at paras 74-75, [2002] 1 SCR 249.
94. The Applicant submits that the CPSA and CRC had a duty of procedural fairness that
applied to the CRC Review and CRC Decision which affected the rights, privileges and
interests of Dr.Makis. In Farhat v CPSA, Justice Pentelechuk noted at para (51):
a duty of procedural fairness applies to the Review Panel’s decisions that affect “the
rights, privileges or interests of an individual”: Cardinal v Director of Kent
Institute, 1985 CanLII 23 (SCC), [1985] 2 SCR 643 at para 14, [1985] SCJ No
78 [Cardinal].
95. The Applicant submits the following observation made by Justice Pentelechuk in Farhat v
CPSA, at para (53):
Procedural fairness ensures that administrative decisions are made using a fair,
impartial, open and transparent process that provides those affected by the decision
an opportunity to know the case against them and to fully put forth their views and
the evidence they wish the decision-making body to consider.
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96. The Applicant proposes the following 5 factors to consider in the context of the duty of
procedural fairness in the administrative law context. From Farhat v CPSA, at para (54):
the Supreme Court in Baker at paras 21-28 outlines five factors to consider in the
context of the duty of procedural fairness in the administrative law context. They include:
(1) the nature of the decision being made and process followed in making it; (2) the
nature of the statutory scheme and the terms of the statute pursuant to which the body
operates; (3) the importance of the decision to the individual or individuals affected; (4)
the legitimate expectations of the person challenging the decision; (5) the choices of
procedure made by the agency itself.
i. The nature of the CRC Decision and process followed in making it
97. The more the administrative process is like a judicial process, the more likely the
procedural protections afforded in a trial model will be required. In this case, Dr.Makis was
afforded the right to make a written submission only. This decision was made unilaterally
by CPSA Hearings Director David Kay on January 17, 2017 via a letter issued to Dr.Makis.
Dr.Makis was unilaterally deprived of the opportunity to make any oral submissions or call
any witnesses pursuant to section 68(4) of the HPA, which, given the serious nature of the
allegations, would have significantly impacted the outcome of the CRC Review and CRC
Decision, as there were up to 25 healthcare staff victims of physical and or verbal abuse
committed by Dr.MacEwan who were Dr.Makis’ healthcare colleagues, that Dr.Makis was
denied the opportunity to call as witnesses. The Applicant submits that this was a breach
of the duty of procedural fairness.
Affidavit of Dr.Makis, filed Jan.24, 2019, at para 5, see Exhibit B.
98. Further, CPSA omitted or deliberately suppressed documents which confirmed that
Dr.MacEwan did not make any written submission to the CPSA or CRC, and that
Dr.MacEwan did not deny any of the allegations in 160350 or 160618. The evidence for
this is the absence of Hearings Director David Kay’s March 28, 2017 letter within the
CPSA Certified Record of Proceedings, Form 9 signed by David Kay. Further, the CRC
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failed or refused to consider Dr.MacEwan’s absence of a written submission and absence
of any denial of the allegations in 160350 and 160618 in its decision-making process when
reaching the CRC Decision. The CRC Decision itself makes no mention of the fact that
Dr.MacEwan did not deny the allegations in either 160350 and 160618 and did not submit
a written response to the allegations in 160350 and 160618. The Applicant submits that
CRC failing to consider this crucial information of the complete absence of response by
the Respondent to the 160618 complaint (Dr.MacEwan) violated the principles of natural
justice and in doing so the CRC also breached the Duty of Procedural Fairness.
Affidavit of Dr.Makis sworn Jan.24, 2019, at para 6, Exhibit C, Mar.28, 2017 letter.
99. The Applicant submits that in a judicial setting, if a respondent fails or refuses to respond
to a Civil Application and fails to present themselves in Court after being properly served,
the presiding judge does not take on the role of the Respondent’s legal counsel. The
Applicant argues that in this case, the CRC took on the role as Dr.MacEwan’s legal
counsel and defended Dr.MacEwan as passionately as if the CRC had been legally
retained to defend Dr.MacEwan. The Applicant submits that this was a breach of CRC’s
legal duties and obligations pursuant to section 3 of the HPA and the HPA as a whole.
100. The Applicant submits that CRC refused to release any details regarding the process it
followed in reviewing documents listed in the “Documents Reviewed by CRC” list on page
1 of the CRC Decision, or any evidence that these documents were reviewed at all. This is
particularly concerning as the CRC did not refer to 905 of the 906 pages of documents of
the CPSA Certified Record of Proceedings, in its entire CRC Decision. Furthermore, the
Applicant also submits that CRC did not review 160350, or Dr.Caffaro’s Decision on
160350 as confirmed in the CPSA Certified Record of Proceedings Form 9. The Applicant
submits that CRC’s failure or refusal to review 160350 or Dr.Caffaro’s Decision on 160350,
and the CRC’s apparent failure or refusal to review any of the 905 pages of documents in
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the CPSA Certified Record of Proceedings was a breach of the duty of procedural
fairness.
CPSA Certified Record of Proceedings, supra, Form 9, Rule 3.19 signed by David Kay
Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, Exhibit H – CRC Decision, page 1.
ii. the nature of the statutory scheme and the terms of the statute pursuant to which
the body operates
101. The plaintiffs submit that the aim or scheme of the HPA as a whole is the safe practice of
medicine in the province of Alberta, which includes regulating not just the safety of the
conduct of physicians toward patients but also the safety of the conduct of physicians
towards their colleagues and co-workers. The College’s role is very clearly described in
section 3 of the HPA and applies to all CPSA employees, bodies and tribunals, including
the CRC.

102. The Applicant submits that in the handling of 160350 and 160618, CPSA Registrar
Dr.Trevor Theman, CPSA Hearings Directors Dr.Kate Reed and David Kay, and CPSA
Complaints Director Dr.Caffaro all abrogated their legal duties and responsibilities
pursuant to section 3 of the HPA and HPA as a whole, to the detriment of Alberta patients
and healthcare staff, and took deliberate steps to cover-up the physical, verbal and other
abuses committed against Alberta healthcare staff and the unlawful, unprofessional and
unethical conduct of AHS Administrator Dr.MacEwan, and did so on behalf of senior AHS
Executives that Dr.MacEwan reports directly to: Senior Medical Director of AHS
CancerControl Alberta Dr.Matthew Parliament and AHS Vice President and AHS Chief
Medical Officer Dr.Francois Belanger.
103. The Applicant submits that this CPSA cover-up started in or about June 2016 after the
filing of 160350 and then 160618, with Dr.Caffaro dismissing both 160350 and 160618,
followed by Dr.Reed attempting to block an appeal of 160350, then Dr.Theman ignoring all
of Dr.Makis’ concerns on Nov.24, 2016; and it is in this milieu of CPSA corruption and full
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abrogation of all duties and responsibilities pursuant to the HPA in its entirety, that the
CPSA Hearings Director David Kay constituted the CRC on Jan.17, 2017, which
immediately compromised the CRC, compromised its mandate (which was evidently to
continue the abuse cover-up) and compromised its ability to be independent and to
conduct an independent review of 160618 and 160350 pursuant to section 68 of the HPA,
which it subsequently failed or refused to do, in violation of its legal duties and obligations
under the HPA.
104. The Applicant submits that the CRC was equally callous in handling allegations of
unprofessional conduct by Dr.MacEwan that harmed healthcare staff as the CRC was in
the handling of unprofessional conduct by Dr.MacEwan that harmed patients. Although the
overall aim of the HPA is to protect patients, healthcare staff and society from incompetent
or abusive physician conduct, the CRC appeared to be wholly unconcerned as to who was
harmed by Dr.MacEwan’s professional misconduct. Allegation 10 of 160618 which
reported potential harm inflicted on patients who received cancer treatments from
Dr.Makis but were medically reported and signed by Dr.MacEwan who had not known
these patients and had no doctor-patient relationship with any of the patients whose
treatments he signed his name to, was treated with the same dismissive callousness as
allegations which reported harm committed against healthcare staff (Allegations 1-9).
Affidavit of Dr.Makis, filed Jan.26, 2018, at paras 5, 8, Exhibits B, E: Caffaro Dismissals.
iii. The importance of the Decision to the individual affected
105. The Applicant proposes the following observation made by Justice Pentelechuk in Farhat
v CPSA, at para [56]:
It is recognized, for example, that a higher standard of justice is required when the
right to continue in one’s profession or employment is at stake.
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The Applicant submits that the CPSA Complaint 160350 was filed against Dr.MacEwan on
June 1, 2016 and two months later, the direct supervisor of Dr.MacEwan, Dr.Matthew
Parliament retaliated against Dr.Makis by not renewing one of Dr.Makis’ AHS contracts.
Although Dr.Makis continues to have one active contract with AHS and active hospital
privileges, Dr.Makis has been unlawfully prevented from working at his CCI medical
practice due to ongoing threats being issued by AHS and CPSA legal counsels, the
unlawful confiscation of Dr.Makis’ office keys and the unlawful changing of Dr.Makis’
medical office workstation passwords, and unlawful removal of Dr.Makis’ items from his
CCI office. The 160618 Allegations 6 to 9, which the CRC claims to have reviewed,
contained extensive documentation of direct sabotage of Dr.Makis’ medical career by
Dr.MacEwan and his AHS Administrator Colleagues Mr.Quinn West and Dr.Matthew
Parliament. The CRC Decision directly affected Dr.Makis’ medical career which was
severely injured first as a result of Dr.Caffaro dismissing 160350 (just prior to the non-
renewal of one of Dr.Makis’ AHS contracts), then by Dr.Caffaro dismissing 160618 and
then the CRC Decision upholding Dr.Caffaro’s dismissals of both 163050 and 160618. By
then, however, Dr.Makis had already filed a $13.5 million lawsuit against AHS, QB1603-
18935, regarding the sabotage of Dr.Makis’ medical career as described herein.
CPSA Certified Record of Proceedings, supra, page 107, AHS Contract non-renewal.
CPSA Certified Record of Proceedings, supra, page 203-220, $13.5 mil lawsuit QB1603-18935.
106. The Applicant submits that a higher standard of justice was required for the CRC Review
and CRC Decision because the right of Dr.Makis to continue in his employment at CCI and
in his profession, were at stake and this was fully known to the CRC Reviewers.
Dr.MacEwan had been caught openly expressing to senior AHS Administrators
responsible for Dr.Makis’ AHS contract, that Dr.MacEwan planned to undertake (and
subsequently undertook) actions to ensure Dr.Makis would be removed from AHS
Organization and that Dr.Makis’ AHS contract would not be renewed (also fully known to
CRC Reviewers):
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I think that we (AHS) should strongly consider exploring contract non-renewal and I
will begin advocating for same this coming week. Your technology staff need to write
everything down. If they will not, then perhaps you/Scott could meet with each of
them individually and record each of her/his experiences with Dr.Makis. I’m
convinced that this physician ought to be dismissed from the organization…it’s likely
the only way forward.
CPSA Certified Record of Proceedings, supra, page 59, Aug.23, 2015 email by Dr.MacEwan.
107. Dr.MacEwan had also confessed that he would solicit complaints from Dr.Makis’
colleagues and would coerce and harass them into filing complaints against Dr.Makis to
get Dr.Makis fired, and then proceeded to do so with Dr.Makis’ technology colleagues
Brittany Sammann, Joanne Snydmiller and a number of other technologists. This is
documented in 160618 Allegation 07 (CPSA Certified Record of Proceedings pages 15-
22). CRC was fully aware that Dr.Makis’ AHS contract was not renewed on July 29, 2016
(CPSA Certified Record of Proceedings page 107), and CRC was fully aware that
Dr.Makis had filed a $13.5 million lawsuit regarding the sabotage of his medical career by
Dr.MacEwan and his AHS Administrator colleagues on October 27, 2016 and CRC was in
possession of the Statement of Claim (CSPA Certified Record of Proceedings 203-220).
The CRC was fully aware of the damaging impact of Dr.Caffaro’s mishandling of 160350
and 160618 on Dr.Makis’ medical career, CRC had all of the above listed supporting
documents available to them prior to the CRC Review and CRC Decision and chose to
ignore all of these documents. The Applicant submits that the CRC Decision contains no
mention of damage to Dr.Makis’ medical career, no mention of the non-renewal of
Dr.Makis’ AHS contract and no mention of the $13.5 million lawsuit that was filed by
Dr.Makis against AHS as a result of Dr.Caffaro’s damages inflicted on Dr.Makis’ medical
career. The Applicant submits that CRC violated procedural fairness by ignoring all of
these documents and factors that contributed to the damage of Dr.Makis’ medical career.
CPSA Certified Record of Proceedings, supra, page 15-22, 107, 203-220.
Page 42 of 50
108. The Applicant submits that there is no evidence that the CRC reviewed any of the
documents contained in the 906-page CPSA Certified Record of Proceedings that
pertained to the sabotage of Dr.Makis’ medical career by Dr.MacEwan (160618,
Allegations 06-09), or that it reviewed the non-renewal of Dr.Makis’ AHS Contract (page
107), or that it reviewed the Statement of Claim filed against AHS QB1603-18935 (pages
203-220). The Applicant submits that the CRC breached the duty of procedural fairness
and principles of natural justice by not reviewing or commenting on any of these
documents which the CRC was in possession of, which showed that Dr.Makis’ medical
career had been severely damaged and destroyed. The CRC was required to maintain a
higher standard of justice given that Dr.Makis’ medical career, medical reputation and
medical employment were at stake and the CRC failed to uphold this higher standard of
justice.
109. The Applicant submits that one such failure of the CRC to uphold a higher standard of
justice is that it deprived Dr.Makis of the opportunity to provide oral submissions or call
witnesses, notwithstanding that section 68 of the HPA provided for these options, which
the CPSA Hearings Director David Kay unilaterally deprived Dr.Makis of out of hand.
110. The Applicant submits that another such failure of the CRC to uphold a higher standard of
justice is that it did not conduct a full and thorough document review of all the documents
available before it (the 906 pages of CPSA Certified Record of Proceedings), and that it
did not conduct a review of Dr.Caffaro’s decision on 160350 or the complaint 160350 itself,
notwithstanding that the CRC Decision then claimed that Dr.Caffaro’s dismissal of 160350
and 160618 were “reasonable” without providing any justification or transparency in the
decision-making process that was used to arrive at the CRC Decision.
Page 43 of 50
111. The Applicant submits that another such failure of the CRC to uphold a higher standard of
justice is that it did not review the CPSA March 28, 2017 letter authored by CPSA
Hearings Director David Kay which confirmed that Dr.MacEwan had not provided a written
submission to CRC and had not responded to any of the allegations in 160350 or 160618
and that Dr.MacEwan did not deny any of these allegations to the CPSA. In fact, the
CPSA Certified Record of Proceedings does not even contain this document (the March
28, 2017 letter), suggesting that the CRC Decision was reached with no consideration of
Dr.MacEwan’s response to 160618 or 160350 as the “Respondent” to Dr.Makis’ CPSA
Complaints. The Applicant submits that it was the responsibility of the CPSA Hearings
Director David Kay to ensure that the CRC had the March 28, 2017 document, and that
this document was deliberately suppressed by the CPSA. By failing to account for an
absence of response by the Respondent Dr.MacEwan, and an absence of any denial of
the allegations in 160618 or 160350, the CRC failed to uphold a higher standard of justice.
Affidavit of Dr.Makis sworn Jan.24, 2019, at para. 6, see Exhibit C, Mar.28, 2017 letter.
iv. The legitimate expectations of the person challenging the decision
112. Regarding the expectations of a person challenging a tribunal decision, in Farhat v CPSA
justice Pentelechuk noted in para [57]:
A higher duty of procedural fairness will be imposed if the claimant has a legitimate
expectation that a certain procedure will be followed or that a certain result will be
reached in their case. This takes into account the promises or regular practices of
the decision-makers and the consideration that it is generally unfair to act in
contravention of representations as to procedure.
113. The Applicant submits that Dr.Makis, as a regulated member of the CPSA who is well
aware of his professional obligations pursuant to CPSA Code of Ethics and CPSA
Standards of Practice, had a legitimate expectation that CPSA Officials such as the CPSA
Registrar Dr.Theman, CPSA Hearings Directors (Dr.Kate Reed, David Kay) and CPSA
Complaints Director Dr.Caffaro, as well as the members of the CRC who are regulated
Page 44 of 50
members of the CPSA (Dr.Randy Naiker – Chair, Dr.Brinda Balachandra), in handling
160350, 160618 and the CRC Review and CRC Decision, all would abide by their legal
duties and obligations pursuant to the HPA (including section 3 and 68), all would abide by
their professional duties and obligations pursuant to the CPSA Code of Ethics and CPSA
Standards of Practice, and all would follow proper procedures in keeping with the aim of
the HPA to protect healthcare staff, patients and society from unprofessional and unethical
conduct. The Applicant submits that the CPSA Officials involved in the handling of 160350,
160618 and the CRC Decision breached the duty of procedural fairness owed to Dr.Makis
by failing or refusing to abide by their legal and professional duties and obligations as
outlined above.
CMA, CMA Code of Ethics, Update 2004 (emphasis added) [TAB 6]

114. Dr.Makis had legitimate expectations of receiving a fair and honest CRC Review and CRC
Decision, because Dr.Makis is a regulated member of the CPSA, knows well his
professional duties and obligations pursuant to the CPSA Code of Ethics and CPSA
Standards of Practice and had the reasonable expectation that he would be treated
honestly, fairly and in accordance with the principles of natural justice, as any other
Alberta physician could expect to be treated by the CPSA and its Officials, Administrators,
Employees, Agents, Bodies, Tribunals or Committees who had been entrusted by society
to Administer the HPA in good faith and who were, at all material times, expected by abide
by their legal duties and obligations under common law and pursuant to the HPA.
115. Accordingly, the Applicant submits that Dr.Makis had the legitimate and reasonable
expectation that Dr.MacEwan would be held to the same professional standards pursuant
to the CPSA Code of Ethics and CPSA Standards of Practice in regards to 160350 and
160618, that any other Alberta physician would be held to, in a similar situation.
Furthermore, the Applicant submits that neither the CPSA Code of Ethics nor CPSA
Page 45 of 50
Standards of Practice, provide any unprofessional conduct exemptions for physicians
holding a senior AHS Administrative position, such as the position held by Dr.MacEwan.
116. The Applicant submits that CPSA Officials Dr.Michael Caffaro, Dr.Kate Reed, David Kay,
Dr.Trevor Theman, and CRC Panel members Dr.Randy Naiker (Chair) and Dr.Brinda
Balachandra failed or refused to hold Dr.MacEwan to the same professional standards
defined by CPSA Code of Ethics and CPSA Standards of Practice as they would
reasonably be expected to hold any other Alberta physician to, and by doing so, these
CPSA Officials violated the principles of natural justice, and breached their professional as
well as their legal duties and obligations pursuant to the HPA.
117. Furthermore the Applicant submits that the above listed CPSA Officials, by failing or
refusing to uphold and enforce the CPSA Code of Ethics and CPSA Standards of Practice
in their handling of 160350 and 160618 as required by law under section 3 of the HPA,
have harmed the integrity of the practice of medicine in Alberta.
118. The Applicant submits that the CRC was unfair to Dr.Makis by acting in contravention of
representations at to procedure. The CRC Decision repeatedly and fraudulently
misrepresents that it reviewed “all relevant” documents and upheld Dr.Caffaro’s decision
to dismiss 160618 on the basis that it was similar to 160350, however, the documentary
evidence conclusively proves that the CRC did not review 160350 at all and did not
compare 160350 to 160618 in order to be able to reasonably uphold Dr.Caffaro’s Decision
and legally defend that decision.
v. The choices of procedure made by the agency itself
119. The Applicant submits that prior to the CRC Review, CPSA Officials deliberately took
every opportunity to suppress and cover-up all of the allegations of Dr.MacEwan’s
unprofessional and abusive conduct in 160350 and 160618, to the detriment of healthcare
staff and patients alike. Dr.Caffaro dismissed 160350 unreasonably. Dr.Kate Reed blocked
Page 46 of 50
Dr.Makis from Appealing 160350 on the basis of a false claim of Dr.Makis’ Appeal being
“24 hours late” which Dr.Makis denies. Dr.Theman ignored Dr.Makis’ November 24, 2016
letter and concerns about the abuse of Dr.Makis’ healthcare colleagues. David Kay
deprived Dr.Makis of the opportunity to provide oral submissions or call witnesses to the
CRC Panel. CRC Panel Chair Dr.Randy Naiker and Dr.Brinda Balachandra upheld the
decisions of Dr.Caffaro to dismiss 160350 and 160618 and rendered a CRC Decision that
there was “insufficient evidence” of unprofessional conduct or violations of professional
standards or harm to society to warrant an Investigation or Hearing. The Applicant submits
that the behaviour of CPSA Officials in the handling of 160350 and 160618 was consistent
at all material times with bad faith and malicious intent. The Applicant submits that the
subsequent legal actions QB1603-18935, QB1803-01472 (this Judicial Review) and
QB1803-16582 are the direct result of the bad faith and malicious conduct of CPSA
Officials in the handling of 160350 and 160618. Furthermore, both Dr.Viliam Makis and
Dr.David Williams have suffered damages to their medical careers with Dr.Williams
resigning and moving to BC in fear for his safety, as he reported to the Alberta Human
Rights Commission in a letter dated June 25, 2017:
It is only now as I am safe and secure working in a different province that I can testify
to the malicious, nefarious, bullying, sexist and racist behaviour that is constantly
displayed by RM (Dr.Robert MacEwan) towards healthcare and support staff. He is
unsympathetic to all he encounters except when there is a benefit to be gained. RM
(Dr.Robert MacEwan) governs the failing department at the CCI as a despot,
violating Human Rights at will. He has many complaints originating from all levels of
the department and nothing has so far been addressed. I feel this matter should be
investigated, however I am concerned for retaliatory action RM (Dr.Robert
MacEwan) may inflict upon the department.
Affidavit of Dr.Makis sworn Jan.24, 2019, at para. 7, see Exhibit D, Dr.Williams letter.
and Dr.Makis was prevented from practicing medicine for 3 years (by CPSA and AHS) and
was unable to find new employment.
Page 47 of 50
120. The Applicant submits that the choices of procedure made by the CPSA CRC Review
Panel also reflect this overall bad faith and malicious intent to effect a cover-up instead of
protecting the health, well-being and safety of Alberta’s healthcare staff and patients.
These choices included but were not limited to:
• CRC deprived Dr.Makis of the opportunity to make an oral submission or to call

witnesses to the CRC Review, notwithstanding that this choice was available under
section 68 of HPA and there were potentially up to 25 witnesses or victims of abuse;
• CRC did not review the 160350 complaint, or Dr.Makis’ 160350 Appeal documents;
• CRC did not review Dr.Caffaro’s decision to dismiss the 160350 complaint;
• CRC did not conduct an independent comparison of the 160350 and 160618
complaints to determine which Allegations in 160618 were “new” and could not be
dismissed “out of hand” as Dr.Caffaro had done;
• CRC did not conduct a proper review of 160618 (this is inferred from the CRC
Decision which incorrectly claimed Allegation 5 was the only “new” Allegation);
• CRC did not review any of the 906-pages of the CPSA Certified Record of
Proceedings save for page 31 (this is inferred from the CRC Decision which does not
reference any of the 905 remaining pages);
• CRC did not apply the CPSA Code of Conduct or CPSA Code of Ethics to the
alleged unprofessional conduct of Dr.MacEwan;
• CRC did not apply the CPSA Standards of Practice to the alleged unprofessional
conduct of Dr.MacEwan;
• CRC did not justify its Decision to dismiss Allegations 1-4 of 160618;
• CRC did not justify its Decision to dismiss Allegations 6-10 of 160618;
• CRC took the position that Dr.Makis’ allegations of abuse were not worthy of belief;
• CRC took the position that Dr.David William’s allegations of abuse were not worthy
of belief;
• CRC took the position that 25 healthcare staff who were victims of abuse or were
witnesses to abuse or were witnessed to be victims of abuse, were not worthy of
belief
• CRC Decision-making process was not made transparent to Dr.Makis;
• CRC Decision did not identify the contributions or decisions of the three individual
CRC Panel members;
• CRC Decision-making process and CRC Decision were not intelligible.
• CRC Decision did not take into account Dr.MacEwan’s lack of response to 160618 or
160350 allegations
• CRC Decision did not take into account Dr.MacEwan’s lack of denial of 160618 or
160350 allegations.
121. The Applicant submits that as a result of the above choices of procedure made by the
CRC, the CRC Proceedings did not meet the level of fairness required by law, and that the
CRC Review Panel repeatedly breached the duty of procedural fairness.
Page 48 of 50
122. The Applicant submits that as Justice Pentelechuk concluded in Farhat v CPSA in para
(69):
denial of a right to a fair hearing must always render a decision invalid because it is
an independent, unqualified right that any person affected by an administrative
decision is entitled to have. What impact a fair hearing may have had on the
decision, is not relevant. An unfair assessment cannot be justified by reference to the
stellar qualifications, experience or expertise of those conducting the assessment.
The Applicant submits that Dr.Makis was denied a fair, honest, independent and impartial
CRC Review, which renders the CRC Decision invalid.
V. RELIEF SOUGHT
The plaintiffs seek from this Honourable Court:
(1) Dr.Makis applies for an Order in the nature of certiorari, setting aside the CPSA CRC
Decision.
(2) Dr.Makis also applies for an Order in the nature of mandamus, directing that the CPSA
refer the Applicant’s CPSA complaints (160350 and 160618) for an Independent
Investigation and or for a public Hearing pursuant to sections 61 to 79 (inclusive) of the
Health Professions Act (“HPA”).
(3) Dr.Makis applies for an Order declaring that the CPSA, CPSA Complaints Director
Dr.Michael Caffaro, and CPSA CRC Review Panel chaired by Dr.Randy Naiker, failed or
refused to uphold their legal duties and obligations pursuant to the HPA, and breached the
duty of procedural fairness owed to Dr.Makis.
(4) costs such as this Honourable Court may deem fit.
(5) such other Order as this Honourable Court may deem just.
ALL OF WHICH IS RESPECTFULLY SUBMITTED this 25th day of January, 2019.
Per:_________________________________
Dr.Viliam Makis MD, FRCPC
Self-represented litigant, for the Applicant
Page 49 of 50
TABLE OF AUTHORITIES
TAB AUTHORITIES
1. Health Professions Act, R.S.A. 2000 c.H-7 [TAB 1]
2. Farhat v College of Physicians and Surgeons of Alberta, 2014 ABQB 731 [TAB 2]
3. Dunsmuir v New Brunswick, [2008] 1 SCR 190, 2008 SCC 9 [TAB 3]
4. Zakhary v College of Physicians and Surgeons of Alberta, 2013 ABCA 336,

561 AR 87 [TAB 4]
5. CPSA, CPSA Code of Conduct, Reissued: June 5, 2014 [TAB 5]
6. CMA, CMA Code of Ethics, Update 2004 [TAB 6]
7. CPSA, CPSA Standards of Practice, Reissued: September 1, 2012 [TAB 7]
8. Al-Ghamdi (Re), 2017 CanLII 145468 (AB CPSDC) [TAB 8]
9. Makis (Re), 2018 CanLII 127231 (AB CPSDC) [TAB 9]
Page 50 of 50
Province of Alberta
HEALTH PROFESSIONS ACT
Revised Statutes of Alberta 2000

Chapter H-7
Current as of January 1, 2017
Office Consolidation
© Published by Alberta Queen’s Printer
Alberta Queen’s Printer

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10611 - 98 Avenue
Edmonton, AB T5K 2P7
Phone: 780-427-4952
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Shop on-line at www.qp.alberta.ca
RSA 2000
Section 3 HEALTH PROFESSIONS ACT Chapter H-7
(c) has the capacity and, subject to this Act, the rights, powers
and privileges of a natural person.
1999 cH-5.5 s2
College’s role
3(1) A college
(a) must carry out its activities and govern its regulated
members in a manner that protects and serves the public
interest,
(b) must provide direction to and regulate the practice of the

regulated profession by its regulated members,
(c) must establish, maintain and enforce standards for

registration and of continuing competence and standards
of practice of the regulated profession,
(d) must establish, maintain and enforce a code of ethics,
(e) carry on the activities of the college and perform other

duties and functions by the exercise of the powers
conferred by this Act, and
(f) may approve programs of study and education courses for

the purposes of registration requirements.
(2) A college may not set professional fees, provide guidelines for
professional fees or negotiate professional fees on behalf of some
or all of its regulated members unless the Minister grants the
college an approval under section 27.
(3) A college or a council or committee of a college may not be a

certified bargaining agent as defined in the Labour Relations Code.
RSA 2000 cH-7 s3;2001 c21 s2
Annual report
4(1) A college must submit to the Minister an annual report of its
activities in a form acceptable to the Minister that contains the
information requested by the Minister, including but not restricted
to
(a) a statement respecting the number of complaints made and

their disposition, including the number of hearings closed
to the public in whole or in part, the number of appeals
and the number of regulated members dealt with under
section 118;
(b) information respecting registration;
14
RSA 2000
(c) a description of and information about the college’s

continuing competence program;
(c.1) a description of and information about inspections under

Part 3.1;
(d) whether the college has an approval under section 27 and,

if so, a statement describing how it is complying with
conditions imposed on the approval, if any;
(e) a statement respecting the committees and tribunals

established under this Act;
(f) audited financial information or financial information in a

form and manner satisfactory to the Minister.
(2) On receipt of a report under subsection (1), the Minister must

lay a copy of it before the Legislative Assembly if it is then sitting
or, if it is not then sitting, within 15 days after the commencement
of the next sitting.
(3) The Minister may, to ensure that the requirements of this Act
are met, require reports from the college in addition to the annual
report under subsection (1).
RSA 2000 cH-7 s4;2008 c34 s3
Council, President and Registrar
Council established
5(1) The governing body of a college is the council.
(2) The council consists of the president and
(a) the regulated members provided for in the bylaws,
(b) the non-voting members, if any, provided for in the

bylaws, and
(c) subject to section 12(1), the number of public members

appointed by the Lieutenant Governor in Council.
(3) The president and members described in subsection (2)(a) and

(c) are the voting members of the council.
(4) A member described in subsection (2)(a), (b) or (c) continues

to hold office after the expiry of the member’s term until the
member is reappointed or re-elected or a successor is appointed or
elected.
(5) Despite section 12, if a member described in subsection (2)(a),

(b) or (c) is not capable of carrying out the powers and duties of a
15
RSA 2000
member, the council may continue to carry out its powers and
duties until a successor is appointed or elected.
1999 cH-5.5 s5
Council’s role
6 A council manages and conducts the activities of the college,
exercises the rights, powers and privileges and carries out the
duties of the college in the name of and on behalf of the college and
carries out the powers and duties of the council under this Act and
the bylaws.
1999 cH-5.5 s6
President
7 A council must appoint, elect or provide for the appointment or
election of an individual to be president for the purposes of this
Act.
1999 cH-5.5 s7
Registrar
8 A council must appoint or provide for the appointment of an
individual as registrar for the purposes of this Act.
1999 cH-5.5 s8
Committees and Tribunals
Registration committee
9(1) A council
(a) may establish a registration committee consisting of no

fewer than 3 members, the majority of which must be
regulated members, and
(b) if a registration committee is established, must designate a

member of that committee to act as chair.
(2) A member of a registration committee continues to hold office

after the expiry of the member’s term until the member is
reappointed or a successor is appointed.
(3) Despite subsection (1), if a member of a registration committee

is not capable of carrying out the powers and duties of a member,
the registration committee may continue a review of an application
in which the member was participating, and the registration
committee may carry out its powers and duties with respect to that
review.
(4) A registration committee may,
(a) if provided for in the bylaws, review an application for

registration, and
16
RSA 2000
or who negotiates or sets professional fees or guidelines

on professional fees on or on behalf of regulated members
of a college;
(c) a member or officer of a regional health authority or the

Advisory Board.
(3) The public members of a complaint review committee and a

hearing tribunal are the persons designated by a hearings director
from the list, established under subsection (1)(b), of public
members, other than regulated members of the college.
(4) A public member may be appointed to a list of public members

for a term of up to 3 years and may be reappointed, but may not be
appointed for more than 6 consecutive years.
(4.1) A public member may be appointed to a council for a term of

up to 3 years and may be reappointed, but may not be appointed for
more than 6 consecutive years.
(5) Despite subsection (4.1), a member of a council appointed

under subsection (1)(a) continues to be an appointed member after
the expiry of the term of the appointment until the member is
reappointed, the member’s appointment is rescinded or a successor
is appointed.
(6) Public members under this section may, at the rates prescribed
by the Lieutenant Governor in Council, be paid remuneration for
their services by and receive reasonable living and travelling
expenses from the Government incurred in the course of their
duties as members.
RSA 2000 cH-7 s13;2006 c19 s2(2);2008 cH-4.3 s19
Hearings director, complaints director

14(1) A council must provide for the appointment of an individual
as a hearings director for the purposes of this Act.
(2) A hearings director may not chair nor participate in a hearing,

review or appeal under Part 4.
(3) A council must provide for the appointment of an individual as

a complaints director for the purposes of this Act.
1999 cH-5.5 s14
Membership lists
15(1) A council must appoint members to a membership list
consisting of no fewer than 4 regulated members to be used for
appointing members to both hearing tribunals and complaint
review committees.
19
RSA 2000
(2) Only regulated members are eligible to be included on a list

referred to in subsection (1).
1999 cH-5.5 s15
Tribunal, complaint review committee established

16(1) The hearings director may establish a hearing tribunal and a
complaint review committee consisting of
(a) 2 or more members from the membership list established

under section 15, and
(b) the number of public members required by section 12(1),
and if a hearing tribunal or complaint review committee is

established, the hearings director must designate a member of that
tribunal or committee to act as chair.
(2) Despite section 13(4), a member of a hearing tribunal or of a

complaint review committee continues to hold office after the
expiry of the member’s term until the member is reappointed or a
successor is appointed.
(3) Despite section 12(2), if a member of a hearing tribunal or of a

complaint review committee is not capable of carrying out the
powers and duties of a member,
(a) the hearing tribunal may continue to hold a hearing in

which the member was participating and the hearing
tribunal may carry out its powers and duties with respect
to that hearing, and
(b) the complaint review committee may continue to review

and ratify a settlement under section 60 and to conduct a
review under section 68 in which the member was
participating and the complaint review committee may
carry out its powers and duties with respect to that
settlement or review.
(4) All members of a hearing tribunal and of a complaint review

committee are voting members.
(5) The hearings director may direct one or more hearing tribunals
or complaint review committees established under this section to
carry out any power or duty that a hearing tribunal or complaint
review committee may carry out under this Act.
1999 cH-5.5 s16
Tribunal, committee powers, duties

17(1) A hearing tribunal’s powers and duties include holding
hearings under this Act.
20
RSA 2000
(2) A complaint review committee’s powers and duties include

reviewing and ratifying settlements under section 60 and
conducting reviews under section 68.
1999 cH-5.5 s17
Panels
Council, committee panels

18(1) Subject to section 12,
(a) a person or committee designated by a council may

designate 3 or more members of council to sit as a panel
of council and designate a member of the panel to act as
chair, or
(b) the chair of the registration committee and of the

competence committee may designate 3 or more members
of the registration committee or competence committee to
sit as a panel of the registration committee or competence
committee and designate a member of the panel to act as
chair.
(2) A person or committee designated by a council may direct a

panel of the council to carry out the powers and duties of the
council with respect to a review under Part 2 and an appeal under
Part 4 or section 118.
(3) The chair of the registration committee or of the competence

committee may direct a panel of the registration committee or of
the competence committee to carry out any power or duty that the
registration committee or competence committee may carry out
under this Act.
(4) If a member designated under subsection (1) is not capable of

carrying out the powers and duties of a member, the panel may
continue an appeal or review an application in which the member
was participating and the panel may carry out its powers and duties
with respect to that appeal or application.
(5) A power or duty carried out by a panel of the council, of the

registration committee or the competence committee is a power or
duty carried out by the council, registration committee or
competence committee.
(6) Two or more panels of the council, of the registration

committee or of the competence committee may carry out their
powers and duties simultaneously.
(7) Any reference in this Act or any other enactment to a council,

registration committee or competence committee is deemed to be
21
RSA 2000
Section 53.5 HEALTH PROFESSIONS ACT Chapter H-7
(4) Information respecting a regulated member that is obtained

under this Part may be provided to the complaints director if the
registrar makes a referral to the complaints director in respect of
that regulated member under this section.
2008 c34 s9
Inspection committee
53.5(1) A council may establish an inspection committee to carry
out the powers and duties of the registrar under this Part except
those described in section 53.3.
(2) An inspection committee must consist of one or more members

appointed by the council.
(3) If a council establishes an inspection committee under

subsection (1), the powers and duties of the registrar under this
Part, except those described in section 53.3, are vested in and may
be exercised by the inspection committee, and any reference to the
registrar in this Part, except in section 53.3, is deemed to be a
reference to the inspection committee.
2008 c34 s9
Part 4
Professional Conduct
Division 1
Complaint Process
Making a complaint
54(1) A person who makes a complaint to a complaints director
regarding a regulated member or a former member must do so in
writing and must sign the written complaint.
(2) A complaint under subsection (1) is not affected by the person

about whom the complaint is made ceasing to be a regulated
member before the proceedings with respect to the complaint are
completed.
(3) Despite subsection (1)(b), a complaint cannot be made about a

former member if 2 years have elapsed since the person became a
former member.
(4) Despite subsection (1)(b), a complaint about a former member

who was a member under a former Act but has not been a regulated
member under this Act may be made under this Part only if
discipline proceedings under the former Act could be commenced
if that Act were still in force.
48
RSA 2000
(5) If information, a notice or non-compliance is treated as a

complaint under section 56 and acted on under section 55, the
information, notice or non-compliance is deemed to be a complaint.
RSA 2000 cH-7 s54;2006 c19 s2(7)
Acting on a complaint
55(1) Within 30 days after being given a complaint or treating
information as a complaint, the complaints director must give
notice to the complainant of the action taken with respect to it.
(2) The complaints director
(a) may encourage the complainant and the investigated

person to communicate with each other and resolve the
complaint,
(a.1) may, with the consent of the complainant and the

investigated person, attempt to resolve the complaint,
(b) may make a referral to an alternative complaint resolution

process under Division 2,
(c) may request an expert to assess and provide a written

report on the subject-matter of the complaint,
(d) may conduct, or appoint an investigator to conduct, an

investigation,
(e) if satisfied that the complaint is trivial or vexatious, may

dismiss the complaint,
(f) if satisfied that there is insufficient or no evidence of

unprofessional conduct, may dismiss the complaint, and
(g) may make a direction under section 118.
(3) If the complaints director dismisses the complaint, the

complaints director must, within 30 days, give notice to the
complainant of the dismissal and the right to apply for a review by
the complaint review committee under section 68.
RSA 2000 cH-7 s55;2001 c21 s13
Aware of unprofessional conduct

56 Despite not receiving a complaint under section 54, but subject
to section 54(3) and (4), if the complaints director has reasonable
grounds to believe that the conduct of a regulated member or
former member constitutes unprofessional conduct, receives a
referral under Part 3, Part 3.1, Schedule 7 or Schedule 21, is given
notice under section 57, is given information orally or is aware of
non-compliance with a direction under section 118, the complaints
49
RSA 2000
director may treat the information, notice or non-compliance as a

complaint and act on it under section 55.
RSA 2000 cH-7 s56;2001 c21 s14;
2006 c19 s2(8);2008 c34 s10
Termination by employer
57(1) If, because of conduct that in the opinion of the employer is
unprofessional conduct, the employment of a regulated member is
terminated or suspended or the regulated member resigns, the
employer must give notice of that conduct to the complaints
director.
(2) On being given notice under subsection (1), the complaints

director must
(a) treat the employer as a complainant,
(b) despite not receiving a complaint under section 54, treat

the notice as a complaint in accordance with section 56,
and
(c) notify the employer and the regulated member

accordingly.
(3) For the purposes of this section, “employment” includes being

engaged to provide professional services on a full-time or part-time
basis as a paid or unpaid employee, consultant, contractor or
volunteer.
1999 cH-5.5 s57;2000 c15 s4(9)
Offence
57.1 An employer who contravenes section 57 is guilty of an
offence and liable
(a) for a first offence, to a fine of not more than $4000,
(b) for a 2nd offence, to a fine of not more than $8000, and
(c) for a 3rd and every subsequent offence, to a fine of not

more than $12 000.
2007 c32 s1(16)
Division 2
Alternative Complaint Resolution
Process
58(1) The complaints director may, with the agreement of the
complainant and the investigated person, refer the complainant and
the investigated person to an alternative complaint resolution
process provided for in the regulations at any time before the
commencement of a hearing by the hearing tribunal.
50
RSA 2000
(b) may request an expert to assess and prepare a written

report on the subject-matter of the complaint or matters
arising from the investigation of the complaint.
(3) If, on reviewing a report prepared under this section, the

complaints director determines that the investigation is concluded,
the complaints director must
(a) refer the matter to the hearings director for a hearing, or
(b) dismiss the complaint, if in the opinion of the complaints

director
(i) the complaint is trivial or vexatious, or
(ii) there is insufficient or no evidence of unprofessional

conduct.
(4) Despite subsection (3)(a), if the hearing tribunal has not

commenced a hearing and the complaints director learns of new
evidence that causes the complaints director to be of the opinion
that the complaint is trivial or vexatious or there is insufficient or
no evidence of unprofessional conduct, the complaints director may
withdraw the complaint from the hearings director and hearing
tribunal and dismiss the complaint.
RSA 2000 cH-7 s66;2007 c32 s1(20)
Notification of action taken

67 The complaints director must notify the complainant and the
investigated person in writing of the action taken under section
66(3) and if the complaint is dismissed
(a) must give the reasons, and
(b) notify the complainant in writing of the right to apply to

the hearings director for a review under section 68.
1999 cH-5.5 s67
Review of dismissal of complaint

68(1) A complainant may apply, in writing with reasons, to the
hearings director for a review of the dismissal of a complaint
within 30 days after being notified of the dismissal under section
55 or 67.
(2) Despite section 14(2), on receipt of an application under

subsection (1) the hearings director must notify the investigated
person, give a copy of the application to the complaint review
committee and direct the complaints director to give a copy of the
report made under section 66 to a complaint review committee.
58
RSA 2000
(3) Within 60 days after receipt of a report under subsection (2), a

complaint review committee must commence a review of the report
and the decision to dismiss the complaint.
(4) A complaint review committee may determine whether the

submissions to it with respect to a review under subsection (3) by
the complainant and the investigated person must be written, oral
or both.
(5) The complaint review committee, on complying with

subsection (3), must
(a) refer the matter to the hearings director for a hearing,
(b) direct the complaints director to conduct or appoint an

investigator to conduct a further investigation and to
prepare a report on the further investigation and submit it
to the complaint review committee for its consideration
before acting under clause (a) or (c), or
(c) confirm that the complaint is dismissed if in the opinion

of the complaint review committee
(i) the complaint is trivial or vexatious, or
(ii) there is insufficient or no evidence of unprofessional

conduct.
(6) The complaint review committee must give the complainant

and the investigated person written notification, with reasons, of
any action taken under subsection (5).
1999 cH-5.5 s68
Hearing to be scheduled
69 The hearings director must, within 90 days after receiving a
referral for a hearing, set a date for a hearing with respect to the
complaint unless
(a) the complaints director dismisses the complaint under

section 66(4),
(b) the president grants, on reasonable grounds, an extension

on application by the hearings director, or
(c) the complaints director and the investigated person agree

to an extension.
RSA 2000 cH-7 s69;2007 c32 s1(21)
Admission of unprofessional conduct

70(1) At any time after a complaint has been made but before the
hearing tribunal has made a decision as to whether unprofessional
59
RSA 2000
Section 132.1 HEALTH PROFESSIONS ACT Chapter H-7
(s) subject to an approval under section 27, respecting setting

and negotiating professional fees and guidelines on
professional fees;
(t) respecting the development of or adoption of a code of

ethics and standards of practice.
(2) The Regulations Act does not apply to bylaws under this
section.
RSA 2000 cH-7 s132;2001 c21 s23;2003 c39 s5;
2006 c19 s2(12);2007 c32 s1(30);2016 c9 s9
Approval of programs and courses

132.1 Before the council approves or removes the approval from
a program of study or an educational course under section 3, the
council must consult with the Minister of Health and the Minister
of Enterprise and Advanced Education and must consider the
comments received from those Ministers.
2001 c21 s24;2006 c19 s2(13);2007 c32 s1(31);
2013 c10 s17
Code of ethics, standards of practice

133(1) A council may, in accordance with procedures set out in
the bylaws, develop and propose the adoption of a code of ethics
and standards of practice for a regulated profession and may
develop and propose amendments to an adopted code of ethics or
standards of practice.
(2) The college must provide, for review and comment, a copy of a
proposed code of ethics and proposed standards of practice and
proposed amendments to
(a) its regulated members,
(b) the Minister, and
(c) any other persons the council considers necessary.
(3) A council may adopt a code of ethics and standards of practice

and may adopt amendments to a code of ethics or standards of
practice after it has reviewed and considered the comments
received from a review described in subsection (2).
(4) The Regulations Act does not apply to a code of ethics or to

standards of practice adopted or amended under this section.
(5) The college must ensure that copies of the code of ethics and
standards of practice adopted under subsection (3) are readily
available to the public and regulated members, and the copies may
be distributed in the manner directed by the council.
RSA 2000 cH-7 s133;2007 c32 s1(32)
101
Court of Queen=s Bench of Alberta
Citation: Farhat v College of Physicians and Surgeons of Alberta, 2014 ABQB 731
2014 ABQB 731 (CanLII)

Date: 20141202
Docket: 1403 00552
Registry: Edmonton
Between:
Ziad Farhat
Applicant
- and -
College of Physicians and Surgeons of Alberta
Respondent
_______________________________________________________
Reasons for Judgment

of the
Honourable Madam Justice D.L. Pentelechuk
_______________________________________________________
I. Overview
[1] Ziad Farhat applies for judicial review of the Decision of the Review Panel of the
Appeals Committee [Review Panel] of the Council of the College of Physicians and Surgeons of
Alberta [Council]. The Review Panel dismissed Dr. Farhat’s appeal from the findings of the
College of Physicians and Surgeons of Alberta [College] that Dr. Farhat was not competent to
practice as a Pediatric Radiologist. Accordingly, he was denied licensing registration with the
College.
[2] The issues raised in this judicial review are whether the College complied with its
statutory duty of disclosure under section 30(4) of the Health Professions Act, RSA 2000, c H-7
[HPA], and whether the assessment of Dr. Farhat’s competency to practise as a pediatric
radiologist was procedurally fair.
Page: 2
II. Background
[3] The Council of the College establishes different registration categories for physicians
under the authority of the HPA and the Physicians, Surgeons and Osteopaths Professional
Regulation 350/2009, ss 3(4) and 5(2) [Regulations]. The relevant sections of the HPA and the
Regulations are attached as Schedule ‘A’ to this Judgment.

[4] As a general rule, specialists on the General Register of the College have certification
from the Royal College of Physicians and Surgeons of Canada [the RCPSC].
[5] Section 33(1) of the HPA allows for physicians like Dr. Farhat, who do not have
certification with the RCPSC, to apply for licensure for individual practice by applying to the
Provisional Register – Physician Undergoing Practice Assessment.
[6] Dr. Farhat graduated from medical school in Russia in 2000, and then completed four
years of general radiology in Syria.
[7] Dr. Farhat was recruited to work at the Alberta Children’s Hospital in Calgary and was
placed on the Courtesy Register of the College from November 2009 to October 2011 for the
purposes of a fellowship in diagnostic radiology with the University of Calgary.
[8] Dr. Farhat was placed on the Provisional Register- Physician Undergoing Practice
Assessment as of October 1, 2012 for the purpose of determining whether he was competent to
enter into independent practice. The application for registration process is outlined in the HPA, ss
28-30.
[9] The Provisional Physician Assessment Program is not a training experience, but rather, a
pass/fail assessment. If the physician fails, they are immediately removed from the Register,
however, they may reapply for another assessment if they demonstrate to the College that the
appropriate remedial measures have been taken to address deficiencies and an appropriate
sponsor has been secured.
III. The Assessment
[10] The Assessment and Competency Enhancement Department of the College contracted
with Dr. Bhargava to conduct Dr. Farhat’s Preliminary Clinical Assessment at the Stollery
Children’s Hospital in Edmonton as the Alberta Children’s Hospital in Calgary, who wished to
employ Dr. Farhat, was in a conflict of interest.
[11] The assessment involved six pediatric radiologists, including Dr. Bhargava. They
determined Dr. Farhat was not competent to function as Pediatric Radiologist. As a result, his
application for individual practice registration was refused.
[12] Dr. Bhargava sent a letter, dated December 3, 2012, to the College summarizing Dr.
Farhat’s deficiencies as follows:
Dr. Farhat was assessed from October 29, 2012 to November 23, 2012. This included
direct observation of his fluoroscopic skills, ultrasound skills, and interactions with
patients and their families. The evaluation also included assessment of 200 reports that
Dr. Farhat dictated in ultrasound, CT, MRI, general radiography, and fluoroscopy. In
addition, Dr. Farhat was given two exams; a short answer question format exam at the
level of a pediatric radiologist and a multiple choice question exam at the level of a
diagnostic radiologist. The results of these assessments were discussed by the assessors
Page: 3
as a team and it was felt that Dr. Farhat was NOT competent to function as a pediatric
radiologist.
We found that Dr. Farhat’s knowledge of clinical pediatric radiology was deficient. He
scored less than 40% on the short answer questions for which we should have expected a
minimally competent pediatric radiologist to have scored 70%. He scored just over 50%
on the multiple choice questions directed at the lower level of a diagnostic radiology

resident, where a pass was felt to be a score of 70%. He was unaware of a number of
pathologies and their imaging manifestations that we would have expected a pediatric
radiologist to be aware of. He is able to elicit a relevant history accurate to context. We
noticed examples where he was unable to recognize emergent conditions and did not
appropriately notify referring physicians. We found that his fluoroscopic skills were
deficient with resulting high radiation doses. He was felt to be somewhat more competent
in general radiographs, ultrasound and CT, but given his overall poor knowledge base he
would not be a useful consultant. He gravitated to read studies that required minimal
competence. He was felt to be incompetent in reading MRI studies and had poor
detection skills. This, coupled with a deficiency in knowledge, would not allow him to be
safe to read or supervise MRI.
In terms of his communication skills, he is able to establish a therapeutic relationship and
communicate well with patients and their families. His reports however, are deficient and
special note was made that there is a lack of recognition of errors in his reports. This
resulted in factual errors, typographical errors, and errors in sides (right vs left).
[13] Dr. Farhat interacted effectively with health professionals, and we have no concerns
about his collaborative skills. We were unable to assess his managerial skills, health advocacy
skills, or scholarly activity. The Assistant Registrar of the College wrote to Dr. Farhat enclosing
Dr. Bhargava’s report stating:
Based upon the information supplied by Dr. Bhargava and despite the shortened duration
of the assessment, I am concluding that you are not ready for independent practice in this
province. As a result, I won’t be arranging any further assessment as the evidence
supplied demonstrates to me that you require further training in order to be considered for
licensure in Alberta.
IV. Appeal to the Review Panel of the Appeals Committee of the Council of the
College
[14] Dr. Farhat appealed the Decision of the College to the Review Panel, raising two
procedural issues:
1) The failure of the College to disclose the evaluation records which gave rise to the
denial of his registration;
2) His condensed evaluation.
[15] Before the appeal hearing, Dr. Farhat requested disclosure under s 30(4) of the HPA
which reads as follows:
An applicant may, on request, review the documents used by and created by the registrar,
registration committee or competence committee when considering the applicant’s
application.
Page: 4
[16] In response, Dr. Bhargava advised that the Stollery Hospital uses a paper-less reporting
system and that once Dr. Farhat dictated his reports and signed off on them, his supervising
radiologist would review the report and correct any mistakes. At that point, the report is released
into the healthcare system. He advised none of Dr. Farhat’s reports were saved in the system, so
nothing was available for release to him. Further, he refused to release the tests or test scores to

preserve the validity of the tests for future use.
[17] The Review Panel heard the appeal on August 28, 2013 and issued written reasons
dismissing the appeal on October 9, 2013. The Review Panel found that the team approach
increased the reliability of the assessment results and although the assessment process was new,
the group was familiar with and experienced in assessments generally. The Review Panel
accepted Dr. Bhargava’s response to the disclosure request, found that his letter of December 3,
2012 was sufficient disclosure and that Dr. Farhat was not deprived of procedural fairness.
[18] Further, the Review Panel found that while the assessment was slated for three months,
the Letter of Understanding signed by Dr. Farhat acknowledged that once Dr. Farhat had clearly
demonstrated or failed to demonstrate the necessary knowledge and skills, the assessment could
be concluded by the College.
V. Standard of Review
[19] The parties disagree on the standard of review applicable to the Review Panel’s
interpretation and application of the College’s duty of disclosure under s 30(4) of the HPA. The
College argues the issue involves an interpretation of its home statute, and as such, the
appropriate standard of review is reasonableness. However, Dr. Farhat argues that the issue falls
within the category of questions of law that are “both of central importance to the legal system as
a whole and outside of the [Review Panel’s] specialized area of expertise will be governed by
correctness”: Dunsmuir v New Brunswick, 2008 SCC 9 at paras 55, 60, [2008] 1 SCR 190
[Dunsmuir]. He submits that the correctness standard of review should apply to this issue.
[20] In Dunsmuir at para 62, the first step of the standard of review analysis requires the
Court to ascertain “whether the jurisprudence has already determined in a satisfactory manner
the degree of deference to be accorded with regard to a particular category of question.”
[21] Counsel did not provide any decisions that determine the standard of review for the
interpretation of s 30(4) of the HPA. Nonetheless, I note that there is a presumption that the
reasonableness standard applies to a tribunal’s interpretation of its own statute: Dunsmuir at para
54; Alberta (Information and Privacy Commissioner) v Alberta Teachers’ Association, 2011
SCC 61 at para 30.
[22] The Supreme Court also indicates that “where the first inquiry proves unfruitful, courts
must proceed to an analysis of the factors making it possible to identify the proper standard of
review.” The factors to consider at this second stage include: (1) the presence or absence of a
privative clause; (2) the purpose of the tribunal as determined by interpretation of enabling
legislation; (3) the nature of the question at issue, and; (4) the expertise of the tribunal.
Significantly, it is not “necessary to consider all of the factors, as some of them may be
determinative in the application of the reasonableness standard in a specific case”: Dunsmuir at
paras 62, 64.
Page: 5
[23] Of the factors referenced in Dunsmuir, only the absence of a privative clause in the HPA
points toward a standard of correctness.
[24] The Review Panel is a body or tribunal established by the Council of the College,
pursuant to the provisions of the HPA, s 32. The College acts through the Council, its governing
body: HPA, ss 5, 6. The College has a duty to “carry out its activities and govern its regulated
members in a manner that protects and serves the public interest”: HPA, s 3(1). The Review

Panel is clearly an expert tribunal in the context of the HPA. The relevant issue involves a
question of law and the interpretation of a provision of the HPA, the Review Panel’s home
statute. All of these factors point to a reasonableness standard.
[25] In my view, the interpretation of s 30(4) of the HPA is not a question of central
importance to the legal system as a whole or to administrative law generally, but is one specific
to the administrative regime governing applications for registration of healthcare professionals. I
conclude that the appropriate standard of review to the issue of the Review Panel’s interpretation
and application of the duty of disclosure under s 30(4) of the HPA is reasonableness.
[26] On the issue of procedural fairness, the parties agree that the Court is not required to
conduct an assessment of the appropriate standard of judicial review. Rather, procedural fairness
is evaluated on the basis of whether or not the procedures and safeguards adopted by a tribunal in
a particular situation have complied with the duty of fairness: Moreau-Bérubé v New Brunswick
(Judicial Council), 2002 SCC 11 at paras 74-75, [2002] 1 SCR 249. I agree with both parties.
[27] Thus, in assessing procedural fairness, the question for the Court is whether the
proceedings met the level of fairness required by law: Goold v Alberta (Office of the Children’s
Advocate), 2011 ABCA 63 at para 14, 502 AR 298; Farook v Alberta Colleges of Pharmacies,
2010 ABCA 306 at para 36. This duty of fairness is assessed according to the factors set out by
the Supreme Court of Canada in Baker v Canada (Minister of Citizenship and Immigration),
[1999] 2 SCR 817 at paras 21-28 ,174 DLR (4th) 193(WL) [Baker].
VI. Was the Review Panel’s Decision on the Issue of Disclosure Reasonable?
[28] In Dunsmuir at para 47, the majority of the Supreme Court of Canada explain the
standard in the judicial review context as an inquiry into the existence of justification,
transparency and intelligibility within the decision making process and whether the decision falls
within a range of possible acceptable outcomes.
[C]ertain questions that come before administrative tribunals do not lend themselves to
one specific, particular result. Instead, they may give rise to a number of possible,
reasonable conclusions. Tribunals have a margin of appreciation within the range of
acceptable and rational solutions. A court conducting a review for reasonableness
inquires into the qualities that make a decision reasonable, referring both to the process of
articulating the reasons and to outcomes. In judicial review, reasonableness is concerned
mostly with the existence of justification, transparency and intelligibility within the
decision–making process. But it is also concerned with whether the decision falls within a
range of possible, acceptable outcomes which are defensible in respect of the facts and
law.
[29] It is against this standard that the Review Panel’s Decision must be measured.
Page: 6
[30] As a starting point, the Stinchcombe level of disclosure required in a criminal context
does not apply in civil or administrative proceedings: Mission Institution v Khela, 2014 SCC 24
at para 83, [2014] 1 SCR 502.
[31] The College points out that Dr. Bhargava is not part of the competency committee but
rather was contracted by it. It argues a reasonable interpretation of the HPA, s 30(4) is that
compliance with its disclosure obligation is met by providing Dr. Farhat with the documents the

College received following his assessment. These documents were Dr. Bhargava’s letter of
December 3, 2012 summarizing the areas of deficiency and his letter of February 1, 2013 in
response to Dr. Farhat’s letter of appeal.
[32] This Court observes that a basic principle of interpretation is that an Act must be read as
a whole. Our Court of Appeal recently reiterated this principle stating that: “The Court
interpreting must not look only at the precise passage in question and the rules of grammar. It
must also use the context and the aim or scheme of the Act”: Zakhary v College of Physicians
and Surgeons of Alberta, 2013 ABCA 336 at para 16, 561 AR 87.
[33] Sections 29 and 30 of the HPA deal with applications for registration. Read as a whole,
these sections outline basic procedural rights which an applicant is entitled to, including the right
to notice of the decision, the right to reasons and the right of appeal. The right to disclosure is
part of this framework.
[34] Section 30(4) specifically indicates that the applicant may review the documents used by
and created by the registrar, registration committee or competency committee. Dr. Bhargava was
contracted by the competency committee and acting with its authority. To suggest documents
used by or created by Dr. Barghava need not be produced because he was contracted to the
competency committee is not a reasonable interpretation of this section.
[35] Further, the section refers to documents, not merely particulars, which suggests the
applicant is entitled to the evidentiary foundation for the decision of the registrar, registration
committee or competency committee.
[36] Indeed, the College’s Manual for Assessors and Supervisors conducting Practice
Readiness Assessments indicates an interim evaluation report must be completed and submitted
to the College six weeks after the assessment has commenced, and a final evaluation report must
be completed and submitted to the College within one week following conclusion of the
assessment: Certified Record of Proceedings, pp 254-262 [Certified Record]. The sample report
provided in the Manual directs that documentation be provided to support those competency
components that need improvement.
[37] Neither report was completed by Dr. Bhargava. The College argues this Manual serves
only as a guide and need not be followed to the letter, but the level of disclosure provided to Dr.
Farhat should be compared to that contemplated in the Manual, which outlines a defined
assessment process that is open and transparent.
[38] Dr. Farhat was not provided with any documentation to support the deficiencies as
determined by Dr. Bhargava, and outlined in his correspondence of December 3, 2012 and
February 1, 2013. The Registrar, in turn, accepted Dr. Bhargava’s letter of December 3, 2012 at
face value, without requesting a completed assessment form or any supporting documentation.
As a result, Dr. Farhat was deprived of the evidentiary foundation to Dr. Bhargava’s conclusion
that he was not competent to practice as a pediatric radiologist.
Page: 7
[39] In its reasons, the Review Panel found that the December 3, 2012 letter “contained
sufficient detail and specificity to allow the College to reliably make a decision respecting Dr.
Farhat’s application for registration.” In my opinion, section 30(4) of the HPA is for the benefit
of the applicant, and in focusing on whether the College had sufficient detail regarding Dr.
Farhat’s registration application, the Review Panel was dismissive of Dr. Farhat’s statutory right
to the documents used by or created by the assessment team.

[40] The Review Panel failed to provide reasons for why it accepted Dr. Bhargava’s refusal to
release the test scores in order to preserve the integrity of the test questions. By comparison, the
Medical Council of Canada Evaluating Examination, which Dr. Farhat successfully passed,
allows the physician to receive supplemental feedback on their examination performance, which
information assists in interpreting their performance and to identify relative strengths and
weaknesses. Further, an explanation regarding the scoring of the examination can be accessed:
Certified Record, p 281.
[41] The Review Panel also failed to provide reasons for why it accepted Dr. Bhargava’s
explanation that the various diagnostic reports prepared by Dr. Farhat were not retained and
therefore could not be provided to him.
[42] There is nothing in the Record to indicate Dr. Farhat’s diagnostic reports could not have
been saved, had Dr. Bhargava and the assessment team chosen to do so.
[43] The College argues that Dr. Farhat’s interpretation of the HPA, s 30(4) would allow Dr.
Farhat to indirectly access records which he could not access directly under the Health
Information Act, RSA 2000, c H-5 [ HIA] and the Freedom of Information and Protection of
Privacy Act, RSA 2000, c F-25. I disagree.
[44] Under the HIA, Dr. Bhargava would be designated a “custodian” under s 1(1)( f)(ix). The
relevant regulation is: s 2(2)(i) of the Health Information Regulation, Alta Reg 70/2001, which
reads:
(2) For the purposes of section 1(1)(f)(ix) of the Act, the following are designated as
custodians:
…
(i) Regulated members of the College of Physicians and Surgeons of Alberta;
[45] Section 32(1) of the HIA allows a custodian to disclose “non-identifying health
information” for any purpose. Further, under the HIA, s 35(1)(p), a custodian may disclose
individually identifying diagnostic, treatment and care information without the patient’s consent,
if the disclosure is authorized or required by an enactment of Alberta or Canada.
[46] There is nothing in the Record to suggest that Dr. Farhat’s diagnostic reports, had they
been retained, could not have had the identifying patient information redacted, but in any event,
it appears Dr. Bhargava was authorized to release the reports under the authority of s 35(1)(p) of
the HIA.
[47] The Provisional Register- Physician Undergoing Practice Assessment is apparently new
and Dr. Farhat’s assessment team was unfamiliar with the process. The Record does not disclose
whether Dr. Farhat was provided with the Assessment Manual. Indeed, counsel acknowledged
the Manual was not before the Review Panel. This perhaps explains the incongruity between the
process outlined in the Manual and process followed with Dr. Farhat, and why the Review Panel
emphasized the assessment team’s familiarity and experience with assessments generally.
Page: 8
[48] The Review Panel held the disclosure was sufficient, even though none of the documents
used by or created by Dr. Bhargava and the assessment team were provided. In doing so, the
Review Panel relied on the experience and qualifications of the assessment team as the support
for its finding that the conclusions reached by Dr. Bhargava were reliable. This is somewhat akin
to accepting an expert’s conclusory opinion without requiring the factual underpinnings or the
evidentiary foundation to that opinion.

[49] In my view, the Review Panel did not demonstrate the necessary justification,
transparency and intelligibility within its Decision, and its conclusion that Dr. Farhat was
provided with adequate disclosure under s 30(4) of the HPA does not fall within a range of
possible, acceptable outcomes which are defensible in respect of the facts and law.
[50] While it is not necessary, in light of my finding, to address whether there was a breach of
procedural fairness, this issue was argued by the parties, so I will briefly comment.
VII. Was there a Breach of the Duty of Procedural Fairness?
[51] Both parties agree that a duty of procedural fairness applies to the Review Panel’s
decisions that affect “the rights, privileges or interests of an individual”: Cardinal v Director of
Kent Institute, [1985] 2 SCR 643 at para 14, [1985] SCJ No 78 [Cardinal].
[52] As earlier indicated, in assessing whether or not there has been a breach of procedural
fairness, the Dunsmuir standard of review analysis is not engaged. The material inquiry in this
regard focuses on the question whether the proceedings met the required level of fairness:
Farook at para 36: Goold at para 14.
[53] As the starting point, the duty of procedural fairness is flexible, variable and contextual in
nature. Procedural fairness ensures that administrative decisions are made using a fair, impartial,
open and transparent process that provides those affected by the decision an opportunity to know
the case against them and to fully put forth their views and the evidence they wish the decision-
making body to consider.
[54] As indicated earlier, the Supreme Court in Baker at paras 21-28 outlines five factors to
consider in the context of the duty of procedural fairness in the administrative law context. They
include: (1) the nature of the decision being made and process followed in making it; (2) the
nature of the statutory scheme and the terms of the statute pursuant to which the body operates;
(3) the importance of the decision to the individual or individuals affected; (4) the legitimate
expectations of the person challenging the decision; (5) the choices of procedure made by the
agency itself. Given my earlier analysis – under the disclosure issue – of the nature of the HPA
and associated Regulations, being the statutory scheme and the terms of the statute pursuant to
which the College and the Review Panel operate, I will now turn to address each of the
remaining factors in the context of the evidence before me.
The nature of the decision being made and the process followed in making it
[55] Generally, the more the administrative process is like a judicial process, the more likely
the procedural protections afforded in a trial model will be required. Dr. Farhat was afforded the
right to make both written and oral submissions, but witnesses did not testify. The Review Panel
was obliged to provide reasons for its Decision and Dr. Farhat had a statutory right to disclosure.
The importance of the decision to the individual affected
Page: 9
[56] It is recognized, for example, that a higher standard of justice is required when the right
to continue in one’s profession or employment is at stake. The Review Panel refused Dr. Farhat’s
application for licensure as an independent physician, the result being that he continues in the
capacity of a student or resident. Dr. Farhat may reapply upon satisfying the College that he has
addressed the identified deficiencies and providing he has a sponsor.
The legitimate expectations of the person challenging the decision

[57] A higher duty of procedural fairness will be imposed if the claimant has a legitimate
expectation that a certain procedure will be followed or that a certain result will be reached in
their case. This takes into account the promises or regular practices of the decision-makers and
the consideration that it is generally unfair to act in contravention of representations as to
procedure.
[58] The Record does not indicate whether Dr. Farhat was provided with a copy of the
Applicant’s Manual for Practice Readiness Assessments. In my view, he was entitled to receive
this. The Manual indicates clinical objectives are to be identified and that the applicant and the
assessor review those objectives at the first meeting. The Manual also indicates the assessor is
required to submit formal evaluation reports of the applicant’s performance at prescribed
intervals, and that both parties should review and sign the evaluation reports before submitting
them to the College.
[59] While the Manual suggests the clinical assessment should be three months in length, both
the Manual and the Letter of Understanding signed by Dr. Farhat indicate the assessment would
be terminated in the event concerns are identified about patient safety or inappropriate conduct
by the applicant: Certified Record, p 51.
The choices of procedure made by the agency itself
[60] This mandates respect for the choices of procedure made by the agency itself,
particularly when the statute leaves the tribunal or agency with the ability to choose its own
procedure, or when the tribunal or agency has expertise in determining the appropriate
procedures.
[61] Dr. Bhargava was advised that he could terminate the assessment once he determined that
Dr. Farhat either did or did not definitively meet the required level of competence. I find the
decision to conclude the assessment, in and of itself, did not deprive Dr. Farhat of procedural
fairness as the College – and invariably the Review Panel – has control over its own process.
[62] The shortened assessment of less than four weeks, however, underscores the need to
provide Dr. Farhat with sufficient detail and supporting documentation which would allow him
to make full answer and defence before the Review Panel. Disclosure is mandated by the HPA, s
30(4). The letters of Dr. Bhargava do not permit Dr. Farhat to fully understand the case against
him and do not allow him to make full answer and defence to the College’s refusal to license
him. The letters merely summarized Dr. Bhargava’s professional opinion that Dr. Farhat is not
qualified to practice as a pediatric radiologist.
[63] In considering the five factors outlined in Baker, and the statutory duty of disclosure
under s 30(4) of the HPA, I find the degree of procedural fairness owed to Dr. Farhat to be
relatively high and it was not met in this case.
Page: 10
[64] To rebut Dr. Bhargava’s conclusions, the College suggests physicians from the Alberta
Children’s Hospital could have vouched for Dr. Farhat’s skills. This is not a compelling
argument as this institution, and the physicians that practice within it, were conflicted and unable
to perform his assessment. Presumably, the Review Panel would have placed limited weight on
such evidence.
[65] The College also argues that imposing unreasonable or inappropriate procedural

requirements on busy specialists, like Dr. Bhargava, will send a “chill” through the assessment
process and grind it to a halt as physicians will be reluctant to act as assessors if they face too
many administrative obligations.
[66] First, there is nothing in the Record to indicate that it was impossible to print off a
selection of Dr. Farhat’s diagnostic reports to demonstrate the deficiencies noted by Dr.
Bhargava or to develop some means of summarizing the content of the tests written, as is done
for physicians taking the Medical Council of Canada Evaluating Examination. Nor does the
Record indicate such disclosure would impose an undue burden on the College.
[67] The College’s own Manual indicates an evaluation process far more structured and
interactive than that afforded Dr. Farhat. The Manual speaks of providing feedback. Dr.
Bhargava did not do so, as he understood he did not have to. The Manual speaks of developing
an explicit set of objectives to be reviewed with the applicant at the start of the assessment, as
well as reports being prepared at six weeks and at the conclusion of the assessment, to be
reviewed with and signed by the applicant. These steps were not done or followed.
[68] There is nothing to suggest the assessment team was not imminently qualified to assess
Dr. Farhat’s competence. The issue is not whether the conclusion reached in the assessment is
correct, but whether the assessment was conducted fairly.
[69] As stated in Cardinal at para 23, denial of a right to a fair hearing must always render a
decision invalid because it is an independent, unqualified right that any person affected by an
administrative decision is entitled to have. What impact a fair hearing may have had on the
decision, is not relevant. An unfair assessment cannot be justified by reference to the stellar
qualifications, experience or expertise of those conducting the assessment.
Page: 11
V. Conclusion
[70] The Decision of the Review Panel is quashed.
[71] Dr. Farhat is entitled to a new assessment to be overseen by a new assessor, in
accordance with the Practice Readiness Assessment Manual. A new assessment is necessary as
the documentation which would support the competency deficiencies noted by Dr. Bhargava was

not retained.
Heard on the 13th day of November, 2014.

Dated at the City of Edmonton, Alberta this 2nd day of December 2014.
Dawn Pentelechuk
J.C.Q.B.A.
Appearances:
Kenneth W. Fitz
McLennan Ross LLP
for the Applicant Ziad Farhat
Craig D. Boyer
Shores Jardine LLP
for the Respondent College of Physicians and Surgeons of Alberta
Page: 12
Schedule A
College’s role
3(1) A college
(a) must carry out its activities and govern its regulated members in a

manner that protects and serves the public interest,
(b) must provide direction to and regulate the practice of the regulated
profession by its regulated members,
(c) must establish, maintain and enforce standards for registration and of
continuing competence and standards of practice of the regulated profession,
(d) must establish, maintain and enforce a code of ethics,

(e) carry on the activities of the college and perform other duties and
functions by the exercise of the powers conferred by this Act, and
(f) may approve programs of study and education courses for the purposes
of registration requirements.
(2) A college may not set professional fees, provide guidelines for professional fees
or negotiate professional fees on behalf of some or all of its regulated members
unless the Minister grants the college an approval under section 27.
(3) A college or a council or committee of a college may not be a certified
bargaining agent as defined in the Labour Relations Code.
RSA 2000 cH-7 s3;2001 c21 s2
Annual report
4(1) A college must submit to the Minister an annual report of its activities in a form
acceptable to the Minister that contains the information requested by the Minister,
including but not restricted to
(a) a statement respecting the number of complaints made and their
disposition, including the number of hearings closed to the public in whole or
in part, the number of appeals and the number of regulated members dealt
with under section 118;
(b) information respecting registration;
(c) a description of and information about the college’s continuing

competence program;
(c.1) a description of and information about inspections under Part 3.1;
(d) whether the college has an approval under section 27 and, if so, a
statement describing how it is complying with conditions imposed on the
approval, if any;
Page: 13
(e) a statement respecting the committees and tribunals established under

this Act;
(f) audited financial information or financial information in a form and

manner satisfactory to the Minister.
(2) On receipt of a report under subsection (1), the Minister must lay a copy of it

before the Legislative Assembly if it is then sitting or, if it is not then sitting, within
15 days after the commencement of the next sitting.
(3) The Minister may, to ensure that the requirements of this Act are met, require
reports from the college in addition to the annual report under subsection (1).
RSA 2000 cH-7 s4;2008 c34 s3
Council, President and Registrar
Council established
5(1) The governing body of a college is the council.
(2) The council consists of the president and

(a) the regulated members provided for in the bylaws,
(b) the non-voting members, if any, provided for in the bylaws, and
(c) subject to section 12(1), the number of public members appointed by the
Lieutenant Governor in Council.
(3) The president and members described in subsection (2)(a) and (c) are the voting
members of the council.
(4) A member described in subsection (2)(a), (b) or (c) continues to hold office after
the expiry of the member’s term until the member is reappointed or re-elected or a
successor is appointed or elected.
(5) Despite section 12, if a member described in subsection (2)(a), (b) or (c) is not
capable of carrying out the powers and duties of a member, the council may continue
to carry out its powers and duties until a successor is appointed or elected.
1999 cH-5.5 s5
Council’s role
6 A council manages and conducts the activities of the college, exercises the rights,
powers and privileges and carries out the duties of the college in the name of and on
behalf of the college and carries out the powers and duties of the council under this
Act and the bylaws.
1999 cH-5.5 s6
President
7 A council must appoint, elect or provide for the appointment or election of an
individual to be president for the purposes of this Act.
Page: 14
1999 cH-5.5 s7
Registrar
8 A council must appoint or provide for the appointment of an individual as
registrar for the purposes of this Act.
1999 cH-5.5 s8

Committees and Tribunals
Registration committee
9(1) A council
(a) may establish a registration committee consisting of no fewer than 3

members, the majority of which must be regulated members, and
(b) if a registration committee is established, must designate a member of

that committee to act as chair.
(2) A member of a registration committee continues to hold office after the expiry of
the member’s term until the member is reappointed or a successor is appointed.
(3) Despite subsection (1), if a member of a registration committee is not capable of
carrying out the powers and duties of a member, the registration committee may
continue a review of an application in which the member was participating, and the
registration committee may carry out its powers and duties with respect to that
review.
(4) A registration committee may,
(a) if provided for in the bylaws, review an application for registration, and
(b) undertake any other power or duty given to it under this Act or the
bylaws.
1999 cH-5.5 s9
Competence committee
10(1) A council
(a) may establish a competence committee, and
(b) must establish the competence committee if the college is authorized by

regulation to undertake practice visits.
(2) A competence committee must consist of no fewer than 3 members appointed by
the council and the majority of members must be regulated members and the council
must designate a member of that committee to act as chair.
(3) A council may, by bylaw, direct the registration committee to carry out the
powers and duties of a competence committee except those described in subsection
(6)(b).
Page: 15
(4) A member of a competence committee continues to hold office after the expiry
of the member’s term until the member is reappointed or a successor is appointed.
(5) Despite section 12, if a member of a competence committee is not capable of

carrying out the powers and duties of a member, the competence committee may
continue to conduct a practice visit in which the member was participating, and the

competence committee may carry out its powers and duties with respect to that
practice visit.
(6) A competence committee
(a) may make recommendations to the council on continuing competence

requirements and the assessment of those requirements,
(b) may, if authorized by the regulations, provide for practice visits as part
of the continuing competence program and conduct a practice visit of
regulated members, and
(c) may undertake any other power or duty given to it under this Act or the
bylaws.
(7) Despite subsection (6) and section 20, if a competence committee is authorized
to conduct practice visits it shall not carry out any powers or duties under sections 28
to 30.
RSA 2000 cH-7 s10;2008 c34 s4
Competence committee appointee

11 A competence committee may appoint one or more persons who have technical
expertise or other relevant knowledge to inquire into and report to the competence
committee with respect to any matter related to any power or duty of the competence
committee.
RSA 2000 cH-7 s11;2007 c32 s1(3)
Required public members
12(1) Twenty-five percent of the voting members of a council, a complaint review
committee and a hearing tribunal and of a panel of any of them must be public
members but with the consent of the council the percentage of the public members
may be greater than 25%.
(2) Despite the bylaws governing quorum, the number of public members required
by subsection (1) must be present at an appeal under Part 4 before a council, a
ratification of a settlement and a review by a complaint review committee and a
hearing by a hearing tribunal.
(3) Despite subsections (1) and (2), the powers and duties of a council, complaint
review committee or hearing tribunal or a panel of any of them are not affected by a
vacancy in the office of a public member for up to 6 months from the date that the
schedule to this Act that governs the college comes into force.
RSA 2000 cH-7 s12;2007 c32 s1(4)
Page: 16
1999 cH-5.5 s27
Part 2
Registration
Applying for Registration

Application for registration
28(1) An application for registration as a regulated member is complete for the
purpose of consideration under section 29(3) if it is in the required form and given to
the registrar by the applicant along with
(a) evidence of meeting the requirements for competence in the practice of
the profession as required by subsection (2),
(b) the application fee provided for in the bylaws,
(c) evidence of having the amount and type of professional liability

insurance, if required by the regulations,
(d) evidence of being a Canadian citizen or a person lawfully permitted to
work in Canada, if required by the regulations,
(e) evidence of having good character and reputation, if required by the
regulations,
(f) evidence of meeting standards of language proficiency, if required by

the regulations, and
(g) information required by the registrar under section 33(4)(b).

(2) An applicant may provide evidence of competence in the practice of the
profession
(a) by fulfilling one or more of the following as required by the regulations:

(i) education requirements, that may include being enrolled in a
program of studies,
(ii) experience requirements,
(iii) successful completion of examinations, or
(iv) holding certificates or diplomas,
(b) by being registered with a profession in another jurisdiction recognized

by the regulations or the council as having substantially equivalent
competence and practice requirements and meeting the requirements for
persons to be registered with that profession in that jurisdiction, or
(c) by satisfying the registrar, the registration committee or competence
committee, of having as determined in accordance with the regulations, a
Page: 17
combination of education, experience, practice or other qualifications, that

demonstrates the competence required for registration as a regulated member.
(3) If there are reasonable and probable grounds to be of the opinion that an
applicant by engaging in the regulated profession as a regulated member would
create a danger to the public or be unsafe because of a disability or incapacity, the

registrar, the registration committee or competence committee may require an
applicant for registration to undergo physical or mental examinations by a person
agreed on by the applicant and the registrar, registration committee or competence
committee or, failing an agreement, designated by the registrar, registration
committee or competence committee for the purpose of assisting the registrar,
registration committee or competence committee in determining whether the
applicant by engaging in the regulated profession as a regulated member would
create a danger to the public or be unsafe.
RSA 2000 cH-7 s28;2007 c32 s1(7)
Receipt of application
29(1) The registrar must, as soon as reasonably possible, on receipt of an application
for registration as a regulated member, give notice to the applicant that the
application has been received, whether it is complete and if it is not complete, why it
is not complete.
(2) When an incomplete application is made complete by the applicant the registrar
must, as soon as reasonably possible, give notice to the applicant that a complete
application is received.
(3) On receipt of a complete application by the registrar, the registrar, registration

committee or competence committee, as provided for in the bylaws, must consider
the application, and make a decision under section 30 and notify the applicant of the
decision as soon as reasonably possible.
(4) An application for registration as an other member under section 33(1)(b) must
be considered by the college in accordance with the bylaws.
1999 cH-5.5 s29
Decision on application
30(1) On considering a complete application for registration as a regulated member,
the registrar, the registration committee or the competence committee, as provided
for in the bylaws, must
(a) approve the application,

(b) defer registration if in the opinion of the registrar, registration committee
or competence committee it is in the best interest of the public to defer the
registration of the applicant until the applicant complies with conditions
imposed by the registrar, registration committee or competence committee, or
(c) refuse the application for registration.
Page: 18
(2) The registrar, registration committee or competence committee may impose

conditions on an approval under subsection (1)(a) that in the opinion of the registrar,
registration committee or competence committee are in the best interest of the public.
(3) On making a decision under subsection (1), the registrar, registration committee
or competence committee must

(a) give notice of the decision to the applicant,
(b) in the case of the registration committee or competence committee, give

notice of the decision to the registrar, and
(c) in the case of a decision to impose conditions on an approval, to defer a
registration or to refuse an application, give reasons for the decision and
notify the applicant as to how the applicant may request a review of the
decision under section 31.
(4) An applicant may, on request, review the documents used by and created by the
registrar, registration committee or competence committee when considering the
applicant’s application.
(5) If the applicant is not notified of the decision under this section by the date that
is 120 days after notice was given under section 29 that the application for
registration is complete, the applicant may request a review under section 31.
1999 cH-5.5 s30;2000 c15 s4(7)
Review application
31(1) An applicant whose application for registration is accepted subject to
conditions or whose registration is deferred or whose application is refused by the
registrar, registration committee or competence committee may, within 30 days after
being given a copy of the decision, request a review by the council in accordance
with subsection (3).
(2) An applicant who is not notified of a decision by the date described in section
30(5) may, within 30 days from that date, request a review by the council in
accordance with subsection (3).
(3) A request for a review must

(a) be in writing,
(b) set out the reasons why the application for registratio n should be
approved with or without conditions, and
(c) be given to the registrar, who must give a copy of the request to the
council.
(4) On being given a request for a review, the registrar must, within 30 days, notify
the applicant of the date, time and place at which the council will conduct the review.
Page: 19
(5) A review must be commenced not later than 60 days after the registrar is given
the request for a review.
(6) The college may, in accordance with the bylaws, charge a fee for a review.
1999 cH-5.5 s31
Review of registration decision

32(1) An applicant and the registrar, the registration committee or competence
committee may appear with or without counsel and make representations to the
council at a review.
(2) On reviewing a decision pursuant to a request for a review under section 31, the
council may
(a) confirm, reverse or vary the decision of the registrar, registration

committee or competence committee and make any decision that the
registrar, registration committee or competence committee could have made,
(b) refer the matter back to the registrar, registration committee or
competence committee and direct the registrar, registration committee or
competence committee to make a further assessment of the application and
make a decision under section 30 on the application, and
(c) make any further order the council considers necessary for the purposes
of carrying out its decision.
(3) The council must conduct the review as soon as reasonably possible and on
making a decision must give the applicant and the registrar a copy of its decision
with the reasons for the decision.
1999 cH-5.5 s32
Registration
Registers of members
33(1) A council
(a) must establish, in accordance with the regulations, a regulated members

register for one or more categories of members who provide professional
services of the regulated profession, and
(b) may, in accordance with the bylaws, establish other members registers
for one or more categories of non-regulated members.
(2) The name of a regulated member who is suspended remains in the register.
(3) The registrar must enter the following information for each regulated member in
the appropriate category of register established under subsection (1)(a):
(a) the full name of the member;
Page: 20
ALBERTA REGULATION 350/2009
Health Professions Act
PHYSICIANS, SURGEONS AND

OSTEOPATHS PROFESSION REGULATION

Definitions
1 In this Regulation,
(a) “Act” means the Health Professions Act;
(b) “College” means the College of Physicians and Surgeons of Alberta;
(c) “Competence Committee” means the competence committee of the

College;
(d) “Complaints Director” means the complaints director of the College;
(e) “Council” means the council of the College;

(f) “courtesy register” means the courtesy register category of the
regulated members register;
(g) “emergency register” means the emergency register category of the
(h) “general register” means the general register category of the regulated
members register;
(i) “limited practice register” means the limited practice register category
of the regulated members register;
(j) “provisional register” means the provisional register category of the

(k) “Registrar” means the registrar of the College;
(l) “students register” means the students register category of the

(m) “telemedicine register” means the telemedicine register category of

the regulated members register.
Register categories
2 The regulated members register established by the Council under section 33(1)(a)
of the Act has the following categories:
Page: 21
(a) general register;

(b) provisional register;
(c) limited practice register;
(d) courtesy register;

(e) emergency register;
(f) telemedicine register;
(g) students register.
Registration
General register
3(1) An applicant for registration as a regulated member on the general register must
(a) have received a medical or an osteopathic medical degree from a

program approved by the Council,
(b) have successfully completed post-graduate medical training approved

by the Council, and
(c) have successfully completed the registration examination approved by
the Council.
(2) An applicant must have completed the requirements set out in subsection (1)
within the 3 years immediately preceding the date the Registrar receives a complete
application.
(3) If an applicant is unable to meet the requirements set out in subsection (2), the
applicant must
(a) within the 3 years immediately preceding the date the Registrar
receives the complete application, have been registered in good standing
and carried on an active practice in a jurisdiction that regulates the practice
of medicine or osteopathy, or
(b) demonstrate to the satisfaction of the Registrar that the applicant is

currently competent to practise medicine or osteopathy.
(4) For the purposes of subsection (3)(b), the Registrar may require an applicant to
undergo any examination, testing, assessment, training or education that the Registrar
considers necessary.
Equivalent jurisdiction
4 An applicant for registration as a regulated member on the general register who is
currently registered as a physician, surgeon or osteopath in good standing in another
Page: 22
jurisdiction recognized by the Council under section 28(2)(b) of the Act as having
substantially equivalent registration requirements to the registration requirements set
out in section 3 may be registered on the general register.
Substantial equivalence

5(1) An applicant for registration who does not meet the registration requirements
under section 3 but whose qualifications have been determined by the Registrar
under section 28(2)(c) of the Act to be substantially equivalent to the registration
requirements under section 3 may be registered on the general register.
(2) In determining whether an applicant’s qualifications are substantially equivalent

under subsection (1), the Registrar may require the applicant to undergo any
examination, testing or assessment activity the Registrar considers necessary.
(3) For the determination under subsection (2), the Registrar may use the services of
experts and other resources to assist with the examination, testing or assessment
activity.
(4) The Registrar may require an applicant to pay all the costs incurred under
subsections (2) and (3).
(5) The Registrar may require an applicant under subsection (1) to undergo any
education or training activities the Registrar considers necessary in order for the
applicant to be registered.
(6) The Registrar may require an applicant under subsection (1) to provide any other
relevant information or evidence that the Registrar considers necessary in order to
assess an application under this section.
Provisional register
6(1) Subject to subsection (2), an applicant for registration as a regulated member
may be registered on the provisional register if the applicant has successfully
completed all the requirements for the granting of a medical or an osteopathic
medical degree from a medical program approved by the Council and the applicant
(a) has not passed the registration examination approved by the Council,
(b) is enrolled in a program of post-graduate medical training in Alberta

approved by the Council,
(c) is undergoing an assessment of qualifications for the purpose of
determining substantial equivalency under section 5, or
(d) is engaged in education or training activities for the purpose of
registration under section 5.
(2) Every regulated member registered on the provisional register must practise in
accordance with the conditions specified by the Registrar.
190 dunsmuir v. new brunswick [2008] 1 S.C.R.
David Dunsmuir Appellant David Dunsmuir Appelant
v. c.
Her Majesty the Queen in Right of the Sa Majesté la Reine du chef de la province
Province of New Brunswick as represented by du Nouveau-Brunswick, représentée par le
Board of Management Respondent Conseil de gestion Intimée
2008 SCC 9 (CanLII)

Indexed as: Dunsmuir v. New Brunswick Répertorié : Dunsmuir c. Nouveau-Brunswick
Neutral citation: 2008 SCC 9. Référence neutre : 2008 CSC 9.
File No.: 31459. No du greffe : 31459.
2007: May 15; 2008: March 7. 2007 : 15 mai; 2008 : 7 mars.
Present: McLachlin C.J. and Bastarache, Binnie, LeBel, Présents : La juge en chef McLachlin et les juges
Deschamps, Fish, Abella, Charron and Rothstein JJ. Bastarache, Binnie, LeBel, Deschamps, Fish, Abella,
Charron et Rothstein.
on appeal from the court of appeal for en appel de la cour d’appel du nouveau-
new brunswick brunswick
Administrative law — Judicial review — Standard of Droit administratif — Contrôle judiciaire — Norme
review — Proper approach to judicial review of admin- de contrôle — Démarche appropriée pour le contrôle
istrative decision makers — Whether judicial review judiciaire d’une décision administrative — Le contrôle
should include only two standards: correctness and rea- judiciaire devrait-il s’effectuer au regard de deux normes
sonableness. seulement : celle de la décision correcte et celle de la
raisonnabilité?
Administrative law — Judicial review — Standard Droit administratif — Contrôle judiciaire — Norme de
of review — Employee holding office “at pleasure” in contrôle — Fonctionnaire provincial amovible congédié
provincial civil service dismissed without alleged cause sans motif avec indemnité de quatre mois de salaire tenant
with four months’ pay in lieu of notice — Adjudicator lieu de préavis — Arbitre concluant que sa loi habilitante
interpreting enabling statute as conferring jurisdiction l’autorisait à déterminer si le congédiement constituait
to determine whether discharge was in fact for cause — en fait un congédiement pour motif — Arbitre statuant
Adjudicator holding employer breached duty of proce- que l’employeur avait manqué à son obligation d’équité
dural fairness and ordering reinstatement — Whether procédurale et ordonnant la réintégration de l’employé
standard of reasonableness applicable to adjudicator’s — La norme de la décision raisonnable s’appliquait-elle
decision on statutory interpretation issue — Public à l’interprétation de la loi par l’arbitre? — Loi rela-
Service Labour Relations Act, R.S.N.B. 1973, c. P‑25, tive aux relations de travail dans les services publics,
ss. 97(2.1), 100.1(5) — Civil Service Act, S.N.B. 1984, c. L.R.N.‑B. 1973, ch. P-25, art. 97(2.1), 100.1(5) — Loi sur
C‑5.1, s. 20. la Fonction publique, L.N.‑B. 1984, ch. C‑5.1, l’art. 20.
Administrative law — Natural justice — Procedural Droit administratif — Justice naturelle — Équité
fairness — Dismissal of public office holders — Employee procédurale — Congédiement d’un titulaire de charge
holding office “at pleasure” in provincial civil service publique nommé à titre amovible — Congédiement sans
dismissed without alleged cause with four months’ pay motif avec indemnité de quatre mois de salaire tenant
in lieu of notice — Employee not informed of reasons lieu de préavis — Employeur n’ayant pas précisé les
for termination or provided with opportunity to respond motifs du congédiement ni donné à l’employé la possi-
— Whether employee entitled to procedural fairness — bilité d’y répondre — L’employé avait-il droit à l’équité
Proper approach to dismissal of public employees. procédurale? — Démarche appropriée pour le congé-
diement d’un fonctionnaire.
220 dunsmuir v. new brunswick  Bastarache and LeBel JJ. [2008] 1 S.C.R.
greater flexibility of having multiple standards of à l’existence de normes de contrôle multiples. Même
review. Though we are of the view that the three- si nous sommes d’avis que le modèle des trois
standard model is too difficult to apply to justify normes est trop difficile à appliquer pour que son
its retention, now, several years after Southam, we maintien soit justifié, nous estimons qu’aujourd’hui,
believe that it would be a step backwards to simply plusieurs années après l’arrêt Southam, supprimer
remove the reasonableness simpliciter standard and simplement la norme de la raisonnabilité simplici-
revert to pre-Southam law. As we see it, the prob- ter et revenir à l’état antérieur à cet arrêt consti-
lems that Southam attempted to remedy with the tuerait un recul. Selon nous, la solution aux pro-
2008 SCC 9 (CanLII)

introduction of the intermediate standard are best blèmes que la Cour a tenté de résoudre dans l’arrêt
addressed not by three standards of review, but by Southam en introduisant la norme intermédiaire
two standards, defined appropriately. réside dans l’application non pas de trois, mais de
deux normes, convenablement circonscrites.
[45] We therefore conclude that the two vari- [45] Nous concluons donc qu’il y a lieu de fondre
ants of reasonableness review should be collapsed en une seule les deux normes de raisonnabilité.
into a single form of “reasonableness” review. The Il en résulte un mécanisme de contrôle judiciaire
result is a system of judicial review comprising emportant l’application de deux normes — celle de
two standards — correctness and reasonableness. la décision correcte et celle de la décision raisonna-
But the revised system cannot be expected to be ble. Or, la nouvelle approche ne sera plus simple et
simpler and more workable unless the concepts it plus facile à appliquer que si les concepts auxquels
employs are clearly defined. elle fait appel sont bien définis.
[46] What does this revised reasonableness [46] En quoi consiste cette nouvelle norme de
standard mean? Reasonableness is one of the most la raisonnabilité? Bien que la raisonnabilité figure
widely used and yet most complex legal concepts. parmi les notions juridiques les plus usitées, elle
In any area of the law we turn our attention to, we est l’une des plus complexes. La question de ce qui
find ourselves dealing with the reasonable, reason- est raisonnable, de la raisonnabilité ou de la ratio-
ableness or rationality. But what is a reasonable nalité nous interpelle dans tous les domaines du
decision? How are reviewing courts to identify an droit. Mais qu’est-ce qu’une décision raisonnable?
unreasonable decision in the context of administra- Comment la cour de révision reconnaît-elle une
tive law and, especially, of judicial review? décision déraisonnable dans le contexte du droit
administratif et, plus particulièrement, dans celui
du contrôle judiciaire?
[47] Reasonableness is a deferential standard [47] La norme déférente du caractère raisonnable

animated by the principle that underlies the devel- procède du principe à l’origine des deux normes
opment of the two previous standards of reasona- antérieures de raisonnabilité : certaines questions
bleness: certain questions that come before admin- soumises aux tribunaux administratifs n’appellent
istrative tribunals do not lend themselves to one pas une seule solution précise, mais peuvent plutôt
specific, particular result. Instead, they may give donner lieu à un certain nombre de conclusions rai-
rise to a number of possible, reasonable conclusions. sonnables. Il est loisible au tribunal administratif
Tribunals have a margin of appreciation within the d’opter pour l’une ou l’autre des différentes solu-
range of acceptable and rational solutions. A court tions rationnelles acceptables. La cour de révision
conducting a review for reasonableness inquires se demande dès lors si la décision et sa justifica-
into the qualities that make a decision reasonable, tion possèdent les attributs de la raisonnabilité. Le
referring both to the process of articulating the rea- caractère raisonnable tient principalement à la jus-
sons and to outcomes. In judicial review, reasona- tification de la décision, à la transparence et à l’in-
bleness is concerned mostly with the existence of telligibilité du processus décisionnel, ainsi qu’à
[2008] 1 R.C.S. dunsmuir c. nouveau-brunswick  Les juges Bastarache et LeBel 221
justification, transparency and intelligibility within l’appartenance de la décision aux issues possibles
the decision-making process. But it is also con- acceptables pouvant se justifier au regard des faits
cerned with whether the decision falls within a et du droit.
range of possible, acceptable outcomes which are
defensible in respect of the facts and law.
[48] The move towards a single reasonableness [48] L’application d’une seule norme de raisonna-
standard does not pave the way for a more intrusive bilité n’ouvre pas la voie à une plus grande immix-
2008 SCC 9 (CanLII)

review by courts and does not represent a return to tion judiciaire ni ne constitue un retour au for-
pre-Southam formalism. In this respect, the con- malisme d’avant l’arrêt Southam. À cet égard, les
cept of deference, so central to judicial review in décisions judiciaires n’ont peut-être pas exploré suf-
administrative law, has perhaps been insufficiently fisamment la notion de déférence, si fondamentale
explored in the case law. What does deference au contrôle judiciaire en droit administratif. Que
mean in this context? Deference is both an attitude faut-il entendre par déférence dans ce contexte?
of the court and a requirement of the law of judi- C’est à la fois une attitude de la cour et une exi-
cial review. It does not mean that courts are sub- gence du droit régissant le contrôle judiciaire. Il ne
servient to the determinations of decision makers, s’ensuit pas que les cours de justice doivent s’incli-
or that courts must show blind reverence to their ner devant les conclusions des décideurs ni qu’elles
interpretations, or that they may be content to pay doivent respecter aveuglément leurs interprétations.
lip service to the concept of reasonableness review Elles ne peuvent pas non plus invoquer la notion
while in fact imposing their own view. Rather, def- de raisonnabilité pour imposer dans les faits leurs
erence imports respect for the decision-making propres vues. La déférence suppose plutôt le res-
process of adjudicative bodies with regard to both pect du processus décisionnel au regard des faits et
the facts and the law. The notion of deference “is du droit. Elle « repose en partie sur le respect des
rooted in part in a respect for governmental deci- décisions du gouvernement de constituer des orga-
sions to create administrative bodies with delegated nismes administratifs assortis de pouvoirs délé-
powers” (Canada (Attorney General) v. Mossop, gués » : Canada (Procureur général) c. Mossop,
[1993] 1 S.C.R. 554, at p. 596, per L’Heureux-Dubé [1993] 1 R.C.S. 554, p. 596, la juge L’Heureux-
J., dissenting). We agree with David Dyzenhaus Dubé, dissidente. Nous convenons avec David
where he states that the concept of “deference as Dyzenhaus que la notion de [TRADUCTION] « rete-
respect” requires of the courts “not submission nue au sens de respect » n’exige pas de la cour de
but a respectful attention to the reasons offered or révision [TRADUCTION] « la soumission, mais une
which could be offered in support of a decision”: attention respectueuse aux motifs donnés ou qui
“The Politics of Deference: Judicial Review and pourraient être donnés à l’appui d’une décision » :
Democracy”, in M. Taggart, ed., The Province of « The Politics of Deference : Judicial Review and
Administrative Law (1997), 279, at p. 286 (quoted Democracy », dans M. Taggart, dir., The Province
with approval in Baker, at para. 65, per L’Heureux- of Administrative Law (1997), 279, p. 286 (cité avec
Dubé J.; Ryan, at para. 49). approbation par la juge L’Heureux-Dubé dans l’ar-
rêt Baker, par. 65; Ryan, par. 49).
[49] Deference in the context of the reasonable- [49] La déférence inhérente à la norme de la
ness standard therefore implies that courts will raisonnabilité implique donc que la cour de révi-
give due consideration to the determinations of sion tienne dûment compte des conclusions du
decision makers. As Mullan explains, a policy of décideur. Comme l’explique Mullan, le principe
deference “recognizes the reality that, in many de la déférence [TRADUCTION] « reconnaît que
instances, those working day to day in the imple- dans beaucoup de cas, les personnes qui se consa-
mentation of frequently complex administrative crent quotidiennement à l’application de régi-
schemes have or will develop a considerable degree mes administratifs souvent complexes possèdent
In the Court of Appeal of Alberta
Citation: Zakhary v College of Physicians and Surgeons of Alberta, 2013 ABCA 336
Date: 20131003
2013 ABCA 336 (CanLII)

Docket: 1203-0268-AC
Registry: Edmonton
Between:
Dr. Kristina Zakhary
Appellant
- and -
College of Physicians and Surgeons of Alberta
Respondent
_______________________________________________________
The Court:
The Honourable Mr. Justice Jean Côté
The Honourable Mr. Justice Peter Costigan
The Honourable Mr. Justice Brian O’Ferrall
_______________________________________________________
Memorandum of Judgment
Delivered from the Bench
Appeal from the Judgment by

The Honourable Madam Justice J.M. Ross
Dated the 11th day of October, 2012
(2012 ABQB 623, Docket: 1203-06500)
_______________________________________________________
Memorandum of Judgment
Delivered from the Bench
_______________________________________________________

Côté J.A. (for the Court):
[1] The appellant is a physician who was charged before a professional discipline tribunal with
repeatedly failing to respond to an investigator of the respondent College trying to inquire into
another earlier discipline complaint. The appellant agreed that her lack of response was
unprofessional conduct. Both sides made a joint submission that the penalty should be a reprimand
and costs, and the tribunal so ordered. No one appealed, and after the appeal period expired, the
respondent College temporarily published the conviction and penalty.
[2] The appellant physician applied for judicial review of the decision to publish. The Court of
Queen’s Bench dismissed that application because of the deferential standard of review: 2012
ABQB 623. The appellant appeals to us.
[3] The College relies on s 119(1)(f) of the Health Professions Act, RSA 2000, c H-7. It says
that the respondent College’s registrar
(f) subject to the bylaws, may publish or distribute the information referred to in
this subsection and information respecting any order made by a hearing tribunal or
council under Part 4.
Part 4 of the Act is the one dealing with professional discipline.
[4] However, the appellant points out that that paragraph (f) is part of a list of powers,
preceded by words which she suggests form a condition precedent:
If under Part 2 or Part 4 a regulated member’s practice permit is suspended or
cancelled, or if conditions are imposed on a regulated member’s practice permit or
a direction is made under sec. 118(4), . . .
[5] Since reprimands and costs are not mentioned in those opening words, the appellant
physician argues that the condition precedent is not met. So she says that there was and is no power
to publish. The Queen’s Bench Reasons agreed that that was an arguable interpretation of the Act.
[6] However, the judge found also arguable the College’s interpretation of para (f). It points
out that para (f) has two parts. The first part refers to “the information referred to in this
subsection”, which is what the appellant is talking about. But the last part of para (f) allows
publishing something else: “and information respecting any order made by a hearing tribunal or
council under Part 4.” Furthermore the end of para (f) does not speak of the hearing tribunal or
council, which would have referred back to the opening words of s 119(1). Instead it says “a
hearing tribunal or council”, so obviously it can be a tribunal other than one imposing suspension,
cancellation, or practice conditions.
Page: 2
[7] The Reasons found both rival interpretations reasonable, and so dismissed the judicial
review application.

[8] We see no ground to disagree with the conclusion that the College’s interpretation is
reasonable. The drafting of s 119(1) is not perfect; it is also arguable that the opening words
(seeming to make a precondition) clash with the end of para (f) allowing publication of a second
type of information. After all, since the first half of para (f) is about information referred to in
subsec (1), the second half must (at least sometimes) co ver information outside subsec (1).
Otherwise the second half of para (f) would be otiose.
[9] The College was interpreting its home statute, and professional discipline tribunals are the
preeminent example of expert tribunals. This is not a question of law of broad general interest,
such as presumption of innocence, basic rules of statutory interpretation, laws of evidence, or rules
of natural justice.
[10] Rather, the issue is a quirk (the seeming contradiction) in one subsection of one Act.
[11] The appellant relies on the fact that the Health Professions Act governs dozens of different
professions. But can that mean that none of the dozens of regulatory and discipline tribunals acting
under it has expertise? Or that lawyers and accountants get de ference to their interpretation of their
home statute but physicians do not? Surely not. If two or more expert tribunals share a statute, that
does not mean neither has relevant expertise.
[12] The Supreme Court of Canada has ordained deference to the expert tr ibunal’s
interpretation of its home statute. The appellant tries to chip away at the presumed rationale of
those decisions. But we cannot overrule Supreme Court of Canada decisions, whatever their
foundation. And there is no good ground to distinguish them, especially as we should follow
considered dicta of the Supreme Court of Canada.
[13] In any event, we can step past standard of review issue, because judicial review of the
College’s decision on a standard of correctness leads to the same result: the Act allowed
publication here.
[14] The one point upon which the appellant builds her case is the apparent condition precedent
in the opening words of s 119(1). But that point has two serious weaknesses.
[15] First, the most fundamental principle of interpretation is that a n Act or other document
must be read as a whole, interpreting each part in light of all the others. Finding a direct
contradiction between two parts is a last resort, and every effort must be made to interpret each part
so as to live with each other.
[16] The second weakness is the basic rule of statutory interpretation found in Driedger’s The
Construction of Statutes, 2d ed, and adopted by the Supreme Court of Canada over 80 times in
recent years. The court interpreting must not look only at the precise passage in question and the
rules of grammar. It must also use the context and the aim or scheme of the Act. See, for instance,
Page: 3
ATCO Gas & Pipeline v Energy Utilities Board, 2006 SCC 4, [2006] 1 SCR 140, 344 NR 293
(para 48); Re Rizzo and Rizzo Shoes [1998] 1 SCR 27, 221 NR 241 (paras 20-21). That is very
well-established. One must note the rule in Heydon’s Case (1584) 36 Rep 7a, 76 ER 637 about

looking at the evil which the Act seeks to remove, and s 10 of the Interpretation Act which
mandates that statutes are remedial and the courts must give statutes a large and liberal
interpretation to advance their aims and scheme. (See RSA 2000 c I-8.)
[17] The Court of Queen’s Bench Reasons correctly found two possible alternative
interpretations of s 119(1), and neither on its own was unreasonable, they said. That being so,
interpretation as a whole, and interpretation in a contextual and purposive manner, dictate picking
whichever of the two better advances those two aims or canons of interpretation.
[18] Nowhere in the Act is a prohibition on publication in these circumstances. The most the
appellant can suggest is a gap in an express power. But s 3(1)(a) says that the College must govern
its members so as to serve the public interest, and s 2(a) gives it the capacity, rights, powers and
privileges of a natural person. At common law people usually have no power to discipline others;
but they have a power and a right to speak or write or to publish. Those sections have to be read
harmoniously with the rest of the Act, but they have meaning and cannot be ignored. There are no
privacy sections in the Act relevant here.
[19] The aim of professional licensing and regulatory legislation is to let the public pick a
doctor, lawyer, accountant et al. without having to fear an imposter, quack, fake, crook,
incompetent, predator, uncooperative person, or persistent non-performer. Even an astute member
of the public has no means to investigate such things.
[20] Someone wishing a physician has a legitimate interest in knowing the physician’s
efficiency, paper handling skills, and motivation.
[21] Section 42(b)(v) of the relevant Regulation is strong. (See Alta Reg 350/09.) It requires the
College to give information about reprimands to members of the public who inquire. Section
119(4) (plus s 85(3)) of the Act does the same. That ties in closely with the aims of the legislation.
[22] To interpret the Act as not allowing publication of a reprimand, yet require disclosure of it,
would be capricious, and would make the public wishing to select a physician play a game of 20
Questions. Not to mention the media.
[23] The previous legislation on physicians contained repeated presumptions of privacy for
physicians, but this legislation is the opposite. Its scheme is openness. See ss 52, 84 and 85 of the
Health Professions Act and s 42(c) of the Regulation, and note the absence of other privacy
provisions. The aims of all such legislation (just described) are obviously served by that.
[24] Besides, a secret “reprimand” is close to an oxymoron. The Shorter Oxford Dictionary says
“especially one given by a person or body having authority, or by a judge or magistrate to an
offender” (v 2, p 1801, 3d ed 1973, reprinted 1986). The connotation is publicity. A rebuke
administered secretly is really just advice, and no punishment or penalty at all.
Page: 4
[25] Indeed subsecs (2) and (3) of the same s 119 plainly contemplate publicity for some types
of reprimand. It would be odd if some could be published and not others. That is another part of the

Act which must be reconciled with subsec (1) to make both fit and work together.
[26] Therefore, the appeal is dismissed.
Appeal heard on October 1, 2013
Memorandum filed at Edmonton, Alberta

this 3rd day of October, 2013
Côté J.A.
Page: 5
Appearances:

A.L. Friend, Q.C. (no appearance)
K.J. Pirie
for the Appellant
C.D. Boyer
for the Respondent
CPSA Code of Conduct
Expectations of Professionalism for Alberta Physicians
Reissued: June 5, 20141
Introduction
Integrity, trustworthiness, compassion and ethical conduct are the foundation of the practice of medicine.
Patients, co‐workers, learners and others in the healthcare workplace expect professional behavior from
physicians; this behavior has an enormous impact on how health care is delivered and received.
The vast majority of physicians act professionally, and research shows this contributes to a healthier
workplace and good patient outcomes. Alternatively, inappropriate physician behavior can lead to a
number of issues in the healthcare environment, including:
• negative effects on patient safety and quality of care;

• erosion of relationships with staff, patients, learners and families;
• difficulty recruiting and retaining staff;
• reduced work attendance by co‐workers and colleagues; and
• adverse impacts on a physician’s health and/or reputation.
In order to address these issues, expectations of physicians must be clear.
The College of Physicians & Surgeons of Alberta (“CPSA”) Code of Conduct was developed in response
to requests from physicians for clarity and advice about professional behavior. It was written in
consultation with physicians, other healthcare providers, healthcare organizations, regulatory bodies and
post-secondary institutions.
The Code of Conduct is intended to:

• support a culture that aids and encourages effective care of patients and values
professionalism, integrity, honesty, fairness and collegiality;
• promote an optimally caring environment of quality and safety for the health and well-being of
patients and families, physicians, nurses, other healthcare providers, learners, teachers and
others in the healthcare workplace;
• help physicians meet the principles outlined in the Canadian Medical Association (CMA)
Code of Ethics and the CPSA Standards of Practice;
• help physicians model and teach professional behavior;
• encourage open and respectful discussion related to the delivery of health care; and
• support physicians and others in addressing physician behavior that does not meet
professional expectations.
Page 1 of 4
General Principles
The Code of Conduct is based on the following ethical and professional principles:
• Strive for high‐quality patient care.

• Focus on safety.
• Treat others with respect.
• Maintain confidentiality.
• Do the right things for the right reasons.
• Be aware of your professional and ethical responsibilities.
• Be collaborative.
• Take action when inappropriate behavior occurs.
• Communicate clearly.
Scope of the Code of Conduct

The Code of Conduct applies in any environment where a physician interacts with patients, colleagues,
co-workers, learners and others in the healthcare workplace, including physical workplace, telephone,
videoconference and online. The Code also applies in any situation where a member can be identified by
the public as a physician, such as public appearances, printed media and online networks where
information may be shared.
The Code of Conduct clarifies the College’s expectations of Alberta’s physicians in all stages of their
careers, in all facets of medicine, and in all methods of care delivery.
The Code of Conduct is consistent with the CMA’s Code of Ethics and complements the CPSA Standards
of Practice. Physicians are expected to know and abide by these rules; any breach of professional
behavior will be judged against all three of these foundational documents.
While the Code of Conduct outlines expectations regarding professional behavior, when inappropriate
behavior occurs the College will consider:
• the physician’s fitness to practise, which must be addressed; and
• systemic issues within the healthcare system.
NOTE: Although these stressors must be identified and considered, they cannot be used as an excuse
for inappropriate behavior.
Specific Expectations
Accountability
As a physician, I will:
(a) Act, speak, and otherwise behave in the healthcare workplace in a way that promotes safety, high
quality patient care and effective collaboration with others on the healthcare team.
(b) Maintain high standards of personal and professional honesty and integrity.
(c) Take responsibility for my own behavior and ethical conduct regardless of the circumstances.
(d) Be accountable for my personal decisions, actions or non‐actions in the workplace.
(e) Record and report accurately and in a timely fashion clinical information (history, physical findings
and test results), research results, assessments and evaluations.
(f) Communicate with integrity and compassion.
(g) Accurately attribute ideas developed with others and credit work done by others.
Page 2 of 4
(h) Deal with conflicts of interest, real or perceived, openly and honestly.
(i) Engage in lifelong learning.
Confidentiality
(a) Regard the confidentiality and privacy of patients, research participants and educational
participants, as well as their associated health records, as a primary obligation.
(b) Ensure confidentiality by limiting discussion of patient health issues to settings appropriate for
clinical or educational purposes and to caregivers within the “circle of care”. Discussion with
others will occur only with explicit patient consent or as permitted by legal and ethical principles.
(c) Know and comply with applicable legislation regarding confidentiality and health information.
Respect for Others
(a) Interact with patients and families, visitors, employees, physicians, volunteers, healthcare
providers and others with courtesy, honesty, respect, and dignity.
(b) Refrain from conduct that may reasonably be considered offensive to others or disruptive to the
workplace or patient care. Such conduct may be written, oral or behavioral, including
inappropriate words and/or inappropriate actions or inactions.
(c) Respect patient autonomy at all times by appropriately discussing investigation and treatment
options with the competent patient and, only with the patient’s consent, identified other persons.
(d) Ensure appropriate consultation occurs when a patient lacks the capacity to make treatment
decisions, except in emergency circumstances.
(e) Respect the personal boundaries of patients and their rights to privacy and confidentiality; refrain
from physical contact outside the proper role of a physician, sexual overtures and behaviors or
remarks of a sexual nature.
(f) Respect the personal boundaries of co‐workers and their rights to privacy and confidentiality;
refrain from unwanted physical contact, sexual overtures and behavior or remarks of a sexual
nature.
(g) Avoid discrimination based on, but not limited to, age, gender, medical condition, race, color,
ancestry, national or ethnic origin, appearance, political belief, religion, marital or family status,
physical or mental disability, sexual orientation or socioeconomic status. (NOTE: In human rights
legislation, this is known as “protected grounds”.)
(h) Allow colleagues to disagree respectfully without fear of punishment, reprisal or retribution.
(i) Recognize the important contributions of colleagues, whether generalists or specialists.
Page 3 of 4
Responsible Behavior
(a) Ensure patient care and safety assume the highest priority in the clinical setting. The duty of
physicians to advocate for patients does not excuse or justify unacceptable behavior; it must be
done constructively.
(b) Attend to my health and well‐being to enable attendance to professional responsibilities.
(c) Recognize limitations and seek consultation or help when personal knowledge, skills or
physical/mental status is inadequate or compromised.
(d) Maintain professional boundaries:
• minimize self disclosure; and
•
*
refrain from providing care to individuals where a dual relationship exists and objectivity
may be challenged; in circumstances where refraining is not reasonably possible, ensure
care provided is transparent, objective and defensible.
(e) Supervise and assist others as appropriate to their needs and level of expertise.
(f) Participate in quality improvement initiatives and strategies to deal with errors, adverse events,
close calls and disclosure.
(g) Express opinions on healthcare matters in a manner respectful of others’ views and the
individuals expressing those views.
(h) When conducting professional activities, abstain from exploitation of others for emotional,
financial, research, educational or sexual purposes.
(i) Teach and model the concepts of professional behavior in research, clinical practice and
educational encounters.
(j) Encourage and model language, appearance and demeanor appropriate to the professional
healthcare setting.
(k) Endeavor to model professional behavior in all public settings, including online settings,
particularly when there is limited ability to separate personal and professional identities.
(l) Avoid misuse of alcohol or drugs that could impair the ability to provide safe care to patients.
(m) Attend to other factors that could impair the ability to provide safe care to patients.
(n) Address breaches of professional conduct, scientific conduct or unskilled practice by another
healthcare professional by discussion directly with that person or, if necessary, by reporting to the
appropriate authorities using established procedures. Refrain from trivial or vexatious reports that
unjustly discredit the healthcare system or the reputation of other members of the healthcare,
research or academic team.
(o) Know and adhere to the CPSA Standards of Practice.
(p) Participate in professional development and assessment processes.
(q) Respect the authority of the law and understand professional and ethical obligations.
* Dual relationship refers to when multiple roles (personal, professional, business or social) exist between a physician and a patient.
Acknowledgement
This document was developed with input from various health professions and using codes of conduct from other
institutions and organizations. Particularly helpful were statements from the College of Physicians and Surgeons of
Ontario, the University of Calgary Faculty of Medicine, the University of Alberta Office of Equity and Faculty
Development, and the Medical Council of Canada.
_____________
1
Replaces CPSA Code of Conduct; issued April 2010
Page 4 of 4
CMA POLICY
CMA Code of Ethics
(Update 2004)
Last reviewed March 2018: Still relevant
This Code has been prepared by the Canadian Medical Association as an ethical guide for Canadian
physicians, including residents, and medical students. Its focus is the core activities of medicine – such as
health promotion, advocacy, disease prevention, diagnosis, treatment, rehabilitation, palliation, education and
research. It is based on the fundamental principles and values of medical ethics, especially compassion,
beneficence, non-maleficence, respect for persons, justice and accountability. The Code, together with CMA
policies on specific topics, constitutes a compilation of guidelines that can provide a common ethical
framework for Canadian physicians.
Physicians should be aware of the legal and regulatory requirements that govern medical practice in their
jurisdictions.
Physicians may experience tension between different ethical principles, between ethical and legal or regulatory
requirements, or between their own ethical convictions and the demands of other parties. Training in ethical
analysis and decision-making during undergraduate, postgraduate and continuing medical education is
recommended for physicians to develop their knowledge, skills and attitudes needed to deal with these
conflicts. Consultation with colleagues, regulatory authorities, ethicists, ethics committees or others who have
relevant expertise is also recommended.
physical comfort and spiritual and psychosocial

Fundamental Responsibilities support.
1. Consider first the well-being of the patient. 4. Consider the well-being of society in matters
affecting health.
2. Practise the profession of medicine in a manner
that treats the patient with dignity and as a person 5. Practise the art and science of medicine
worthy of respect. competently, with integrity and without
impairment.
3. Provide for appropriate care for your patient,
even when cure is no longer possible, including 6. Engage in lifelong learning to maintain and

© 2004 Canadian Medical Association. You may, for your non-commercial use, reproduce, in whole or in part and in any form or manner,
unlimited copies of CMA Policy Statements provided that credit is given to the original source. Any other use, including republishing,
redistribution, storage in a retrieval system or posting on a Web site requires explicit permission from CMA. Please contact the Permissions
Coordinator, Publications, CMA, 1867 Alta Vista Dr., Ottawa ON K1G 5W8; fax 613 565-2382; permissions@cma.ca.
Correspondence and requests for additional copies should be addressed to the Member Service Centre, Canadian Medical Association,
1867 Alta Vista Drive, Ottawa, ON K1G 5W8; tel 888 855-2555 or 613 731-8610 x2307; fax 613 236-8864.
All policies of the CMA are available electronically through CMA Online (www.cma.ca).
improve your professional knowledge, skills and Relationship
attitudes.
17. In providing medical service, do not
7. Resist any influence or interference that could discriminate against any patient on such grounds
undermine your professional integrity. as age, gender, marital status, medical condition,
national or ethnic origin, physical or mental
8. Contribute to the development of the medical disability, political affiliation, race, religion, sexual
profession, whether through clinical practice, orientation, or socioeconomic status. This does not
research, teaching, administration or advocating on abrogate the physician’s right to refuse to accept a
behalf of the profession or the public. patient for legitimate reasons.
9. Refuse to participate in or support practices that 18. Provide whatever appropriate assistance you
violate basic human rights. can to any person with an urgent need for medical
care.
10. Promote and maintain your own health and
well-being. 19. Having accepted professional responsibility for
a patient, continue to provide services until they
Responsibilities to the Patient are no longer required or wanted; until another
suitable physician has assumed responsibility for
General Responsibilities the patient; or until the patient has been given
reasonable notice that you intend to terminate the
relationship.
11. Recognize and disclose conflicts of interest
that arise in the course of your professional duties
20. Limit treatment of yourself or members of your
and activities, and resolve them in the best interest
immediate family to minor or emergency services
of patients.
and only when another physician is not readily
available; there should be no fee for such
12. Inform your patient when your personal values
treatment.
would influence the recommendation or practice of
any medical procedure that the patient needs or
Communication, Decision Making and Consent
wants.
13. Do not exploit patients for personal advantage. 21. Provide your patients with the information they
need to make informed decisions about their
14. Take all reasonable steps to prevent harm to medical care, and answer their questions to the
patients; should harm occur, disclose it to the best of your ability.
patient.
22. Make every reasonable effort to communicate
15. Recognize your limitations and, when with your patients in such a way that information
indicated, recommend or seek additional opinions exchanged is understood.
and services.
23. Recommend only those diagnostic and
16. In determining professional fees to patients for therapeutic services that you consider to be
non-insured services, consider both the nature of beneficial to your patient or to others. If a service
the service provided and the ability of the patient is recommended for the benefit of others, as for
to pay, and be prepared to discuss the fee with the example in matters of public health, inform your
patient. patient of this fact and proceed only with explicit
informed consent or where required by law.
Initiating and Dissolving a Patient-Physician
2
24. Respect the right of a competent patient to
accept or reject any medical care recommended. 34. Avoid public discussions or comments about
patients that could reasonably be seen as revealing
25. Recognize the need to balance the developing confidential or identifying information.
competency of minors and the role of families in
medical decision-making. Respect the autonomy 35. Disclose your patients' personal health
of those minors who are authorized to consent to information to third parties only with their consent,
treatment. or as provided for by law, such as when the
maintenance of confidentiality would result in a
26. Respect your patient's reasonable request for a significant risk of substantial harm to others or, in
second opinion from a physician of the patient's the case of incompetent patients, to the patients
choice. themselves. In such cases take all reasonable steps
to inform the patients that the usual requirements
27. Ascertain wherever possible and recognize for confidentiality will be breached.
your patient's wishes about the initiation,
continuation or cessation of life-sustaining 36. When acting on behalf of a third party, take
treatment. reasonable steps to ensure that the patient
understands the nature and extent of your
28. Respect the intentions of an incompetent responsibility to the third party.
patient as they were expressed (e.g., through a
valid advance directive or proxy designation) 37. Upon a patient’s request, provide the patient or
before the patient became incompetent. a third party with a copy of his or her medical
record, unless there is a compelling reason to
29. When the intentions of an incompetent patient believe that information contained in the record
are unknown and when no formal mechanism for will result in substantial harm to the patient or
making treatment decisions is in place, render such others.
treatment as you believe to be in accordance with
the patient's values or, if these are unknown, the Research
patient's best interests.
38. Ensure that any research in which you
30. Be considerate of the patient's family and participate is evaluated both scientifically and
significant others and cooperate with them in the ethically and is approved by a research ethics
patient's interest. board that meets current standards of practice.
Privacy and Confidentiality 39. Inform the potential research subject, or

proxy, about the purpose of the study, its source of
31. Protect the personal health information of your funding, the nature and relative probability of
patients. harms and benefits, and the nature of your
participation including any compensation.
32. Provide information reasonable in the
circumstances to patients about the reasons for the 40. Before proceeding with the study, obtain the
collection, use and disclosure of their personal informed consent of the subject, or proxy, and
health information. advise prospective subjects that they have the right
to decline or withdraw from the study at any time,
33. Be aware of your patient’s rights with respect without prejudice to their ongoing care.
to the collection, use, disclosure and access to their
personal health information; ensure that such Responsibilities to Society
information is recorded accurately.
3
41. Recognize that community, society and the product for personal gain.
environment are important factors in the health of
individual patients. 51. Do not keep secret from colleagues the
diagnostic or therapeutic agents and procedures
42. Recognize the profession's responsibility to that you employ.
society in matters relating to public health, health
education, environmental protection, legislation 52. Collaborate with other physicians and health
affecting the health or well-being of the professionals in the care of patients and the
community and the need for testimony at judicial functioning and improvement of health services.
proceedings. Treat your colleagues with dignity and as persons
worthy of respect.
43. Recognize the responsibility of physicians to
promote equitable access to health care resources. Responsibilities to Oneself
44. Use health care resources prudently. 53. Seek help from colleagues and appropriately
qualified professionals for personal problems that
45. Recognize a responsibility to give generally might adversely affect your service to patients,
held opinions of the profession when interpreting society or the profession.
scientific knowledge to the public; when
presenting an opinion that is contrary to the 54. Protect and enhance your own health and well-
generally held opinion of the profession, so being by identifying those stress factors in your
indicate. professional and personal lives that can be
managed by developing and practising appropriate
Responsibilities to the Profession coping strategies.
46. Recognize that the self-regulation of the

profession is a privilege and that each physician
has a continuing responsibility to merit this
privilege and to support its institutions.
47. Be willing to teach and learn from medical

students, residents, other colleagues and other
health professionals.
48. Avoid impugning the reputation of colleagues

for personal motives; however, report to the
appropriate authority any unprofessional conduct
by colleagues.
49. Be willing to participate in peer review of

other physicians and to undergo review by your
peers. Enter into associations, contracts and
agreements only if you can maintain your
professional integrity and safeguard the interests of
your patients.
50. Avoid promoting, as a member of the medical

profession, any service (except your own) or
4
Standards of Practice
The minimum standard of professional behavior and good practice expected of Alberta physicians.
Effective as of September 6, 2018

Standard of Practice
Duty to Report
a Colleague
Under Review: No
Issued by Council: January 1, 2010
Reissued by Council: September 1, 2012
Duty to Report a Colleague

The Standards of Practice of the College of Physicians & Surgeons of Alberta (“the College”) are the minimum standards of
professional behavior and ethical conduct expected of all regulated members registered in Alberta. Standards of Practice are
enforceable under the Health Professions Act and will be referenced in the management of complaints and in discipline
hearings. The College of Physicians & Surgeons of Alberta also provides Advice to the Profession to support the
implementation of the Standards of Practice.
(1) A physician must report another physician to the College when the first physician believes,
on reasonable grounds, that the conduct of the other physician places patients at risk or is
considered unprofessional conduct under the Health Professions Act.
(2) Knowledge of physician conduct that should be reported in subsection (1) includes but is not
limited to situations in which a physician:
(a) makes sexual advances to or enters into a sexual relationship with a patient,
1
(b) suffers from a physical, cognitive, mental or emotional condition that is negatively
2
impacting the work or is reasonably likely to negatively impact the work of the physician,
(c) repeatedly or consistently fails to address his or her behaviour that interferes with the
delivery of care to patients, the ability of other physicians, learners or healthcare workers to
provide care to patients, or
(d) is not competent in the care of patients.
(3) When a patient discloses information leading a physician to believe on reasonable grounds that
another physician has committed a sexual boundary violation with the patient, the first physician
must:
(a) provide the patient with information about how to file a complaint with the College,
(b) offer to file a third person complaint with the patient’s permission, if the patient does not
wish to file a complaint personally, or
(c) at a minimum, document the sexual boundary violation indicating that the patient does not
wish to report to the College when the patient does not give permission to proceed with a third
party complaint; however, the name of the physician may be reported to the College without
providing the name of the patient.
1
As in the definition in Self-Reporting to the College.
2
As in the definition in Self-Reporting to the College.
Terms used in the Standards of Practice:

• “Regulated member” means any person who is registered or who is required to be registered as a member of this College.
The College regulates physicians, surgeons and osteopaths.
• “Must” refers to a mandatory requirement.
• “May” means that the physician may exercise reasonable discretion.
• “Patient” includes, where applicable, the patient’s legal guardian or substitute decision maker.
27 of 70
(4) The physician-patient must be advised of their duty to self-report and must be supported in their
reporting to the College.
(5) The treating physician must advise the physician-patient of their intent to report to the College.
Terms used in the Standards of Practice:

• “Regulated member” means any person who is registered or who is required to be registered as a member of this College.
The College regulates physicians, surgeons and osteopaths.
• “Must” refers to a mandatory requirement.
• “May” means that the physician may exercise reasonable discretion.
• “Patient” includes, where applicable, the patient’s legal guardian or substitute decision maker.
28 of 70
Decision date: December 21, 2017
Publication date: July 12, 2018
2017 CanLII 145468 (AB CPSDC)

Discipline Report
Guilty of disruptive behaviour reaching the threshold of unprofessional conduct
A Hearing Tribunal has found Dr. Mohammed Al-Ghamdi, an orthopedic surgeon from Grande Prairie,
guilty of disruptive conduct on eight of 13 charges. Dr. Al-Ghamdi was the focus of three separate
College investigations—two complaints from personnel within Alberta Health Services (AHS) and one
initiated by the College’s Complaints Director.
The concerns arose from Dr. Al-Ghamdi’s interactions with healthcare colleagues (physicians and nurses)
and from AHS management. The hearing began in April 2015, with a decision issued on April 11, 2017,
followed by a further sanction decision on Dec. 21 2017.
Dr. Al-Ghamdi has appealed that decision and Council will hear that appeal in September of 2018.
Background
It was alleged that “Since 2003 [Dr. Al-Ghamdi has] demonstrated a pattern of disruptive conduct in [his]
dealings with a number of [his] medical colleagues and nursing staff at the Queen Elizabeth II hospital,
which has resulted in a breakdown of [his] professional relationship with those colleagues and staff to
the detriment of the health services at that hospital, with particular acts in one or more of the following
categories of conduct,” which included these eight charges on which Dr. Al-Ghamdi was found guilty:
1. Failing to participate in and follow the on-call schedule and procedures for orthopedic surgery at
the hospital.
2. Purporting to have a parallel on-call schedule of his own to try to avoid having to deal with the
on-call orthopedic surgeon at the hospital when booking a patient for surgery.
3. Failing to cooperate with his medical colleagues and nursing staff to ensure surgical cases were
performed on the basis of medical need for urgent care.
4. Cultivating a culture of fear and distrust through making complaints to the Alberta Human
Rights commission, the College and Association of Registered Nurses of Alberta or the College of
Physicians & Surgeons of Alberta.
5. Cultivating a culture of fear and distrust through threatening legal action.
6. Cultivating a culture of fear and distrust through making numerous complaints to administration
at the hospital and the health authority.
7. Failing to follow the issue/dispute resolution processes set out in the bylaws and policies
applicable to hospital medical staff.
8. Having nursing staff open sterilized packs of surgical instruments, which were not reasonably
required for the procedure at hand and thereby making those instruments unavailable for other
surgeons until the nursing staff had re-sterilized the instrument packs.
Penalty
The penalty ordered by the Tribunal included:
1. A practice permit suspension for a minimum of two years. Dr. Al-Ghamdi may apply to the

Registrar for reinstatement after two years, if he completes a comprehensive assessment
program to determine his fitness to practise. The program must be approved by the Registrar in
advance and Dr. Al-Ghamdi is responsible for all costs of such an assessment. In addition, Dr. Al-
Ghamdi would be expected to successfully complete any and all direction from the
comprehensive assessment, including any recommended therapy, courses on interpersonal
communication and endorsement of a mentor acceptable to the College. Dr. Al-Ghamdi would
be responsible for all associated costs.
2. Dr. Al-Ghamdi was awarded eight-thirteenths of the cost of the hearing, inclusive of the cost of
legal counsel retained by the Hearing Director to assist with Dr. Al-Ghamdi’s multiple objections
and other actions. The sum of $701,450.57 is to be paid in full, no later than three years from
the date of the sanction decision – a failure to do so allows for the suspension of Dr. Al-
Ghamdi’s practice permit.
Dr. Al-Ghamdi can still practise medicine while his appeal to Council is pending.
Commentary
The basic tenet of the matters—the issue of physician disruption in the workplace and its impact on the
healthcare team—cannot be overstated. The delivery of modern healthcare requires a responsible and
functional team approach, as envisioned by the Code of Conduct and the Code of Ethics.
Decision date: Oct. 29, 2018
Publication date: Jan. 10, 2019

Discipline Report
Edmonton physician sanctioned for threatening behaviour
Dr. Viliam Makis, a nuclear physician from Edmonton, was found guilty of unprofessional conduct and
sanctioned by a College Hearing Tribunal.
Background
It was alleged that in April 2017, Dr. Makis confronted a former colleague who had previously provided
the College with information about his conduct (as part of a separate complaints investigation). Dr.
Makis accused his former colleague of lying about him and suggested there would be negative
consequences for doing so.
While the confrontation was not physically aggressive, Dr. Makis’ former colleague found the exchange
threatening and inappropriate. The incident was reported to the College, where the Associate
Complaints Director initiated a complaint.
Dr. Makis denied the allegations. The Hearing Tribunal reviewed all of the evidence and felt the former
colleague’s version of events was credible. Dr. Makis was found guilty as his conduct was considered
contrary to the Canadian Medical Association’s Code of Ethics.
Order of the Hearing Tribunal
As a result of the finding of unprofessional conduct, the Hearing Tribunal ordered the following
sanctions:
1. Dr. Makis received a reprimand.

2. Within 40 days of the decision, Dr. Makis must arrange for an assessment of his fitness to
practise medicine, and provide the College’s Registrar with evidence of the scheduled
assessment and the assessment’s results.
3. If Dr. Makis fails to arrange for the assessment within the required time, the Registrar will make
the arrangements. Once the Registrar receives the results of the assessment, he will determine
what (if any) follow-up action is required.
4. If Dr. Makis fails to arrange for the assessment, fails to undergo the assessment, does not
provide the Registrar with the assessment’s results or fails to comply with any required follow-
up, his practice permit will be suspended.
5. If Dr. Makis is found fit to practise medicine without conditions, his practice permit (if
suspended) will be restored and he will be responsible for the full costs of the investigation and
hearing (totaling $74,453). If the assessment reveals concerns about Dr. Makis’ fitness to
practise, his permit will reflect any required conditions and he will be responsible for 50 per cent
of the investigation and hearing costs.
Dr. Makis has appealed the Tribunal’s decision to College Council. A date for the appeal hearing has not
yet been set.

Commentary
Each physician practising in Alberta has a responsibility to uphold the privilege of profession-led
regulation by conducting themselves professionally and treating colleagues with respect. Furthermore,
anyone should be able to come forward with concerns about a physician’s practice or behaviour without
fear of retaliation. Intimidation of witnesses by physicians is never appropriate and poses a threat to the
College’s ability to regulate the medical profession and ensure that patients are receiving safe and
appropriate care.

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COURT FILE NUMBER 1803 01472 Clerk’s Stamp

COURT QUEEN’S BENCH OF ALBERTA

JUDICIAL CENTRE EDMONTON

APPLICANT(S) DR.VILIAM MAKIS

RESPONDENT(S) COLLEGE OF PHYSICIANS AND SURGEONS OF

ADDRESS FOR SERVICE Attention: Dr.Viliam Makis

BRIEF OF THE PLANTIFF/APPLICANT, DR.VILIAM MAKIS FOR A JUDICIAL REVIEW to be

ADDRESS FOR SERVICE AND 5970 Mullen Way, #36560

ADDRESS FOR SERVICE AND Shores Jardine LLP

IV. LAW AND ARGUMENT…………………………………………….…………………………..7

a. Standard of Review applicable to CRC Decision – Reasonableness…….....7

i. Legal obligations of CPSA and CPSA Officials…………….……………....8

ii. Legal obligations of Applicant Dr.Makis……………………………………10

iii. Legal obligations of CPSA Complaints Director and CRC………..….…11

b. Was the CRC Decision unreasonable?.............................……………..…….13

i. Unreasonable conduct of CPSA Officials that led to CRC Review…….13

ii. CRC Decision is unreasonable – Documents reviewed……………..….18

iii. CRC Decision is unreasonable – Misrepresented Background………..20

iv. CRC Decision is unreasonable – Decision………………………………..21

c. Did the CRC Breach the Duty of Procedural Fairness?..................…...…...36

i. Nature of CRC Decision and process followed………...……………..….37

ii. Nature of statutory scheme and terms of the statute……………………39

iii. The importance of the Decision to the individual affected……………..40

iv. The legitimate expectations of the person challenging decision……..44

v. The choices of procedure made by the agency itself…………………...46

VI. TABLE OF AUTHORITIES….………………………………………………………………50

College of Physicians and Surgeons of Alberta (“CPSA”) Complaint Review Committee

Dr.Michael Caffaro’s dismissal of a CPSA Complaint No.160618 regarding serious

allegations of physically and verbally abusive, unprofessional, unlawful and unethical

(“CCI”), Dr.Robert MacEwan (“Dr.MacEwan”).

Decision to dismiss the entire 160618 complaint (the “CRC Decision”).

duty of procedural fairness owed to Dr.Makis.

2018, and January 24, 2019.

6. Dr.Makis is a Nuclear Medicine physician who provided medical services at CCI in

Edmonton, AB, from August 5, 2013 until October 31, 2016.

Affidavit of Dr.Makis filed Jan.26, 2018 at para. 2-3.

Diagnostic Imaging Department of CCI, Dr.Makis became a victim of repeated workplace

Dr.MacEwan. After filing a harassment complaint against Dr.MacEwan in August 2014,

Dr.MacEwan to senior AHS Officials, including Dr.MacEwan’s supervisor and AHS

was subjected to a pre-meditated campaign of career sabotage by Dr.MacEwan who

Dr.MacEwan’s unlawful, unprofessional and unethical conduct to the CPSA pursuant to

section 54 of the HPA, which became CPSA File No.160350.

Affidavit of Dr.Makis filed Jan.26, 2018 at para. 2-4.

career sabotage committed by Dr.MacEwan against Dr.Makis and Dr.Makis’ healthcare

intent of covering-up the allegations.

Affidavit of Dr.Makis filed Jan.26, 2018 at para. 4-5.

Affidavit of Dr.Makis filed Jan.26, 2018 at para.6; see Exhibit C.

allegations of unprofessional conduct of Dr.MacEwan. On November 15, 2016, Dr.Caffaro

Affidavit of Dr.Makis filed Jan.26, 2018 at para.7-8, Exhibits D and E.

QB1603-18935 for $13.5 million in damages inflicted on Dr.Makis’ medical career by

CPSA Certified Record of Proceedings, supra, at pages 203-220.

CPSA Certified Record of Proceedings, supra, at page 127.

the CPSA CRC, pursuant to section 68 of the HPA.

Affidavit of Dr.Makis filed Jan.26, 2018 at para.11, see Exhibit G.

Dr.MacEwan and Dr.Parliament in December 2015, and Dr.Caffaro’s Dismissals of these

incidents of unprofessional conduct by dismissing 160350 and 160618. Dr.Williams

documented Dr.MacEwan’s physically and verbally abusive conduct toward CCI

offers this option.

evidence of unprofessional conduct to warrant a CPSA Investigation or Hearing.

Affidavit of Dr.Makis filed Jan.26, 2018 at para.12, see Exhibit H.

of healthcare staff committed by Dr.MacEwan.

Affidavit of Dr.Makis filed Jan.24, 2019, at para. 8, see Exhibit E.

20. On February 7, 2018, CPSA Registrar Dr.Scott McLeod launched an investigation of

Dr.Michael Caffaro’s professional misconduct regarding Dr.Caffaro’s role in the sabotage