1. The parties have submitted a statement of agreed facts, findings and determinations to be read in conjunction with a filed Tribunal book. The parties advised that they did not need to be heard by the Tribunal, and I was not directed to any particular material in the Tribunal book, which runs to some 281 pages. I have cross-checked the agreed facts insofar as they reflect the documentary material in the Tribunal book and have had regard to particular material which I refer to in these reasons.
2. I have summarised the agreed facts below. Consistent with the agreed statement and correspondence between the parties I will use non-binary general-neutral pronouns for the respondent.
3. The respondent admits the allegations in the application.
4. The respondent is 41 years old. They held general registration as a medical practitioner from 8 January 2018 to 25 November 2022. The respondent's registration has been suspended since 25 November 2022.
5. From January 2022 until July 2022, and from September 2022 until 25 November 2022 the respondent practiced as a general practitioner at two medical centres.
6. The applicant received the following notifications in respect to the respondent:

(a) On 15 and 17 July 2022 in respect to an alleged instance of self-prescribing Mersyndol Forte on 9 July 2022 (the 9 July 2022 conduct).

(b) 30 August 2022 concerning a number of prescribing events alleged to have occurred between 1 January 2020 and 29 August 2022 (the prescribing conduct).

(c) 4 November 2022 concerning a prescribing event alleged to have occurred on 26 June 2022 (the 26 June 2022 conduct).

1. In response to the notifications the applicant took the following steps:

(a) On 15 September 2022 the applicant cautioned the respondent in respect to the 9 July 2022 conduct.

(b) On 13 October 2022 the applicant commenced an investigation into the prescribing conduct.

(c) On 25 November 2022 the applicant took immediate action to suspend the respondent's registration.

(d) On 30 November 2022 the applicant commenced an investigation into the 26 June 2022 conduct.

(e) On 31 October 2024 the applicant filed the application with the Tribunal.

(f) On 10 January 2025 the applicant filed amended particulars of the application.

1. The 9 July 2022 conduct does not form part of the grounds for the application and I have had regard to it only in terms of history and context.

Agreed facts in respect to ground 1: inappropriately prescribing medications including drugs of dependence to AA

1. At the relevant times the respondent lived with their partner, AA. AA has a number of serious medical conditions. As a result of her medical conditions AA has ongoing health issues, including pain, urinary retention, urinary tract infections, and bladder and bowel dysfunction.
2. Except for two periods which are not relevant to the application, AA was subject to an authority under s 59E of the Poisons Act 1971 between 20 May 2019 and 16 May 2024.
3. Section 59E of the Poisons Act provides that the Secretary of the Department administering the Act may authorise a medical practitioner to make narcotic substances available for the use of a patient. Section 59C(5) prohibits a medical practitioner from making a narcotic substance available to a person if the practitioner knows or ought to have known that that person is the subject of an authority under s 59E(1).
4. Between 1 March 2020 and 4 July 2022 the respondent issued 33 prescriptions for AA. Of those prescriptions, 24 were for drugs of dependence within the meaning of Sch 1 to the Poisons (Drugs of Dependence) Order 2009, being Valpam, Comfarol Forte, Paracetamol/Codeine, Diazepam and Mersyndol Forte.
5. The respondent ought to have known that AA was the subject of authorities issued under s 59E of the Poisons Act at the time of issuing the prescriptions.
6. Diazepam and Paracetamol/Codeine are notifiable restricted substances pursuant to Sch 1 of the Poisons (Notifiable Restricted Substances) Order 2009. The respondent's prescriptions for those medications may be in breach of s 59C(5) of the Poisons Act.
7. The respondent did not keep and maintain clinical records in respect to any of the prescriptions. They did not communicate their prescribing to AA's treating practitioners.
8. The respondent's prescribing to AA over a prolonged period posed a serious risk to AA in that it:

(a) interfered with AA's existing doctor-patient relationships; and

(b) enabled a pattern of avoidance by AA of seeking medical care.

Agreed facts in respect to ground 2: using the prescribing identity of another registered medical practitioner to self-prescribe medications including a drug of dependence

1. On 26 June 2022 the respondent logged into the BestPractice account of another medical practitioner without that practitioner's knowledge. The respondent used that practitioner's prescribing identify to falsify three electronic prescriptions (e-Scripts) for themself for:

(a) Augmentin Duo Forte;

(b) Keflex; and

(c) Mersyndol Forte.

1. Mersyndol Forte is a drug of dependence within the meaning of Sch 1 to the Poisons (Drugs of Dependence) Order.
2. The respondent sent the e-Scripts to their mobile phone and manually deleted the prescribing records for the e-Scripts from the BestPractice records. The respondent deleted the e-Scripts from the BestPractice record in order to conceal the falsified prescriptions.
3. The respondent's conduct might constitute an offence against s 24(4) of the Misuse of Drugs Act 2001 which provides that a person must not obtain a prescription by means of conduct that the person knows to be false, misleading or deceptive.

1. At the relevant times the respondent was a general practice registrar. They have impressive academic qualifications including bachelors degrees in science, in arts and in law as well as medicine, and masters degrees in bioethics and public health. They were at that time an adjunct professor at the University of Tasmania, an OSCE examiner and a committee member of the Australasian Association of Bioethics and Health Law.
2. There is no indication in the material that the respondent engaged on any relevant conduct after the first notification was received by the applicant on 15 July 2022, although they had limited opportunity, being suspended on 25 November 2022.
3. The respondent readily admitted their conduct in their written responses to the applicant. They provided a clinical explanation for the incidents of prescribing for AA. Her health needs were significant and weighed heavily on the respondent. After the initial notification they took steps to distance themself from AA's care. Their actions and response demonstrate insight into their conduct, to the extent that they contemplated ceasing practice and moved to a rural practice to reduce the possibility of treating patients with whom they had any relationship.
4. The respondent explained their conduct in respect to ground 2 in the context of mental health issues they were experiencing at the time. The Tribunal book includes reports obtained by the respondent's legal practitioners from two treating general practitioners and a treating psychologist, Ms Martine Plakalovic and a report from a psychiatrist, Dr Michael Evenhuis, following an independent medical examination.
5. Dr Evenhuis' report is dated 2 May 2023. He identified the respondent as having autism spectrum disorder and diagnosed major depressive disorder and panic disorder and a major depressive episode. He identified complicated multiple causal factors in addition to the disciplinary action. He noted that the respondent has obsessional personality traits with some difficulties with emotional regulation, self-esteem and identity and that they described a need to fulfil the needs of others even if at their own expense. He describes the circumstances of the respondent's impaired judgement and their insight into the nature and culpability of their conduct, although they had an impaired understanding of their motivation for the conduct. Dr Evenhuis confirmed that the respondent does not have a substance use disorder. Toxicology reports provided by the respondent indicate no issue of drug dependence. He expressed the opinion that the respondent was unlikely to engage further in inappropriate prescribing behaviour and that they had a good prognosis for recovery but may struggle to return to work full time in medicine because of their underlying psychological vulnerabilities.
6. Ms Plakalovic's first report is dated 19 July 2023. Her opinions are consistent with those of Dr Evenhuis. She considered that the respondent's conduct was in part reflected by their personality traits of prioritising responsibility for other's needs and needing to help others. She expressed the view that that the respondent did not then have the capacity to return to work as a medical practitioner in any capacity and she expressed reservations in respect to a future return. In a submission to the applicant provided on 29 August 2023 the respondent agreed that they were not then capable of returning to work. A subsequent report of Ms Plakalovic dated 22 February 2024 indicates improvement in the respondent's condition and some ambivalence by them concerning return to medical practice. In a brief report dated 28 February 2024 the respondent's general practitioner, Dr Gordon Orr, expressed a view that the respondent could return to work as a medical practitioner.

1. It is agreed that the respondent was required to act in accordance with the professional standards set out in the following practice standards published by the applicant:

(a) From 8 January 2018 to 30 September 2020 - Good medical practice: A code of conduct for doctors in Australia, March 2014 (the 2014 Code).

(b) From October 2020 - Good medical practice: A code of conduct for doctors in Australia, October 2020 (the 2020 Code).

1. The respondent admits that their conduct in respect to ground 1 breached clauses 2.1.4, 3.14, 5.2.1 and 8.4.1 of the 2014 Code and clauses 3.1.4, 4.15, 7.2.1 and 10.5.1 of the 2020 Code. It is not necessary to set out those clauses in detail, but they relate to providing good patient care by referring a patient to another practitioner when it is in the patient's best interests, avoiding wherever possible, providing medical care to anyone with whom the practitioner has a close personal relationship, ensuring that services provided are necessary and likely to benefit the patient, and keeping accurate records of relevant details of patient management.
2. The respondent admits that the conduct in respect to ground 2 breached clauses 2.1, 2.2, 11.2.2, 11.2.3, 11.2.5 and 11.2.8 of the 2020 Code. Clauses 2.1 and 2.2 relate to professional values, including honesty and ethics, and the protection and promotion of the health of the individual and community trust in the medical profession. Clauses 11.2.2, 11.2.3, 11.2.5 and 11.2.8 relate to self-care and not self-prescribing.
3. The parties agreed that the admitted conduct in respect to each ground constitutes professional misconduct within paragraphs (a) and (c) of the definition in s 5 of the National Law.

1. The parties made a joint submission that the Tribunal should:

(a) Make factual findings in accordance with this statement of agreed facts, findings and determinations.

(b) Pursuant to s 196(1)(b)(iii) of the National Law, find that the admitted conduct constitutes professional misconduct as defined in s 5 of the National Law

(c) Order the following sanctions:

(i) an order pursuant to s 196(2)(a) of the National Law that the Respondent be reprimanded; and

(ii) an order pursuant to s 196(2)(e) of the National Law that the Respondent's registration be cancelled; and

(iii) an order pursuant to s 196(4)(a) that the Respondent be disqualified from applying for registration for 6 months from the date of the Tribunal's order

(d) order that the respondent pay the applicant's taxed costs of the proceeding, if not agreed.

1. The parties did not refer the Tribunal to any relevant comparative cases.

1. The parties agree that the impugned conduct of the respondent constituted professional misconduct under s 5 of the National Law.
2. In Health Care Complaints Commission v Litchfield (1997) 41 NSWLR 630 at 637 the Court said that "the gravity of professional misconduct is not to be measured by reference to the worst cases, but by the extent to which it departs from proper standards".
3. Having regard to the agreed facts the admissions made by the respondent as to the facts and the characterisation of their conduct, the professional standards raised in the Codes of Conduct and potential breaches of the Poisons Act and the Misuse of Drugs Act I am satisfied that the conduct of the respondent was substantially below the standard reasonably expected of a relevant registered medical practitioner and I accept the parties agreed position that it constituted professional misconduct.

1. Upon a finding that a practitioner has behaved in a way that constitutes professional misconduct, s 196(2) of the National Law provides the following range of sanctions:

(2) If a responsible tribunal makes a decision referred to in subsection (1)(b), the tribunal may decide to do one or more of the following - > > (a) caution or reprimand the practitioner; > > (b) impose a condition on the practitioner's registration, including, for example - > > (i) a condition requiring the practitioner to complete specified further education or training, or to undergo counselling, within a specified period; or > > (ii) a condition requiring the practitioner to undertake a specified period of supervised practice; or > > (iii) a condition requiring the practitioner to do, or refrain from doing, something in connection with the practitioner's practice; or > > (iv) a condition requiring the practitioner to manage the practitioner's practice in a specified way; or > > (v) a condition requiring the practitioner to report to a specified person at specified times about the practitioner's practice; or > > (vi) a condition requiring the practitioner not to employ, engage or recommend a specified person, or class of persons, > > (c) require the practitioner to pay a fine of not more than $30,000 to the National Board that registers the practitioner; > > (d) suspend the practitioner's registration for a specified period; > > (e) cancel the practitioner's registration.

2. If an order for cancellation of registration is made s 196(4) provides a power to disqualify a former practitioner from applying for re-registration within a specified period:

(4) If the tribunal decides to cancel a person's registration under this Law or the person does not hold registration under this Law, the tribunal may also decide to do one or more of the following - > > (a) disqualify the person from applying for registration as a registered health practitioner for a specified period; > > (b) prohibit the person, either permanently or for a stated period, from doing either or both of the following - > > (i) providing any health service or a specified health service; > > (ii) using any title or a specified title; > > (c) impose restrictions, either permanently or for a stated period, on the provision of any health service or a specified health service by the person.

3. In Psychology Board of Australia v Straatsma [2025] TASCAT 54 at [29] to [30] I said the following in respect to the principles relevant to disciplinary sanctions:

29. The general principles relevant to disciplinary sanctions were conveniently summarised in Medical Board of Australia v Singh (S) [2017] WASAT 33 at [23]- [29]: > > 23 The Tribunal repeats what it stated in Medical Board of Australia and Myers [2014] WASAT 137 (S). The jurisdiction of the Tribunal is protective rather than punitive, and such protection runs to both the public and the profession (Craig v Medical Board of South Australia [2001] SASC 169; (2001) 79 SASR 545 at [41] (Craig); Re Maraj (a Legal Practitioner) (1995) 15 WAR 12 at 25; Legal Profession Complaints Committee v Love [2014] WASC 389 (Love) at [19]; Law Society of New South Wales v Foreman [1994] NSWCA 69; (1994) 34 NSWLR 408 (Foreman) at 440G‑441A-B; Legal Profession Complaints Committee and in de Braekt [2013] WASAT 124 at [24]- [26]; New South Wales Bar Association v Hamman [1999] NSWCA 404 (Hamman) at [21] and [77]). > > 24 The appropriate sanction is to be considered at the time of the making of the sanction and not by reference to the date of the unprofessional acts (Legal Profession Complaints Committee and A Legal Practitioner [2013] WASAT 37 (S) (A Legal Practitioner (S)) at [23]; Legal Profession Complaints Committee v Segler [2014] WASC 159 at [7]; A Solicitor v Council of the Law Society of NSW [2004] HCA l; [2004] HCA 1; (2004) 216 CLR 253 (A Solicitor [2004] NSW) at [15]; Love at [16]). > > 25 It is the practitioner's conduct that attracts any sanction (A Legal Practitioner (S) at [24]; Smith v New South Wales Bar Association [1992] HCA 36; (1992) 176 CLR 256 at 267-268 and 271-272; A Solicitor [2004] NSW). > > 26 As the Tribunal explained in A Legal Practitioner (S) at [24]: > > [I]n determining the appropriate penalty, care needs to be taken that the penalty reflects the matters with which the practitioner is charged and not other conduct including the defence of the action by the practitioner which is ultimately held to be unsuccessful: Smith v New South Wales Bar Association [1992] HCA 36; (1992) 176 CLR 256 (Smith) at 267-268 and 271-272[.] > > 27 Where there is a choice of sanctions, the Tribunal will choose that sanction which maximises the protection of the public (Quinn v Law Institute of Victoria [2007] VSCA 122 at [31]). > > 28 The dominant purpose of the disciplinary regulation of the medical profession is the protection of the public by the maintenance of proper standards within the profession. Hence, the impact which an appropriate penalty would have upon a practitioner guilty of misconduct, and personal hardship to a practitioner, are necessarily secondary considerations (see Legal Profession Complaints Committee v Detata [2012] WASCA 2014 at [47]; Legal Profession Complaints Committee v Masten [2011] WASC 71 at [29]; and Legal Profession Complaints Committee and Leask [2010] WASAT 133 at [54]). > > 29 There are circumstances in which a 'global' approach to sanction, rather than the imposition of separate sanction for each unprofessional act, may be more appropriate in vocational disciplinary proceedings namely, where the facts of the case are so inextricably woven as to make it difficult to meet a clear standard of prescription (A Legal Practitioner (S) at [5]; Stirling v Legal Services Commissioner [2013] VSCA 374 (Stirling) at [72]‑[75]). > > 30. In Medical Board of Australia v Singh at [30] the Tribunal identified a non-exhaustive list of twelve interrelated matters that may require consideration, which I set out with citations deleted and some editing:

• Any need to protect the public against further misconduct by the practitioner.
• The need to protect the public through general deterrence of other practitioners from similar conduct.
• The need to protect the public and maintain public confidence in the profession by reinforcing high professional standards and denouncing transgressions and thereby articulating the high standards expected of the profession, such that, even where there may be no need to deter a practitioner from repeating the conduct, the conduct is of such a nature that the Tribunal should give an emphatic indication of its disapproval.
• In the case of conduct involving misleading conduct, including dishonesty, whether the public and fellow practitioners can place reliance on the word of the practitioner.
• Whether the practitioner has breached any act, regulation, professional guidelines or code of conduct, and whether the practitioner has done so knowingly.
• Whether the practitioner's conduct demonstrated incompetence, and if so, to what level.
• Whether or not the incident was isolated such that the Tribunal can be satisfied of his or her worthiness or reliability for the future.
• The practitioner's disciplinary history.
• Whether or not the practitioner understands the error of the practitioner's ways, including an assessment of any remorse and insight (or a lack thereof) shown by the practitioner, since a practitioner who fails to understand the significance and consequences of misconduct is a risk to the community.
• The desirability of making available to the public any special skills possessed by the practitioner.
• The practitioner's personal circumstances at the time of the conduct and at the time of imposing the sanction. However, the weight given to personal circumstances cannot override the fundamental obligation of the Tribunal to provide appropriate protection of the public interest in the honesty and integrity of practitioners and in the maintenance of proper standards of professional practice.
• Any other matters relevant to the practitioner's fitness to practice and other matters which may be regarded as aggravating the conduct or mitigating its seriousness. In general, mitigating factors such as no previous misconduct or service to the profession are of considerably less significance than in the criminal process because the jurisdiction is protective not punitive.

1. A reprimand may constitute a serious form of censure and condemnation for professional misconduct: Nursing and Midwifery Board of Australia v Dutton (Review and Regulation) [2016] VCAT 495 [252]. For the reasons set out below I am satisfied that the respondent's conduct warrants a reprimand.

Cancellation of registration and disqualification

1. I am also satisfied that the seriousness of the conduct warrants cancellation of the respondent's registration as a medical practitioner. In Veterinary Practice Board of Western Australia and Burstein [2024] WASAT 140 at [35] the State Administrative Tribunal of Western Australia summarised principles relevant to suspension and cancellation of registration (with footnoted authorities inserted):

35. A number of cases have discussed suspension versus cancellation of a practitioner's right to practise, however that may be achieved: Veterinary Surgeons' Board of Western Australia and Alexander [2014] WASAT 105 (S) (Alexander); Legal Services and Complaints Committee and Khosa [2023] WASAT 90 (S) (Khosa); Singh v Medical Board of Australia [2019] WASCA 51 (Singh); Nadkarni v Medical Board of Australia [2022] WASCA 109; Dental Board of Australia and Nairn [2022] WASAT 86; (2022) 106 SR (WA) 359, [17]-[22]; and Psychology Board of Australia v Fawcett [2023] WASAT 86; (2023) 111 SR (WA) 19, (Fawcett). The following principles may be distilled therefrom: > > (a) Where a conclusion is reached that a practitioner is presently unfit to practise, then a choice may be made between suspension and cancellation of the practitioner's registration/striking off: Khosa [191]; Singh [36]. > > (b) Present unfitness to practise includes a serious breach of professional obligations reflecting, to a significant degree, upon the practitioner's fitness to practise. Khosa [191]; Singh [34]. > > (c) The proper use of suspension is in cases where the practitioner has fallen below the high standards to be expected of a member of their profession, but where the Tribunal is satisfied that, upon completion of the period of suspension, the practitioner will be fit to resume practice: Khosa [191]; Alexander [20] and [21]; Nairn [19]. > > (d) Where the practitioner's unfitness to practice reveals that they lack the qualities of character necessary to discharge the responsibilities of practise (or that they are otherwise permanently or indefinitely unfit to practise), cancellation of registration/striking off rather than suspension will, at least ordinarily, be the appropriate response: Khosa [192]; Alexander [19] and [21] Singh [34] and [37]; Nairn [16]. > > (e) Permanent or indefinite unfitness to practise will be a sufficient basis for cancelling the practitioner's registration/striking off but is not a necessary condition for cancellation, unless the relevant statutory regime makes it a necessary condition (which the VP Act does not). Singh [38]; Nairn [16]; Fawcett [53]. > > (f) If the Tribunal has the power to impose a period of suspension, then the length of the suspension imposed must both represent the period after which the Tribunal is satisfied that the practitioner will be fit to practise (Khosa [191]; Alexander [20] and [21]; Nairn [19]) and be commensurate with the overall seriousness of the professional misconduct when viewed in the context of all of the relevant factors: Nadkarni [82]. > > (g) If the Tribunal has the power to order that a practitioner be disqualified from applying for registration for a specified period, or has the power to fix a period within which registration may not be sought, then: > > (i) that period indicates the minimum period within which the Tribunal considers the practitioner should not be able to practise their profession: Singh [44]; Fawcett [54] citing Nairn [18]; and > > (ii) all of the factors relevant to penalty are relevant to the determination of the period of disqualification including: the protective purpose; the seriousness of the conduct; deterrence, both specific and general; the denunciation of misconduct in order to uphold public confidence in professional standards; and 'signalling that those whose conduct does not meet the required standards will not be permitted to practise': Singh [43]-[45] and [97].

2. The medical reports indicate that the respondent's conduct can be seen in the context of personality traits that compelled them to provide assistance to AA when they would have been aware that their conduct was contrary to their ethical obligations and might be illegal and would put their at risk of professional approbation. I am satisfied from the practitioner's responses to the applicant, their actions after being advised of the notifications, their agreement to facts and the proposed determinations, and the medical reports that they are remorseful and have insight into the nature of their misconduct. On the basis of Dr Evenhuis' opinion I am satisfied that they would be unlikely to repeat the prescribing behaviour, but I observe that the personality traits that lead to their conduct will remain.
3. The conduct occurred over an extended period of almost two and a half years and cannot be considered an isolated occurrence, but it did not extend to prescribing beyond the respondent and AA.
4. The practitioner's competence was not in issue. However, they knowingly breached professional guidelines over an extended period, breached laws and acted dishonestly. The respondent's conduct was such as to undermine public confidence in the profession and the confidence of fellow practitioners in the respondent and requires a sanction that will provide both specific and general deterrence.
5. The respondent's conduct in prescribing narcotic medication in circumstances where it would have been readily apparent that it was ethically and legally wrong for them to do so, and to actively attempt to hide that prescribing by dishonestly using the identity of another prescriber, constitutes a serious breach of professional obligations reflecting, to a significant degree, upon the respondent's fitness to practise. The respondent demonstrated conduct inconsistent with the qualities of character necessary to discharge the ethical responsibilities of practise.
6. There is no indication of any disciplinary history, other than the caution issued on 15 September 2022, which I consider should be seen in the global context of the practitioner's course of conduct and not as a prior matter.
7. The respondent did not raise any matters of hardship to themself or others.
8. Taking into account the protection of the public, the seriousness of the conduct, specific and general deterrence, and denunciation of the respondent's conduct in order to uphold public confidence in professional standards, I consider that the agreed period of six months disqualification from applying for re-registration is a reasonable period that properly reflects those matters. In this respect I take into account that the respondent has served a period of suspension since November 2022, and has lacked capacity to practise for at least a significant part of that period.

1. Section 40 of the Health Practitioners Tribunal Act and s 195 of the National Law provide a power to award costs. The parties have agreed that the respondent should pay the applicant's costs. They have not referred to a scale of costs. It is common for the Tribunal to award costs in health practitioner matters at 90 per cent of the Supreme Court scale. Given the issues and conduct of this matter I am satisfied that that is appropriate in this case.

1. I make the following orders:
   1. Shannon Lovell Greene is reprimanded pursuant to s 196(2)(a) of the Health Practitioner Regulation National Law (Tasmania).
   2. The registration of Shannon Lovell Green as a medical practitioner is cancelled pursuant to section 196(2)(e) of the Health Practitioner Regulation National Law (Tasmania).
   3. Shannon Lovell Green is disqualified from applying for registration as a registered health practitioner for a period of six months from the date of these orders pursuant to section 196(4)(a) of the Health Practitioner Regulation National Law (Tasmania).
   4. Shannon Lovell Greene is to pay the Medical Board of Australia's costs of and incidental to the application calculated at 90 per cent at the scale of fees in Part 1 of Schedule 1 of the Supreme Court Rules 2000 as at the date that the relevant work was undertaken, to be agreed or taxed by a Registrar of the Tribunal and to be paid within 28 days of agreement or the issue of a certificate of taxation whichever first occurs.