The board’s records indicate the most telling documents relating to Isom’s porn-viewing were sealed by a judge as a part of the arbitration, including depositions and findings by forensic experts after Isom’s computer was seized with a subpoena. But the board’s records included the final arbiters’ ruling, which states, “Dr. Isom repeatedly used Internet access to view and download sexually oriented material in the workplace in violation of the anti-harassment policy he and Drs. Boyd and Underwood established for their joint endodontic offices.” While Isom contended he did not download or otherwise place the material on the computer, the ruling states that “forensic analysis showed that the material was downloaded under Dr. Isom’s login.” He “did not promptly close the screen image or delete the file,” the arbitrators found, but viewed the material “in full view of the two employees for an estimated 15 to 20 seconds.”

Interviews with the employees revealed the details of the masturbation episode: Isom’s turn toward the staff member before zipping his fly and the apology made to her alone after office hours. Nevertheless, investigator Paul Kleinstub advised the dental board that “…Dr. Isom’s viewing of material apparently protected (by) the 1st Amendment and…accidentally viewed by an employee does not appear to be a violation of (state rules), distasteful as those incidents may be.”

In the short history of online porn in the workplace, office standards have not kept pace with the medium’s proliferation. A March Nielsen survey found that 21 million Americans accessed porn on work computers during that month, or 30 percent of working adults. Because porn consumption has exploded so quickly, it is little understood, according to Wendy Maltz, a licensed clinical social worker and nationally recognized sex and relationship therapist. While some experts believe porn can be powerfully addictive, eliciting similar kinds of symptoms and behaviors as many drugs, it doesn’t fit neatly into the arenas that attract funding for research and treatments. And unlike gaming and cigarettes, porn is not taxed, so it doesn’t support public education on its own ills.

In Portland, prevailing cultural attitudes may even further complicate the issue. Sex therapists and sex workers alike routinely call our fair city “Pornland” for its notoriously prolific sex industry. A live-and-let-live morality combines with Oregon’s liberal interpretation of free speech to create a comparatively permissive environment for adult entertainment. Oregon voters have twice rejected attempts to regulate the locations of such businesses. No one has proven that Portland is home to more sex shops and strip clubs than any other American city, but the claim has become a kind of sotto voce civic boast.

Beyond the issues of personal kicks versus sexual harassment raised by porn in the workplace, Isom’s case provokes the question of whether a doctor’s office porn-cruising habits could impact patients and whether the state’s medical regulatory boards are obliged to inform the public when that cruising is well-documented and the subject of a complaint.

Experts on sexual pathology such as Dr. Mary Anne Layden, director of the Sexual Trauma and Psychopathology Program at the Center for Cognitive Therapy at the University of Pennsylvania, believe professional boards and other employment officials should take immediate action with people who are unable to control sexual habits at work. In a draft released in February, she notes, the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders now lists such behaviors as symptoms of “hyper-sexual disorder,” a problem Layden argues should be treated with similar urgency as incidents of alcohol or drug abuse.