Sexual abuse initiative
Sexual Abuse Principles
The following principles ground the College’s initiative on sexual abuse. They
articulate the College’s approach to sexual abuse of patients by physicians. The
principles are meant to provide guiding statements on each topic.1
principle 1: Harm and Breach of Trust
Sexual abuse2 is harmful and physicians must never have any sexual involvement with patients. Any form of
sexual relations between physicians and patients is sexual abuse; patients cannot consent to sexual relations with
their physician.
There is an inherent power imbalance in the physician-patient relationship. The physician-patient relationship
is fiduciary in nature, requiring physicians to act with the utmost good faith and to ensure patients’ best interests
are paramount.
Sexual abuse of patients exploits this power imbalance, is contrary to physicians’ fiduciary duties and is a
breach of trust. Sexual abuse harms not only the individual patients who are abused, but also the public at large
by undermining the public’s trust in the medical profession.
principle 2: Prevention
Education of physicians and medical trainees is essential to prevent sexual abuse of patients. Physicians must
have a clear understanding of their obligations to maintain appropriate boundaries with patients, and that any
sexual involvement with patients is harmful, is considered sexual abuse, and is never acceptable.
Education of the public is also essential. The public needs clear information about the differences between
appropriate and inappropriate physician-patient interactions and what patients can expect from physicians.
Patients also need to be aware of steps they can take to keep themselves safe, and to question anything they
have experienced that doesn’t feel right. This includes information regarding how to share their concerns with the
College and others, and the support the College provides when they do so.3
principle 3: Physician Responsibility: Individual and Collective
Physicians have responsibility both individually and collectively to prevent and respond to sexual abuse of
patients.
Individually, physicians must maintain appropriate boundaries with patients and must not sexually abuse
patients.4 Physicians must also make a mandatory report when they have reasonable grounds to believe that a
patient has been sexually abused by a regulated health-care professional.5
Collectively, physicians together with organizations, hospitals and others, have a shared ethical responsibility
to prevent and respond to sexual abuse of patients.
Issue 3, 2015 Dialogue
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