Sexual Abuse Principles- Update: Principles Approved

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    Stakeholder feedback

    View the feedback we received to our online survey

    View the comments posted to our online discussion page

    Our Process

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    The College’s Sexual Abuse Principles received final approval from Council on September 10, 2015, and now officially ground the College of Physician and Surgeons of Ontario’s Sexual Abuse Initiative.

    We would like to thank all those who submitted their feedback and contributed to this consultation. While not every comment or suggested edit was incorporated into the final version, all comments were carefully considered.

    Below is a brief summary of the consultation process, including an overview of the feedback received and revisions undertaken:



    Who we heard from

    • 33 submissions were received in response to this consultation.
    • Feedback was primarily submitted by physicians and members of the public, but we also heard from a few key organizations such as the Ontario Medical Association, the College of Physicians and Surgeons of Alberta, the Information and Privacy Commissioner of Ontario, and the Professional Association of Residents of Ontario.
    View the feedback: Survey reportWritten Comments

    What we heard

    Other important considerations

    • Feedback received predominantly focused on the general topic of sexual abuse and the College’s approach to handling sexual abuse matters, and not about the Principles themselves.
    • That being said, the majority of the organizational respondents provided general support for the draft Principles and the majority of online survey respondents indicated that the draft Principles are clear, easy to understand, and clearly articulate the College’s role in protecting the public.
    • Some respondents requested clarification or additional detail on a variety of topics, including: the definition of sexual abuse, the College’s role and processes, and the support available to patients/victims of sexual abuse.
    • Other respondents expressed differing views on the definition of sexual abuse, which challenged the notion that sexual abuse is harmful and unacceptable, and on whether a power imbalance between physicians and patients exists.
    • Of those respondents who provided constructive criticism on the draft Principles, suggestions included:
      oExplicitly stating in Principle 1 that any sexual involvement with patients is considered sexual abuse, to help emphasize this point as stated in Principle 2.
      o Including additional information on mandatory reporting in Principle 3.
    • In addition to the feedback, we considered a wide range of other information while developing the final version of the Principles. This included:
        • Relevant legislation, including the definition of sexual abuse set out in the Regulated Health Professions Act, 1991 (RHPA) and the mandatory reporting requirement set out in Section 85.1(1) and 85.3(1) of the Health Professions Procedural Code under the RHPA.
        • College policies and guidelines related to sexual abuse and boundaries.
        • The College’s zero tolerance approach to sexual abuse.

    How we responded to your feedback

    • A few key revisions and additions were made to the draft Principles in response to your feedback. The majority aimed to improve the overall clarity of the document, ensure consistency with the College’s Mandatory and Permissive Reporting policy, and to provide links to sections of the College’s website where more information on sexual abuse and boundaries can be found.
    • A few of the more significant revisions are highlighted below, as are two important instances where revisions were not made:
    Decision Rationale
    • A statement about the fact that the Principles are meant to provide guiding statements on each topic has been included in the introductory paragraph.
    • This statement clarifies the scope and purpose of the document.
    • Principle 1 has been amended to reinforce the fact that patients cannot consent to sexual relations with their physician, and the definition of sexual abuse from the RHPA has been included as a footnote.
    • These revisions were made to provide further clarity on the definition of sexual abuse.
    • The revised Principles have not changed the position that any sexual involvement with patients is harmful, is considered sexual abuse, and is never acceptable.
    • The College’s zero tolerance approach to sexual abuse aligns with the Principles.
    • Principle 1 has not been modified to include an explicit statement that any sexual involvement with patients is considered sexual abuse.
    • This specific point is already clearly stated in Principle 2.

    The final version

    • The Sexual Abuse Principles received final approval from Council on September 10, 2015. They now officially ground and inform the College’s Sexual Abuse Initiative.

    Read the Final Principles

    Key messages of the final Principles:

    • Any form of sexual relations between physicians and patients is sexual abuse. Physicians must never have any sexual involvement with patients as sexual abuse is harmful to both patients and the public.
    • Physicians have responsibility both individually and collectively to prevent and respond to sexual abuse of patients.
    • Education of physicians, medical trainees and the public is essential to prevent sexual abuse of patients.
    • Public protection is the College’s top priority in relation to sexual abuse of patients. When a physician has sexually abused a patient the College will impose penalties to ensure that individual patients and the broader public are protected.