Maintaining Appropriate Boundaries and Preventing Sexual Abuse – Preliminary Consultation (CLOSED)

The College’s Maintaining Appropriate Boundaries and Preventing Sexual Abuse policy is currently being reviewed. The policy helps physicians understand and comply with the legislative provisions of the Regulated Health Professions Act, 1991 (RHPA) regarding sexual abuse. It sets out the College’s expectations of physicians to maintain appropriate boundaries and not become sexually involved with patients, former patients in certain circumstances, and persons closely associated with patients.

View the current policy

To assist with this review, we are inviting feedback from all stakeholders, including members of the medical profession, the public, health system organizations and other health professionals on the current policy. Comments received during this preliminary consultation will assist the College in updating the policy. When a revised draft is developed, it will be recirculated for further comment before it is finalized by Council.

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We want to hear your thoughts on the current policy…

• Submit your comments to our discussion forum
• Complete a brief online survey concerning the current policy
• Send us your comments via Email

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Sexual abuse of patients by physicians was identified as a significant problem in 1991, when the College of Physicians and Surgeons of Ontario released several reports from its Task Force on patient sexual abuse. These reports provided the impetus for changes to the RHPA, and a number of provisions that deal with sexual abuse were specifically added to the RHPA to address this issue. Under the RHPA, any form of sexual relations between physicians and patients is considered to be sexual abuse. Consent by the patient is no defence to sexual abuse. This reflects the College’s zero tolerance position regarding the sexual abuse of patients by physicians.

The College has set out policy expectations for physicians on boundaries and sexual abuse since 1992. The College’s current Maintaining Appropriate Boundaries and Preventing Sexual Abuse policy was approved by Council in 2008. The policy helps physicians understand and comply with their legal obligations by outlining the relevant provisions regarding sexual abuse set out in the RHPA, and sets out College’s expectations of physicians’ behaviour within the physician-patient relationship, after the physician-patient relationship ends, and with respect to persons closely associated with patients. The policy states that physicians must maintain appropriate boundaries and must not become sexually involved with patients, former patients in certain circumstances, and persons closely associated with patients.

In December 2014, the College’s Council launched a Sexual Abuse Initiative to ensure that the College is doing all that it can to support and protect patients from physician sexual abuse. The initiative involved a review of the sexual abuse provisions in the RHPA and a review of College processes with respect to sexual abuse. At the same time, the Government created a Sexual Abuse Task Force to review the RHPA to ensure the legislation is effective in preventing and dealing with the sexual abuse of patients by health professionals. As a result of this work, the Government passed the Protecting Patients Act, 2017 in May 2017, which contained a series of amendments to the RHPA.

Before the policy review commenced, minor revisions were made to the College’s Maintaining Appropriate Boundaries and Preventing Sexual Abuse policy in June 2017 to reflect the provisions in the Protecting Patients Act, 2017 that are currently in force. A comprehensive policy review is now underway to assess the current policy in its entirety to determine what revisions may be required to ensure that the policy is clear, informative, and reflective of the boundaries and sexual abuse issues often encountered in medical practice.

Have Your Say

We would like to hear your thoughts on the current policy, along with suggestions you may have for how the policy could be improved.

In particular, we are interested to know:

• Does the policy clearly articulate the physician’s legal and professional obligations with respect to boundaries and sexual abuse?
• Are there any issues not included in the current policy that should be addressed? If so what are they?
• Are there other ways in which the policy could be improved?

The deadline to provide feedback on the current policy is December 4, 2017.

Next Steps

The College is committed to ensuring that the Maintaining Appropriate Boundaries and Preventing Sexual Abuse policy embodies the values and duties of medical professionalism, and is consistent with the College’s mandate to protect the public. The feedback obtained during this preliminary consultation will be carefully reviewed and used to evaluate the existing policy. While it may not be possible to ensure that every comment or suggested edit will be incorporated into the revised draft, all comments will be carefully considered.

Once a revised draft policy has been developed, stakeholders will be invited to review the revised document and provide further feedback before it is considered for final approval by Council.

Final decisions regarding policy revisions are made by College Council.

To ensure transparency, the College will post all consultation feedback in accordance with our posting guidelines.

We value your feedback and thank you again for participating in our policy review process.

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