The Case

The College received a complaint from a patient who attended physiotherapy approximately 10 years before to help treat headaches, neck and back pain.

During the assessment, the physiotherapist asked the patient to remove all of their clothing and consent to having their photograph taken while undressed. When speaking with the College, the patient indicated that they did not feel comfortable removing their clothing or having their picture taken, however, as a young adult at the time, they felt compelled to do so, given the PT’s position of trust and authority.

The patient believes the photographs were a violation of their privacy and sexual integrity. While the PT admitted to taking the pictures, they said they were taken for “self-initiated research” and were not sexual in nature.

The PT allegedly took the photos to explore the relationship between head, neck and back pain and the pelvis. There were no further allegations of sexual touching or comments of a sexual nature.

The physiotherapist noted that verbal consent was obtained from the patient to be photographed as part of a research project. However, the patient did not sign a consent form indicating that they wished to participate in a case study for clinical or academic research.

As a significant period of time had passed since the incident, the College was unable to get a copy of the patient file as it had already been destroyed. Therefore, the photos in question or any clinical notes were not reviewed as part of the investigation.

The Standards

It’s important to note that there is no statute of limitations regarding complaints, and all complaints must be investigated regardless of when they occurred. The College is required to investigate the complaint under the rules and standards that were in place at the time of the incident.

In this case, the physiotherapist failed to obtain valid, informed consent from the patient to be photographed or participate in any research initiatives. The College did not find any clinical reasoning for the photographs. However, if there was a valid research study that would justify them, the physiotherapist should have properly explained the scope of the research to the patient and obtained their consent to participate.

Further, the PT did not maintain appropriate boundaries within the therapeutic relationship. There is an inherent power imbalance between physiotherapists and their patients. The PT did not respect the patient’s privacy and abused their position of power.

The Outcome

The physiotherapist received a reprimand and had their license suspended. Additionally, the PT completed a remediation program focused on ethics and appropriate boundaries within the therapeutic relationship.

Terms, conditions and limitations were placed on their certificate of registration and the information is available on the Public Register.

Although these versions of the standards were not in place at the time, here are the relevant standards and resources that would be referred to should a similar case take place today:

Boundaries and Sexual Abuse

Consent

Privacy

Ethics