Sexual Abuse Standard

Standard

Physiotherapists do not engage in behaviour that constitutes sexual abuse, in accordance with the Regulated Health Professions Act (RHPA), 1991.

Expected outcome

Patients can expect that any interaction with a physiotherapist will be free from sexual abuse, which includes conduct, behaviour or remarks of a sexual nature.

Performance expectations

The physiotherapist:

• Does not commence an intimate or sexual relationship with a patient for the duration of the therapeutic relationship, even if the patient agrees to or seeks to initiate an intimate or sexual relationship.
  • Recognizes that due to the inherent power imbalance between patient and PT, patients cannot offer valid consent to commencing a sexual relationship.
• Does not provide treatment to any individual with whom the physiotherapist has a sexual relationship, including their spouse.
  • Understands that these individuals are not exempt from the definition of sexual abuse, unless the care is provided in emergency circumstances or is minor in nature, in which case no fees can be charged.
• Does not engage in any conduct, behaviour, or remarks that constitute sexual abuse, per the definition below, towards a patient for the duration of the therapeutic relationship.
• Recognizes that in Ontario, the therapeutic relationship extends for at least one year after active treatment and may be enduring, depending on:
  • The nature of the patient-physiotherapist relationship,
  • The risk of enduring power imbalance between patient and physiotherapist, and
  • Dependence of the patient on the physiotherapist.
• Must not end a therapeutic relationship for the purpose of pursuing a personal relationship.
• Clearly and thoroughly explains to patients any physiotherapy treatment which could be mistaken to be sexual in nature, ensuring the patient understands its therapeutic purpose, encouraging an open discussion of concerns, and obtaining informed consent before and throughout the treatment.
• Reports all instances where the physiotherapist has reasonable grounds to believe that the conduct of another member of any regulated health profession constitutes sexual abuse or sexual misconduct to the Complaints Director/Registrar of the other regulated member’s regulatory organization¹.

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Definitions

Patient

A patient² is an individual who receives physiotherapy services.

In Ontario, an individual is considered a patient if they interact directly with a physiotherapist and any of the following apply:

• Payment was charged or received for a physiotherapy service.
• The physiotherapist contributed to the individual’s health record.
• The individual consented to a recommended service.

An individual remains a patient for a minimum of one year after active treatment ends. The therapeutic relationship may extend beyond one year if there is an ongoing risk of power imbalance or dependence.

Sexual abuse

Sexual abuse³ of a patient by a physiotherapist includes:

• Sexual intercourse or physical sexual relations between the physiotherapist and patient,
• Touching of a sexual nature (including the patient’s genitals, anus, breasts, or buttocks) of the patient by the physiotherapist that is not appropriate to the clinical setting,
• Sexual behavior or remarks directed by the physiotherapist toward the patient, such as those that could be inappropriate or offensive.

Spouse

Spouse⁴ — a person who is married to the physiotherapist, or who has lived with them in a conjugal (marriage-style) relationship for at least three years.