Combating sexual abuse by doctors

Combating sexual abuse by doctors

September 1994   Women's Health Watch

In late August the Medical Council launched strategies to reduce sexual abuse of patients by their doctors. Three publications have been released under the title 'Trust in the Doctor/Patient Relationship'. A booklet for doctors outlines the Medical Council's position and safeguards a doctor should put in place to avoid inappropriate behaviour and complaints.

One pamphlet for patients is of a general nature and is intended for wide distribution. It describes the kind of professional behaviour patients can expect from doctors. A second pamphlet 'for concerned patients' explains how to complain.

The Medical Council condemns any sexual contact between doctors and current patients, whether the patient consents or even initiates the contact. The Council is still formulating guidelines concerning sexual behaviour towards former patients.

It says that sexual behaviour in a professional context is abusive. It defines sexual behaviour as 'any words or actions designed or intended to arouse or gratify sexual desire'.

It acknowledges that the doctor/patient relationship is not equal and the exploitation of a patient is 'an abuse of power'. Consent would not be a defence at a disciplinary hearing.

The onus is always on the doctor to behave in a professional manner.

To make it easier for victims to come forward and complain about abusive doctors the council has promised a number of reforms of its own processes including support, awareness training for staff, informing complainants when a doctor is reinstated, promote gender balance on panels at hearings, and use screens during hearings so that complainants are not forced into eye contact with the accused.

The council has divided sexual abuse into three categories:

  • sexual impropriety - behaviour or gestures that are sexually demeaning to a patient, or which demonstrate a lack of respect for privacy
  • inappropriate facilities for undressing and draping - examining a patient intimately without consent
  • inappropriate comments eg about the patient's body or underclothing
  • sexualized comments
  • ridiculing the patient's sexual orientation
  • making inappropriate comments about sexual performance
  • requesting sexual details when not relevant
  • conversations involving the sexual problems or fantasies of the doctor.

sexual transgression includes:

  • any inappropriate touching that is of a sexual nature
  • manual internal examination without gloves
  • touching breasts or genitals except as an appropriate examination
  • propositioning a patient.

Sexual violation means doctor/patient sexual activity.

The council says that are danger signals that doctors may be going to abuse. These include:

  • giving patients appointments at odd hours, especially when other staff are not likely to be present
  • invitations to social events, especially dates
  • doctors telling patients intimate details of their personal lives, especially personal crises or sexual desires.

Copies of the pamphlets for patients and doctors can be obtained from: Medical Council of New Zealand, PO Box 11-649, Wellington Phone: (04) 3858902

Another resource is the book and video Broken Boundaries: Understanding Professional Sexual Abuse,

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