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Sexual boundaries

Sexual boundaries. Scott Farley D.C . Objectives. Increase knowledge and understanding of sexual boundaries and a chiropractic physician's ethical and professional obligations Consequences of sexual boundary violations. Reported Prevalence and Incidence.

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Sexual boundaries

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  1. Sexual boundaries Scott Farley D.C.

  2. Objectives • Increase knowledge and understanding of sexual boundaries and a chiropractic physician's ethical and professional obligations • Consequences of sexual boundary violations

  3. Reported Prevalence and Incidence • The majority of reported sexual boundary violations in healthcare involve male health practitioners and female patients/clients • 38-52 % of health professionals report knowing a colleagues who has been/is involved with patients • Greater awareness of professional guidelines and sanctions reduce prevalence

  4. Impact of Boundary Violations on the Patient • The impact on survivors of professional sexual boundary violations/abuse shows considerable and enduring harm • Symptoms include post traumatic stress disorder, anger, sense of betrayal and exploitation, guilt and self-blame • High levels of dependency on the offending health professional, confusion and dissociation are found

  5. What is Physician Sexual Misconduct?

  6. Sexual Misconduct Defined • Behavior that exploits the physician-patient relationship in a sexual way • May be verbal or physical and may include expressions of thoughts and feelings or gestures that are sexual or that reasonably may be construed by a patient/patient’s surrogate as sexual • The practitioner responding to sexual approaches made by a patient or client especially as these may be indicative of previous boundary violation or confusion

  7. Sexual Misconduct Defined • Clinical interventions of an intimate nature which are not warranted by the individual's condition and/or are carried out inappropriately • Clinical interventions such as intimate examinations which are wrongly framed in sexual terms or accompanied by sexual comments • Mutual attraction that is acted upon while a clinical or therapeutic relationship is still in operation or recently terminated

  8. Types of Professional Sexual Misconduct Sexual Impropriety Sexual Violation

  9. Sexual Impropriety • May comprise behavior, gestures or expressions that are seductive, sexually suggestive, disrespectful of patient privacy or sexual demeaning to a patient

  10. Sexual Impropriety Examples • Neglecting to employ disrobing or draping practices respecting the patient’s privacy or deliberately watching a patient dress or undress • Subjecting a patient to an intimate examination • Performing an intimate examination or consultation without clinical justification • Using the physician-patient relationship to solicit a date or romantic relationship

  11. Sexual Impropriety Examples • Inappropriate comments about or to the patient including but not limited to, making sexual comments about a patient’s body or underclothing, making sexualized or sexually demeaning comments to a patient, criticizing the patient’s sexual orientation, making comments about potential sexual performance during an examination • Requesting details of sexual history/sexual preferences when not clinically necessary

  12. Sexual Violation • Sexual violation may include physical sexual contact between a physician and patient, whether or not initiated by the patient, and engaging in any conduct with a patient that is sexual or may be reasonably interpreted as sexual

  13. Sexual Violation Examples • Sexual intercourse in any capacity • Kissing in romantic/sexual manner • Touching breasts, genitals or any sexualized body part for any purpose other than appropriate examination or treatment • Offering practice-related services (treatment, drugs, etc.) in exchange for sexual favors

  14. Avoiding Sexual Misconduct • Respect cultural differences. • Do not use gestures, tone of voice, expressions, or any other behavior that a client could interpret as seductive, sexually demeaning, or sexually abusive. • Refrain from treating a client that you have had a previous intimate relationship with. • Do not make sexualized comment about a client’s body or clothing. • Do not make sexualized or sexually demeaning comments to a client. • Do not criticize sexual orientation. • Do not ask details of sexual history – unless it’s your job.

  15. Avoiding Sexual Misconduct • Do not engage in inappropriate ‘affectionate’ behavior with a client. • Do not talk about your own sexual preference, fantasies, problems, etc. • Learn to detect and deflect seductive clients. • Do not request a date with a client. • Do not engage in any sexual contact. • Maintain good records that reflect any intimate questions of a sexual nature and document any and all comments or concerns made by a client relative to alleged sexual abuse, and any other unusual incident that may occur during the course of, or after an appointment.

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