Definitions
Although the terms patient and client are often used interchangeably by SLPs and audiologists in their practices, when referring to incidents of sexual abuse and sexual misconduct a person who may have experienced sexual abuse or sexual misconduct is referred to as a patient. Patient is a defined term in the Standard of Practice.
| Patient | Client |
|---|---|
A patient means any individual to whom a regulated member provides a health service in their capacity as a SLP or audiologist, but does not include:
Standards of Practice, 5.0 Introduction and Definitions |
A client is “a recipient of speech- language pathology or audiology services, and may be an individual, family, group, community, or population. An individual client may also be referred to as a patient.” |
The HPA is very explicit about what constitutes sexual abuse.
| Sexual Abuse |
|---|
“Sexual abuse means the threatened, attempted or actual conduct of a regulated member towards a patient that is of a sexual nature and includes any of the following conduct:
HPA, s. 1(1)(nn.1) |
Any of the sexually abusive behavior listed in the HPA is sexual abuse. It does not matter where or when the conduct occurred (e.g., at the worksite, outside work hours).
A regulated member of ACSLPA abstains from conduct, behaviour, or remarks directed towards a patient that constitutes sexual abuse as defined by the HPA.
To demonstrate this standard, the regulated member:
- must not enter into or have a sexual relationship with a patient;
- must not threaten or attempt to have a sexual relationship with a patient.
Standards of Practice, 5.1 Sexual Relationships
In the exceptional circumstance that a regulated member is providing health services to their spouse, adult partner, or other person with whom they are in an existing sexual relationship, it is understood that their relationship would fall outside of ACSLPA’s standards of practice.
However, to avoid the risk of unprofessional conduct, regulated members should, “except in particular circumstances, abstain from providing a health service to a spouse, an adult interdependent partner or other person with whom [they] are in an existing sexual relationship”.
Particular circumstances include:
- the regulated member provided the health service to the individual in emergency circumstances or in circumstances where the service is minor in nature;
- there is no abuse of a power imbalance arising from the health service being provided; and
- if further care is required, the regulated member takes reasonable steps, as soon as possible, to transfer care of the individual to another regulated member or regulated health professional.
Standards of Practice, 5.5 Existing Sexual Relationships
| Sexual Misconduct |
|---|
| “Sexual misconduct means any incident or repeated incidents of objectionable or unwelcome conduct, behaviour, or remarks of a sexual nature by a regulated member towards a patient that the regulated member knows or ought reasonably to know will or would cause offence or humiliation to the patient or adversely affect the patient’s health and well-being but does not include sexual abuse.”
HPA, s. 1(1)(nn.2) |
For example, sexual misconduct is:
- Any behaviour, either physical or verbal, with a patient that could reasonably be perceived to be of a sexual nature including:
- making sexually suggestive comments or gestures;
- requesting details of a patient’s sexual history unless relevant to the health service that the speech-language pathologist or audiologist is performing; or
- exploiting or attempting to exploit any real or perceived imbalance of power.
- Any physical contact with a patient that could reasonably be perceived to be of a sexual nature unless the physical contact is required for the health service to occur, in which case the regulated member must, in advance of the physical contact:
- explain to the patient why contact is clinically necessary;
- indicate to the patient the nature, purpose, and likely duration of the contact;
- receive informed consent (from the patient or the patient’s parent, agent or guardian) prior to the contact; and
- ensure that the patient is offered appropriate privacy for the physical contact that occurs.
- Communicating with a patient or soliciting a patient for the purpose of entering a sexual relationship or using any of their personal information or health information to do so.
Standards of Practice, 5.2 Sexual Misconduct
Other Standards Governing Sexual Relationships
A regulated member of ACSLPA abstains from any unwanted or unwelcome behaviour, either physical or verbal, with a patient’s substitute decision-maker, guardian, or parent that could reasonably be perceived to be of a sexual nature.
To demonstrate this standard, when engaging with a patient’s substitute decision-maker, guardian, or parent the regulated member:
a) must not make sexually suggestive comments or gestures;
b) must not exploit or attempt to exploit any real or perceived imbalance of power.
Standards of Practice, 5.6 Conduct of a Sexual Nature
The regulated member does not enter into a sexual relationship with a former patient unless:
- there is no ongoing power imbalance between the patient and the speech-language pathologist or audiologist arising from the former professional relationship;
- sufficient time has passed since the last time health services were provided by the SLP or audiologist, having regard for the nature and extent of the professional relationship between the speech-language pathologist or audiologist and the patient;
- the patient knows and understands that the professional relationship has ended; and
- the patient has consented and is capable of providing consent.
Standards of Practice, 5.4 Sexual Relationships with Former Patients
| Former Patient |
|---|
Former patient means a person to whom one of the following apply:
Standards of Practice, Area 5.0, Glossary |
Government of Alberta
In alignment with the HPA, ACSLPA is explicit in its stance on female genital mutilation to address the possibility that SLPs and audiologists may be asked by their clients to find people and/or organizations willing to perform the surgery.
“A regulated member of ACSLPA shall not procure or perform female genital mutilation as defined by the HPA.”
Standards of Practice, 5.8 Female Genital Mutilation
The HPA was updated in 2022 to “better protect the health and safety of women and girls by strengthening existing laws that ban female genital mutilation in Alberta.”
Key changes include:
- “Ensure health professionals who are convicted of performing, offering, or facilitating female genital mutilation in Alberta will be removed from practice.
- Prohibit individuals convicted of this crime elsewhere from practicing in Alberta.
- Require health profession regulatory colleges to adopt standards of practice, including education, awareness, prevention, and sensitivity training, to better support the physical and mental health of women and girls who may have undergone female genital mutilation.”
Government of Alberta, 2023