Protecting Patients from Sexual Abuse and Sexual Misconduct

As a patient, you can expect your speech-language pathologist or audiologist to maintain professional boundaries. A professional boundary is a parameter of a safe therapeutic relationship, recognizing the power imbalance and responsibilities of a regulated member.

Professional boundaries help define the difference between therapeutic and personal relationships and avoid potential misunderstanding of words and actions.

Your speech-language pathologist or audiologist should treat you respectfully and maintain professional boundaries while providing services, including ensuring informed consent is obtained before they provide services. Where physical touching may be required during your appointment, your speech-language pathologist or audiologist should let you know why and how they will touch you, give you the opportunity to ask questions and respect your decision to proceed or decline the physical touching.

Your speech-language pathologist or audiologist should also take steps to ensure professional boundaries are maintained, outside of providing services, such as declining to meet with you socially (outside of your scheduled appointments), declining any “friend” requests on social media and communicating professionally over the phone or in writing.

If you have concerns about a speech-language pathologist or audiologist’s professional boundaries or if you wish to submit a complaint, please complete ACSLPA’s complaint form or contact the Complaints Director.

Some relevant standards of practice and ethical responsibilities are captured below to assist you in understanding the obligations of speech-language pathologists and audiologists and to assess whether your boundaries have been respected.

Regulated members ensure that they obtain informed consent before the provision of services (Standard 2.3, Informed Consent).

Regulated members maintain appropriate professional boundaries with clients, professional colleagues, students, and others at all times (Standard 2.4, Professional Boundaries). Some indicators for this standard are:

• • Behaving respectfully and responsibly with clients and colleagues;
  • Avoiding sexually suggestive comments/actions, racist or discriminatory comments/actions, or the expression of opinions/remarks that could violate the professional boundaries;
  • Ensuring informed consent; or
  • Consider ending professional relationships if boundaries are violated, cannot be established or cannot be maintained, or transfer care as necessary.

Regulated members demonstrate respect for all persons, promote the well-being of others, and recognize clients’ rights to autonomy in decision-making regarding their care (Responsibility 1, Code of Ethics). This includes providing services in a courteous, compassionate and caring manner (Responsibility 1.3, Code of Ethics).

Regulated members demonstrate respect and support the autonomy of clients to make choices and decisions regarding their own care and/or to refuse treatment and withdraw from services at any time (Responsibility 1.5, Code of Ethics).

Regulated members demonstrate professional behaviour and integrity in the delivery of safe, ethical, quality services (Responsibility 2, Code of Ethics). This includes maintaining appropriate professional boundaries (Responsibility 2.2, Code of Ethics).

We recognize that coming forward with a complaint about sexual abuse, sexual misconduct or boundary violations can be very difficult. The College’s primary objective is to remove barriers in reporting of sexual abuse and misconduct by creating a safe reporting environment and providing transparent information about the process.

If you believe a professional boundary has been violated or are a victim, or someone you know is a victim, of sexual abuse or sexual misconduct, please review our website information on how to submit a complaint.

If you wish to speak to someone directly, please contact the Complaints Director on their confidential line at 780-944-1609 ext 109. Once you contact us, we can assist you with connecting with other resources, including the possibility of funding for treatment and counselling services for victims of sexual abuse or sexual misconduct.

The Complaint Process for Complaints of Sexual Abuse or Misconduct

The process for sexual abuse and sexual misconduct follows the complaints process described in the Health Professions Act, with additional protections, including:

• certain types of resolution and alternative resolution are not available;
• mandatory minimum penalties after a finding of sexual abuse or sexual misconduct;
• requirements for at least one member of the Hearing Tribunal to have the same gender identity as the patient;
• requirements for trauma informed training and sexual violence training for the Hearing Tribunal;
• an opportunity for a complainant of sexual abuse or sexual misconduct to provide a statement of the impact; and
• mandatory publishing of decisions.

Additionally, for complaints of sexual abuse or sexual misconduct is made to the College, the Complaints Director will discuss with the affected the possibility of funding for treatment or counselling. The treatment/counselling is offered through a confidential, voluntary, and independent third-party program with the affected patient directly.

Potential Penalties for Complaints of Sexual Abuse or Misconduct

Each complaint is unique, and a penalty is determined by the Hearing Tribunal based on the circumstances of a complaint. However, some penalties are mandatory if the Hearing Tribunal makes a finding of sexual abuse or sexual misconduct.

If a Hearing Tribunal finds a regulated member’s conduct, in whole or in part, was sexual abuse, the mandatory penalty is cancellation of a regulated member’s permit, including a prohibition from re-applying to the College.

If a Hearing Tribunal finds a regulated member’s conduct, in whole or in part, was sexual misconduct, the mandatory penalty is a suspension of a regulated member’s practice (the length is determined by the Hearing Tribunal). The Hearing Tribunal may also find other penalties appropriate, for example remediation or education. There are also restrictions in the Health Professions Act against regulated members with findings of sexual misconduct re-applying to the College for at least five years, if they were cancelled by the Hearing Tribunal.

The Health Professions Act provides the following definitions:

Sexual Abuse: is defined as threated, attempted or actual conduct of a regulated member towards a patient that is of a sexual nature, including:

• Sexual intercourse between a regulated member and a patient of that regulated member;
• Genital to genital, genital to anal, oral to genital, or oral to anal contact between a regulated member and a patient of that regulated member;
• Masturbation of a regulated member by, or in the presence of, a patient of that regulated member;
• Masturbation of a regulated member’s patient by that regulated member;
• Encouraging a regulated member’s patient to masturbate in the presence of that regulated member; or
• Touching of a sexual nature of a patient’s genitals, anus, breasts or buttocks by a regulated member.

Sexual Misconduct: is defined as 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.

The ACSLPA Standards of Practice defines a patient as any individual to whom a regulated member provides a health service in their capacity as a speech-language pathologist or audiologist, but does not include:

• a patient’s substitute decision-maker, legal guardian, or parent, or
• the regulated member’s spouse, adult interdependent partner or other person with whom the regulated member is in an existing sexual relationship if the health service is provided in accordance with these standards.