Module 6: Summary

• As required by the HPA, ACSLPA funds a patient’s treatment and/or counselling when there is a complaint involving sexual abuse and sexual misconduct towards the patient by a regulated member. The complaint may be submitted by someone other than the patient.
• A decision by ACSLPA to provide funding to a patient does not constitute a finding of unprofessional conduct against the regulated member. The two processes are independent.

“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:

1. sexual intercourse between a regulated member and a patient of that regulated member;
2. 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;
3. masturbation of a regulated member by, or in the presence of, a patient of that regulated member;
4. masturbation of a regulated member’s patient by that regulated member;
5. encouraging a regulated member’s patient to masturbate in the presence of that regulated member; or
6. touching of a sexual nature of a patient’s genitals, anus, breasts or buttocks by a regulated member.”

HPA, s. 1(1)(nn.1)

• A regulated member of ACSLPA abstains from conduct, behaviour, or remarks directed towards a patient that constitutes sexual abuse as defined by the HPA.
• The regulated member:
  • must not enter into or have a sexual relationship with a patient; and
  • must not threaten or attempt to have a sexual relationship with a patient.
• 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.

“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)

• Female genital mutilation or female circumcision involves the injury to or partial or total removal of the external female genitalia for non-medical reasons.
• A regulated member of ACSLPA shall not procure or perform female genital mutilation as defined by the HPA.

• 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:
  • must not make sexually suggestive comments or gestures; and
  • must not exploit or attempt to exploit any real or perceived imbalance of power.
• A regulated member of ACSLPA abstains from conduct, behaviour, or remarks directed towards former patients that constitute sexual abuse or sexual misconduct, as defined by the HPA.
• Never make any assumptions about the patient’s acceptance or tolerance for being touched or in close contact.
• Physical contact is context specific and consent for treatment does not include consent for other physical contact (e.g. hug, pat on the knee).
• Always:
  • ask the patient or caregiver to move hair, head or neck covering(s) or get their consent to do so, as needed;
  • demonstrate respect for the patient;
  • maintain the patient’s dignity (e.g. draping);
  • respect the patient’s personal space;
  • respect their right to withdraw their consent at anytime;
  • use gloves as required for infection control and to reduce intimacy;
  • avoid unnecessary physical contact; and
  • use physical barriers (e.g. pillows) to prevent contact with other body parts.

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 registration and practice permit, including a prohibition from re-applying to the College; or
• sexual misconduct, the mandatory penalty is a suspension of a regulated member’s practice permit; the length of a suspension is determined by the Hearing Tribunal. If the Hearing Tribunal cancels a regulated member’s practice permit because of findings of sexual misconduct, the regulated member cannot reapply to the College for at least five years.

HPA, s. 82(1.1)

Other penalties for unprofessional misconduct include, but are not limited to:

• cancellation of registration and practice permit;
• suspension of the practice permit; fines (i.e. money);
• attending counselling or a treatment program;
• additional training or supervised practice; reprimand (formal statement of disapproval);
• practice permit conditions; or
• a caution.

HPA, s. 82(1)

• Because ACSLPA’s role is to protect and serve the public and not to serve the needs of the members (review Jurisprudence Module 1 if needed), the College must report certain information about imposed practice permit conditions and hearings on the website,the General Register and in the Annual Report.

Must Publish

• conditions imposed/removed, if any, on the regulated member’s practice permit, on the General Register;  (HPA, s. 119(1 & 3))
• a copy of any decision made by a hearing tribunal, council or court of unprofessional conduct based in whole or in part on sexual abuse or sexual misconduct;
• whether a regulated member’s practice permit has been suspended or cancelled as a result of a decision of unprofessional conduct based in whole or in part on sexual abuse or sexual misconduct; and
• any conditions placed on an investigated person’s practice permit as a result of a decision of unprofessional conduct based in whole or in part on sexual misconduct. (HPA, s. 135.92)

Must Notify

• conditions imposed, if any — ACSLPA must notify the regulated members employer, hospital staff (if applicable), and Minister or organization responsible for administering payment for fees, other college(s) and governing bodies (as applicable).