Sexual abuse initiative
draft principles – Articulating Our Approach
The draft principles articulate the College’s approach to sexual abuse matters with content
informed by the College’s mandate, our policy and Council discussion. Please let us know what
you think of these principles in our consultation at www.cpso.on.ca.
principle 1: Harm and Breach of Trust
principle 2: Prevention
Sexual abuse is harmful and physicians must never have
any sexual involvement with patients.
There is an inherent power imbalance in the physicianpatient relationship. The physician-patient relationship
is fiduciary in nature, requiring physicians to act with the
utmost good faith and to ensure patients’ best interests
are paramount.
Sexual abuse of patients exploits this power imbalance,
is contrary to physicians’ fiduciary duties and is a breach
of trust. Sexual abuse harms not only the individual
patients who are abused, but also the public at large by
undermining the public’s trust in the medical profession.
Education of physicians and medical trainees is essential
to prevent sexual abuse of patients. Physicians must have
a clear understanding of their obligations to maintain appropriate boundaries with patients, and that any sexual
involvement with patients is harmful, is considered
sexual abuse, and is never acceptable.
Education of the public is also essential. The public
needs clear information about the differences between
appropriate and inappropriate physician-patient interactions and what patients can expect from physicians.
Patients also need to be aware of steps they can take to
keep themselves safe, and to question anything they
have experienced that doesn’t feel right. This includes information regarding how to share their concerns with the
College and others, and the support the College provides
when they do so.
principle 3: Physician Responsibility:
Individual and Collective
principle 4: Respect, Fairness and
Transparency
Physicians have responsibility both individually and
collectively to prevent sexual abuse of patients and to
respond when they learn a patient has been sexually
abused.
Individually, physicians must maintain appropriate
boundaries with patients and must not sexually abuse
patients. Physicians must also make a mandatory report
when they learn a patient has been sexually abused by a
regulated health-care professional.
Collectively, physicians together with organizations,
hospitals and others, have a shared ethical responsibility
to prevent and respond to sexual abuse of patients.
Complaints and disciplinary processes must ensure that
all individuals – patients and physicians – are treated with
respect. Processes must be fair, impartial and transparent.
In acknowledgment of the inherent power imbalance
between physicians and patients, and the challenges
patients experience in both reporting sexual abuse and
proceeding with the complaints process, the College will
continue to support and empower patients throughout
the College’s complaints and discipline processes.
principle 5: Public Protection
principle 6: Public Confidence
In fulfilling its regulatory duties, the College has a duty to
serve and protect the public interest. Public protection
is the Colle