Sexual Abuse

This issue came to the attention of the Ethical Committee in April 1992 when Rosemary Jarmey attended a seminar organised by the Medical Council on Sexual Abuse in the Doctor/Patient Relationship[1].  The Society sent a submission to the MCNZ Sexual Abuse Working Party in November 1992 supporting the College of Physicians and Surgeons of Ontario’s definition of sexual impropriety and sexual violations[2].  It was agreed that there would be zero tolerance of sexual contact between physiotherapist and patient/client,  and that the Society should adopt the definitions of sexual contact recommended by the Ontario Task Force (for Physiotherapy)[3]. 

The MCNZ information it on “sexual abuse in the doctor-patient relationship” was available to members in December 1993[4].  It was important the Society took action to prevent physiotherapy patient/client relationships which were exploitive and harmful;  however it was vital that in the process we did not create damage where none has existed,  or an environment where human warmth and caring disappear from professional relationships[5]. 

By 1994 the Society accepted the principle of zero tolerance in regard to physiotherapy patient/client relationships.  It was felt there should be further investigation of the word abuse,  and a working party was set up to consider this. The terms of reference for a Working Party were published in July 1994[6].  These Terms of Reference were to develop the guidelines for a policy as stated in the Notice of motion passed at the AGM.

a. To determine the appropriate wording for the policy.  To report  back to Executive by 3 Sept.

b. To determine the appropriate wording for the policy.  

c. To Report  back to Executive by 3 Sept

Objectives -

a. To obtain legal opinion on the words abuse, contact and misconduct

b. To review relevant resource material that is currently available. 

c.  To consult widely within the profession and other groups.  All reasonable expenses for travel,  gathering of resource material, communication and secretarial assistance to be met by the Society.

Progress by the Working Party was published in September 1994[7].  An extra member was added to the party in October 1994,  and questions to be asked were published[8].  A discussion paper was included with the December 1994 Newsletter.  A full and informative report from the Working party was tabled in November 1994 and discussed.  It was agreed that when finalised this discussion document should be forwarded to all members with the December 1994 Newsletter for their information.  Comments should be returned to National Office by 31 January 1995.  Once the comments had been considered,  a rule change would be circulated as a Notice of Motion for discussion at the 1995 annual general meeting.  Executive commended the Working Party on the production of such an informative document.

The Policy formulated at the 1995 AGM

No.3 - Policy on sexual abuse. That members endorse the definition of professional sexual abuse as contained in the Discussion Document on Professional Sexual Abuse Policy - This is the exploitation of a current patient/client , particularly within a sexual contact.  The physiotherapist relationship is not one of equality. In seeking assistance , guidance and treatment the patient is vulnerable.

No 4 Members confirmed the remainder of the Discussion Document on the Professional Sexual Abuse Policy.

No 5 members accept the use of the Discussion Document of Professional Sexual Abuse as an explanatory memorandum.

In May 1996 Margaret Davidson and Barbara Guthrie reported on the Australian Conference on Professional Sexual Abuse,  and made recommendations.  It was felt it would be a good idea to survey the profession,  with results helping to target educational strategies[9].

1. Involve ourselves in discussion with Dr. Rhys Cullen with a view to surveying the profession as to their attitudes to sexual contact with patients.  The results would help to target Educational strategies.  Support for the survey was given in principle.  It was noted that the proposal indicates followup of nonresponders and this may raise concerns about the anonymity of the survey.  Ethical Committee to clarify this aspect of the survey,  confirm the Rhys Cullen does not require a fee,  and present a survey budget and draft survey form to National  Executive for approval.

2. Closer co-operation with the Medical Council of NZ with regard to an assessment and rehabilitation programme for the offender.  Support given in principle - Ethical Committee to work on details and present to National  Executive.

In June 1997 The minutes of the 29 April meeting were tabled and discussed.  Results of the “Sex in the professional Relationship Survey” were published in the August Issue of the Journal of Physiotherapy.  Unhappily it was published just after Christmas and provoked a strong media response.  The National Office published a clarifying notice.  In October 1997 the National Executive members unanimously supported the Ethical Committee’s review and reconfirmation of the NZSP Sexual Abuse Policy.

[1] E/M 7-4-92

[2] E/M 1-11-92

[3] E/M 25-7-93

[4] N/L  December page 3

[5] E/M 24/25 - 7 - 93

[6] N/L July 1994 page 2

[7] N/L September 1994 page 4

[8] N/L October 1994 page 2

[9] E/M 10-5-96