SEXUAL ABUSE PREVENTION PLAN AND DATING GUIDELINES
Document provides guidelines for interaction with patients
September 22, 2000
In February 1995, College Council approved a Sexual Abuse Prevention Plan as required by the Regulated Health Professions Act (Act). This document details the plan and provides guidelines for all members.
[Note: For the purposes of this Plan, a patient is any individual for whom you fill prescriptions and provide pharmaceutical care. This Plan applies to conduct with all patients, irrespective of their consent for a pharmacist's conduct to be otherwise.]
Statement of Philosophy
The Ontario College of Pharmacists regards any act of abuse or harassment of a patient, customer, staff person and/or colleague, as unacceptable and such actions may constitute professional misconduct and/or criminal offence. Furthermore, ignoring harassment or abuse is equal to condoning the abuser's actions and further harming the victim.
Abuse can be sexual, physical, verbal and/or emotional. The Regulated Health Professions Act defines sexual abuse as:
- Sexual intercourse or other forms of physical relations between a member (pharmacist) and his/her patient;
- Touching of a sexual nature of a patient by the member;
- Behaviour or remarks of a sexual nature by the member towards the patient.
[Note: "Sexual nature" does not include touching, behaviour, or remarks of a clinical nature that are appropriate to the service being provided.]
Harassment is defined as any unwelcome action; whether verbal or physical; on a single or repeated basis; which humiliates, insults or degrades; and includes harassment on the basis of race, colour, sex, religion or political affiliation, national or ethnic origin, age, mental or physical disability, sexual orientation, citizenship, creed, record of offenses, and marital or family status.
Code of Acceptable Behaviour
- Pharmacists shall not have sexual intercourse with their patients.
- Pharmacists shall not engage in touching of a sexual nature with their patients.
- All behaviour or remarks of a sexual nature used by pharmacists in dealing with patients shall be of a clinical nature only and appropriate to the service being provided.
- Pharmacists shall be sensitive to each patient's need for dignity, privacy and respect in all situations, including but not limited to: patient counselling, fitting for prosthesis and other physical aids, and patient home visits.
Mandatory Reports
Pharmacists are required by the Act to report whenever they have "reasonable and probable grounds, obtained in the course of practicing their profession, to believe that a member, of the same or a different college, has sexually abused a patient."
Education Plan
Pharmacists must understand the Sexual Abuse Prevention Plan and the related issues of sexual impropriety, abuse and harassment. The College will undertake efforts to educate members and students about these issues; it will also provide training to key College staff on how to handle complaints involving topics of a sexual nature.
Funding for Therapy & Counselling
Pursuant to the Act, the College is required to establish a fund that can provide funding for therapy and counselling for persons who, as patients, were sexually abused by a member of the College. As a result, a fund has been established for this purpose and a regulation has been proposed detailing eligibility criteria. The Patient Relations Committee will administer this fund.
Professional Misconduct
In addition to the Bill 100 amendments made to the Regulated Health Professions Act-which made sexual abuse of patients an offence-the College has included the following additional action that, in and of itself, constitutes professional misconduct: "Abusing a patient, verbally or physically."
Communicating the College's Philosophy to the Public
The College will also endeavour to communicate its abuse and harassment policies in future public relations initiatives.
Reporting Suspected Abuse: A Guide for Pharmacists
As professionals, pharmacists have an obligation to report certain information about suspected abuse that comes to their attention.
Sexual Abuse
Pharmacists are required to report whenever they have reasonable grounds to believe that a patient is being abused by a health care professional. This report must be made in writing within 30 days to the health care professional's College and can only include the patient's name where written consent has been given. There is a $25,000 fine for failure to report although pharmacists are indemnified for making reports in good faith.
Child Abuse
Pharmacists have long been included in the list of professionals who are required to report suspected child abuse, and these reports must be made to a local children's aid society. While indemnity is provided for pharmacists reporting in good faith, there are fines for failing to report. Your local children's aid society is listed in the Blue Pages of your phone book.
Spousal Abuse
While there is no strict legal requirement for pharmacists to report suspected spousal abuse, pharmacists are encouraged to report these cases to the local police. Wherever possible, pharmacists should also provide the abused spouse with information about crisis lines and women's shelters in their area.
Dating Guidelines
Fred Pharmacist is very excited about his new job in Northern Extreme, Ontario. As a new graduate, Fred is looking forward to serving a small community at the only retail pharmacy within 50 miles. He is young, single and enthusiastic.
After two months on the job, Fred is still thrilled with his position but is a bit lonely. After all he went to school in a large urban centre and is used to having an active social life. While he is meeting lots of people, he realizes that he has professional relationships with each of them as patients in his pharmacy. This situation poses a conflict. In a community this small, it is difficult to separate your personal life from your professional life. Anyone Fred is interested in dating is also a patient. He knows that the provisions of the Regulated Health Professions Act (RHPA) prohibit getting sexually involved with a patient. He feels torn and is considering moving back to the city.
To keep pharmacists like Fred working in small communities and to allow them to have personal and intimate relationships, the Patient Relations Committee developed guidelines for pharmacists. The provisions of the RHPA that deal with the sexual abuse of patients would, strictly speaking, prohibit pharmacists from filling a prescription for a spouse, or dating anyone for whom they had filled a prescription. The goals of the Committee in developing these guidelines were to protect the patient from abuse, and protect the pharmacist from misunderstanding. The Committee recommended the following guidelines, approved at the June 1995 Council meeting.
Definition of a Patient
“Patient” is not a defined term in the legislation. The Committee recommended that, for the purposes of the sexual abuse provisions of the legislation, a patient be anyone for whom a patient profile exists in a pharmacy computer or manually kept record system.
The Issue
The provisions of the RHPA that deal with sexual abuse clearly prohibit any sexual contact between a pharmacist and a patient. These provisions recognize the position of power that a pharmacist holds in the community and the fact that a pharmacist has access to confidential information regarding patients.
The Solution
The only clear way for a pharmacist to avoid any problems with the sexual abuse provisions of the RHPA is to keep his/her personal and private lives separate. This means not filling prescriptions for individuals with whom they have sexual contact.
It is reasonable to expect that certain patients may wish to continue having their prescriptions filled at their spouses’ pharmacies. The Committee recommends that if this is the case, the pharmacist tell his/her spouse that he/she has access to information that would otherwise be confidential. This allows the spouse to make an informed choice about where to have his/her prescriptions filled.
If a pharmacist is not married and wishes to commence a personal relationship with a patient, the solution is less clear. Obviously, a pharmacist and a patient cannot contract out of the legislation. Therefore, sexual contact is sexual abuse and could be actionable by a patient against a pharmacist. The Committee recommends that if a pharmacist wants to commence a sexual relationship with a patient, he/she take steps to disclose the nature of his/her power. This diffuses the differential of power between him/herself and the patient. While this does not make the relationship risk-free, it recognizes that it is the differential of power that makes having sex with a patient wrong.
The Committee recommends that a pharmacist reveal that he/she has access to confidential information about the patient. The patient may, at any time, choose to have his/her prescriptions filled elsewhere. The Committee developed a waiver that it proposes the pharmacist ask the patient to sign. It outlines that the pharmacist has told the patient this information, and that the patient still wishes to continue having his/her prescriptions filled at the pharmacy where the pharmacist practices. The pharmacist would then retain the waiver.
The Patient Relations Committee recommend the following wording be used: “I (name of Patient) understand and acknowledge that (name of pharmacist) has access to my confidential patient information and that I could choose to have my prescriptions filled at another pharmacy in order to preserve the confidentiality of that patient information.” This should be followed by the date and signature of the patient.
All questions should be directed to the College's Client Services Department at tel: (416) 962-4861 ext.300.
