Consent matters in healthcare. What to do if something feels wrong

Consent matters in healthcare. What to do if something feels wrong

medical consent

Ever had an experience at a health appointment that wasn’t what you expected? Perhaps you had a strong feeling that something wasn’t right?

As people who work in health regulation, we know that most of Australia’s 800,000 registered health practitioners are doing a great job providing safe and respectful care every day.

However, we know that people seeing a health practitioner, especially women and girls, may feel at their most vulnerable. On International Day for the Elimination of Violence against Women (25 November), it’s important to discuss the safety of women, and what to do if something doesn’t feel right.

In 2019/20, Ahpra received 464 complaints (we call them ‘notifications’) about practitioners failing to maintain appropriate boundaries in their interactions with patients or clients. More than 80 per cent of those cases were about medical practitioners, nurses or psychologists.

Many of these cases involve practitioners breaching the normal boundaries of the patient-practitioner interactions.  Some involve touching patients inappropriately and without adequate informed consent from the patient.

There is no place for sexual contact between a health practitioner and their patient or client. Sexual misconduct is an abuse of the treating relationship, and can cause significant and lasting harm for patients or clients.

In the past three years we referred 150 health practitioners to a tribunal (which has the power to take disciplinary action).

Some recent examples include:

  • The cancellation of a chiropractor’s registration for four and a half years. He was found to have inappropriately touched five female patients without any clinical justification. He was also banned from providing any health service which involves consultation with, or touching, any female patient while he is unregistered.
  • A former psychiatrist being disqualified for five years after being criminally convicted for the sexual assault of a female patient. The tribunal found that there was ‘grooming’ conduct leading up to the assault which included touching the patient’s body inappropriately and disclosing to her that he had an affair with another patient.
  • Suspending a medical practitioner’s registration after he was charged with four counts of sexual assault relating to consultations with three young, female patients, during which he touched them inappropriately without clinical reason to do so. 

When seeing a registered health practitioner, you should expect to receive safe, professional and respectful care. All registered health practitioners must meet their professions’ codes of conduct which outline expected standards of behaviour and professional practice.

Remember it is never appropriate for a health practitioner to engage in a sexual relationship or sexual contact with a current patient. And a health practitioner must only conduct a physical examination when it is clinically indicated and when they have your informed consent.

Before physically examining a patient, a practitioner should explain to you what they will do and why. Not adequately communicating this or going beyond what they said would be done may be a violation of consent. If something feels wrong, it could be.

And to health practitioners we say clear communication is the most effective way to maintain a safe and effective treating relationship with a patient or client. And you are responsible for maintaining professional boundaries in that relationship.

We want all women to feel empowered to speak up and be safe in doing so. Tell us if you think that the practitioner’s behaviour could mean future risk to your own safety or that of other patients.

We understand that making a notification is a big step for someone who has experienced possible sexual misconduct by a practitioner. The process that follows can be complex to navigate. We recently launched a notifier support service to provide emotional support to notifiers and witnesses of sexual misconduct by registered health practitioners. Importantly, it aims to prevent or reduce re-traumatisation of victims through the notification process.

We have long worked with police and sexual assault support services to improve information sharing and upskill our own investigation staff. And we are always looking to improve how we work.

We support professional practice by all registered health practitioners. We know the majority of practitioners are doing the right thing, but we will continue to respond strongly to cases of sexual misconduct. Because part of our role is ensuring that the public can have trust in registered health practitioners –that when you see a registered health practitioner, you will receive safe, professional and respectful care.

Creating real change requires real action. We all have a role to play in preventing sexism, sexual harassment and violence in our communities, including in healthcare.

Anyone with concerns about the behaviour of registered health practitioners can contact the Australian Health Practitioner Regulation Agency on 1300 419 495.

Gill Callister PSM, Chair of Ahpra’s governing board, Dr Anne Tonkin, Chair of the Medical Board of Australia, Rachel Phillips, Chair of the Psychology Board of Australia and Annette Symes, Presiding Member of the Nursing and Midwifery Board of Australia.

Australian Health Practitioner Regulation Agency (Ahpra) and the 15 National Boards register and regulate Australia’s more than 800,000 registered health practitioners.

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