The College of Physicians of Ontario have provided a list of suggestions to help physicians avoid complaints of sexual misconduct and prevent boundary violations. These are also available on the College website.
It is important for physicians to develop practices that clearly communicate the intentions of the physician towards the patient.
Avoid any behaviour, gestures or expressions that may be seductive or sexually demeaning to a patient.
Show sensitivity and respect for patients’ privacy and comfort at all times: do not watch a patient dress or undress, and provide privacy and appropriate covers and gowns.
Obtain permission to do intimate examinations, offer explanations as to the necessity of the examination and answer or anticipate questions concerning the examination.
Use gloves when examining genitals.
Do not make sexualized comments about a patient’s body or clothing.
Do not make sexualized or sexually demeaning comments to a patient.
Do not criticize a patient’s sexual preference.
Do not ask or make comments about potential sexual performance except where the examination or consultation is pertinent to the issue of sexual function or dysfunction.
Do not ask details of sexual history or sexual likes/dislikes unless related to the purpose of the consultation or examination.
Do not request a date with a patient.
Do not kiss a patient. Do offer appropriate supportive contact when warranted.
Do not engage in any contact that is sexual (from touching to intercourse).
Do not talk about your own sexual preferences, fantasies, problems, activities or performance.
Learn to detect and deflect seductive patients and to control the therapeutic setting.
Maintain good records which indicate the necessity for intimate examinations or questions of a sexual nature as well as the pertinent positive or negative clinical findings.
Patients have the right to a third party present during internal/intimate examinations if they wish, with the exception of life-threatening emergencies. In some cases, the physician will be able to provide this third party. In cases where the physician is unable to provide such a person, patients should be informed that they may bring a person of their choosing with them. In non-emergency situations, physicians have the right to insist that a third party be present during internal/intimate examinations, and to refuse to conduct this examination if the patient refuses consent for a third party to be in the room.