Members’ Responsibilities Regarding Abuse Prevention

Penalties for Abusing a Patient/Client

Abusing a patient/client is professional misconduct15. If there are allegations of
abuse against an RT, they will be referred to ICRC and may be referred on to a
Discipline hearing. Discipline proceedings are open to the public, and the outcome
of them will be placed on the Public Register if there is a finding against the

If a Member is found guilty of professional misconduct (abusing a patient/client;
failing to file a report of abuse; contravening the RHPA, etc.), the panel of the
Discipline Committee may take any one or more of the following actions 16

1. Revocation of their certificate of registration

2. Suspension of their certificate of registration for a specified period of

3. Imposition of specified terms, conditions and limitations on the
Member’s certificate of registration for a specified or indefinite period
of time
4. A reprimand

5. A fine of not more than $35,000 payable to the Minister of Finance


6. An order requiring the Member to reimburse the College for sexual
abuse therapy or counselling.


7. An order requiring the Member to post security acceptable to the
College to guarantee the payment of monies for sexual abuse therapy or

For more frank acts of sexual abuse, the Code sets out a mandatory penalty of at
least revocation and a reprimand.

Reporting Suspected Abuse

Suspected abuse by a health professional is difficult to deal with in any situation. It is an RT’s ethical, professional, and sometimes legal responsibility to report any incidents of unsafe professional practice or professional misconduct (physical, verbal, emotional and/or financial abuse involving a regulated or non-regulated health care provider) to the appropriate authority.

The CRTO Standards of Practice states that an RT is accountable for the following:

Reporting sexual abuse of a patient/client by a regulated health professional to the appropriate College;

Reporting to the CRTO whenever their employment of a Member has been terminated for reasons of professional misconduct, incompetence or


Reporting a Member of the CRTO to the College where s/he has reason to suspect incompetence, professional misconduct or incapacity; and

Reporting incidents of unsafe professional practice or professional misconduct

Reporting physical, verbal, emotional and/or financial abuse of a patient/client by a regulated or non-regulated health care provider to the appropriate authority

Standard 13 – Professional Responsibilities


Employers must report to the CRTO, in accordance with regulatory
requirements, the following:

1. whenever, for whatever reason of professional misconduct, incompetence or incapacity, they terminate, suspend or impose restrictions on the employment of a Member; and
2. where they have reason to suspect a Member is incompetent, incapacitated, has sexually abused a patient/client or committed an act of professional misconduct.

Report to relevant authorities of any unsafe practice, unprofessional conduct, or incapacity by other healthcare team members


Report to the appropriate authority the following:


1. Sexual abuse of a patient/client, student, other healthcare team member and/or


2. Verbal, emotional, psychological or physical abuse of a patient/client, student, other member of the healthcare team, or


3. Taking advantage of a patient/client or student as a result of the Member’s position in the relationship

In addition, the RHPA requires RTs to submit a report when they have reasonable grounds, obtained during the course of practising their profession, to believe that a member of the CRTO or a different College has sexually abused a patient/client.


Under the RHPA, Members must report sexual abuse, if any of the following apply:


1. Where they have “reasonable grounds” to believe sexual abuse occurred; or (For example, concrete information from a reliable source or a patient/client, as opposed to rumour).


2. Where they obtained the information concerning sexual abuse during the course of practising the profession; or (The reporting requirement is not intended to capture a member’s conduct or behaviour outside the patient care/employment setting).


3. When they know the name of the alleged abuser (member); or (You are not required to file a report if you do not know the name of the alleged abuser).


4. Where the alleged abuser is registered with one of the health regulatory Colleges; or (If you are not sure, you can check with the College that regulates their profession).


5. Where the person being abused was a patient/client; or
(See the definition of “patient/client”).


6. If the conduct involved sexual abuse as defined by the RHPA.
(See the definition of “sexual abuse”).


Any questions regarding the reporting requirements and process can be directed to the CRTO.

Although there is no obligation under the RHPA to report sexual abuse of non-patients, (e.g. co-workers or students) there is a professional obligation to report another member of the CRTO where there is reason to suspect professional misconduct. (CRTO Standards of Practice – Standard 13 )

A report must be filed with the Registrar of the appropriate College within 30 days of the incident being brought to the RT’s attention, unless the RT reasonably believes the abuser will continue to abuse, in which case they must file the report immediately. The report must be in writing and include:


The RT’s name, address, and a phone number where they can be reached;


The name of the alleged abuser (regulated health care professional);


Details/description of the alleged abuse;


The name of the patient/client, only if the patient/client consents, in writing, to their name being included (if the patient will not give consent you must still submit the report but do not include the patient/client’s name. You should include the fact that you have tried to obtain consent, and that it was refused, in the report);


The names of witnesses or any other persons who might have information about the alleged abuse is also helpful

  • Listen calmly and with an open mind.
  • Take the information seriously.
  • Reassure the person that they are not to blame, and that they are not alone.
  • Be supportive.
  • Involve the appropriate corporation or institution staff, while respecting the person’s privacy.
  • Report the incident to the Registrar of the appropriate College.
  • Ask the person for their written permission to include their name in the report.
  • Make light of the situation.

  • Assume that the crisis has passed.

  • Try to explain the behaviour as having been misinterpreted.

  • Guarantee quick fixes or other promises that cannot be kept.

  • Display a strong emotional reaction of shock, disgust, or embarrassment.

Consequences for Failing to Report

Any person who fails to file a required report as outlined above, is guilty of an
offence and if convicted is liable for a fine up to $25,000 for a first offence17.
Additionally, if you, as a Member of the CRTO, fail to file a report as required, you
may be subject to professional misconduct proceedings18.

The RHPA expressly states that anyone making a report in good faith and on the belief that there are reasonable grounds is protected from retaliation (HPPC , Ss.92.1).

Responsibilities Related to the Child and Family Services Act

The Child and Family Services Act (CFSA) exists to protect and promote the best
interests and well-being of children under 16 years of age. The legislation articulates
the duty to report a child in need of protection and outlines the reasons a child
might be in need of protection19, which includes but is not limited to a child that:


Has suffered, or is likely to suffer, physical harm;


Is neglected or is subject to a pattern of neglect;


Has been, or is likely to be, sexually molested or exploited;


Requires medical treatment to cure, prevent or alleviate physical harm or suffering and the child’s parent or other person having charge of the child does not provide, or refuses or is unavailable or unable to consent to, the treatment; and/or


Has been abandoned

The CFSA outlines that health care professionals have a particular responsibility to
report suspicions of abuse of children. The Act makes it an offence for a health care
professional to not report their suspicion when it is based on “information obtained
in the course of his or her professional or official duties”20. The Act also articulates
the ongoing duty to report subsequent suspicions of abuse, even if the health care
professional has already made previous reports on the same child.

As with reporting abuse of adults under the RHPA, the Child & Family Services Act has several provisions protecting anyone “providing information in good faith” (Child & Family Services Act).


A child is brought into emergency with a severe asthma exacerbation. Upon chest x -ray it is noted that he has lateral and posterior rib fractures that are highly specific for abuse. The health care team discusses their suspicions of abuse and the RT assumes that the physician or one of the nurses will file a report with CAS.

What do you do?

A person who has reasonable grounds to suspect a child is or may be in need of protection must report immediately and directly to the CAS and cannot rely on anyone else to make the report. There is also an ongoing duty to report any additional suspicions, even if previous incidents have already been brought to the attention of the CAS.

  1. CRTO A Commitment to Ethical Practice
  2. CRTO Funding for Supportive Measures (Non-Patient/Client) Policy
  3. CRTO Funding for Supportive Measures (Patient/Client) Policy
  4. CRTO Mandatory Reporting by Member Fact Sheet
  5. Pause Before You Post: Social Media Awareness for Regulated Healthcare Professionals
    eLearning module
  6. CRTO Standards of Practice
  7. Zero Tolerance of Sexual Abuse and Other Forms of Abuse Position Statement
  1. Child and Family Services Act
  2. Criminal Code of Canada
  3. Handbook on Sensitive Practice for Health Care Practitioners: Lessons from Adult Survivors of
    Childhood Sexual Abuse. In Public Health Agency of Canada (Eds.),. Ottawa: Public Health Agency
    of Canada
  4. McPhedran, M., & Sutton, W. (2004). Preventing Sexual Abuse of Patients: A Legal Guide for Health
    Care Professionals. Toronto, ON, Canada: LexisNexis Butterworths.
  5. Ontario Human Rights Commission (2013). Policy on Preventing Sexual and Gender-Based
  6. Regulated Health Professions Act
  7. Statistics Canada. (2011). Violent victimization of Aboriginal women in the Canadian provinces,
  8. Statistics Canada. (2012). Family violence in Canada: A statistical profile, 2010
  9. Statistics Canada. (2013). Measuring violence against women: Statistical trends