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DEFINITIONS

Abuse

For the purposes of this practice guideline, unless otherwise indicated, abuse may
be defined as treating others in a harmful, injurious, or offensive way and
includes, but is not limited to:

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Physical abuse (e.g., pushing, shoving, shaking, slapping, hitting or other physical force that may cause harm);

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Verbal abuse (e.g., derogatory or demeaning comments, cultural slurs, use of profane language, insults);

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Emotional abuse (e.g., threats, intimidation, insults, humiliation and harassment);

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Financial abuse/exploitation (e.g., theft, forging a person’s signature, influencing a patient/client to change their Will);

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Cyber abuse (e.g., cyber bullying by conveying inappropriate images and words through any form of electronic media); and

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Sexual abuse/assault/harassment (see sections on Sexual Abuse, Sexual Assault & Sexual Harassment).

Member 

Refers to a Respiratory Therapist who is, or was, registered with the CRTO.

Non-Patient/Client

An individual who does not meet the definition of patient/client but who alleges sexual misconduct against a Respiratory Therapist. Examples include a Student Respiratory Therapist, family member of a patient/client, or other health care providers.

Patient/Client1

For the purposes of the sexual abuse provisions of the RHPA an individual is
considered a patient/client of the Member if there is a direct interaction between
the Member and the individual and any of the following conditions are met:

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The Member contributed to the individual’s health record;

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The Member charged or received payment for health services provided to the individual;

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The individual consented to health services recommended by the Member; or

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The Member prescribed a drug for the individual

An individual may be, or may continue to be, considered a patient/client of the Member for at least one (1) year after any of the above contacts.

Sexual Abuse

As defined in the Code sexual abuse means:

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Sexual intercourse or other forms of physical sexual relations between the member and the patient;
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Touching, of a sexual nature, of the patient by the member; or
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Behaviour or remarks of a sexual nature by the member towards the patient. Patient/Client2

“Sexual nature does not include touching, behaviour or remarks of a clinical nature that are appropriate for the professional service being provided 3.

Sexual Assault

Conduct that amounts to sexual abuse pursuant to the Code
may also constitute sexual assault in the criminal context. Certain
situations can magnify the gravity of a sexual assault, such as
when the assailant is in a position of trust or authority over the
individual. Sexual assault is defined in the Criminal Code of
Canada (CCC) as any form of sexual contact without both parties’
voluntary consent4. According to the CCC, there is no consent if:

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The accused counsels or incites the complainant to engage in the activity by abusing a position of trust, power or authority​5.

Sexual Harassment

Common types of sexual harassment include:
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Threatening – (e.g., threatening punishment or offering rewards in return for sexual favours);

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Physical harassment;

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Verbal harassment;
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Non-verbal harassment – (e.g., body language, sexual gestures);

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Environmental harassment – (e.g., sexually suggestive pictures or objects in the workplace).

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“Sexual harassment is engaging in a course of vexatious comments or conduct that is known or ought to be known to be unwelcome”

(Ontario Human Rights Code, 2013)

Sexual harassment can also take place virtually (i.e., cyber abuse) through such media as email and/or social media posts containing sexual content.

Sexual Misconduct

Acts of sexual abuse, assault or harassment by a Respiratory Therapist constitute Professional Misconduct ​6.

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Did You Know?

Unless prescribed in regulation, when a registered Member of the profession treats their spouse, they contravene the sexual abuse provision in the RHPA, and can potentially face mandatory revocation of their certificate of registration.

For more information, please see the CRTO’s Conflict of Interest PPG under
“Treatment of a Spouse”.

ADDITIONAL RESOURCES
  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
REFERENCES
  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
    Harassment.
  6. Regulated Health Professions Act
  7. Statistics Canada. (2011). Violent victimization of Aboriginal women in the Canadian provinces,
    2009.
  8. Statistics Canada. (2012). Family violence in Canada: A statistical profile, 2010
  9. Statistics Canada. (2013). Measuring violence against women: Statistical trends

FOOTNOTES

  1. Ministry of Health and Long-Term Care. (1991). Regulated Health Professions Act, Health Professions Procedural Code, s.1(3). Retrieved from www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_91r18_e.htm

  2. Ministry of Health and Long Term Care. (1991). Regulated Health Professions Act, Health Professions Procedural Code, s.1(4). Retrieved from www.e-laws.gov.on.ca/html/statutes/english/elaws_statutes_91r18_e.htm

  3. Government of Canada. (1991). Criminal Code of Canada, s. 153(2) (3). Retrieved from http://lawslois.justice.gc.ca/eng/acts/C-46/

  4. Ibid.

  5. Ministry of Health and Long Term Care. (1993). Respiratory Therapy Act (1991), Ontario Regulation 753/93. Retrieved from https://www.ontario.ca/laws/regulation/930753?search=753%2F93.htm