A male doctor can choose to only treat female patients if an observer or chaperone is present under proposed Medical Board of Australia guidelines.
The board is finalising new rules for doctors to use nurses or receptionists as a ‘witness to the consultation’ under draft guidelines on sexual boundaries for doctors and patients.
It follows growing fears of doctors having false abuse allegations made against them.
Medical Board of Australia is currently finalising new guidelines on sexual boundaries in the doctor patient relationship (stock image)
‘A doctor may choose to have an observer present during an intimate examination of a patient or in any consultation,’ the draft guidelines state.
‘An observer can provide an account of the consultation if later there is an allegation of improper behaviour.’
If a patient declines to have an observer present, the doctor can proceed with the consultation or help the patient to find another doctor.
A number of Brisbane specialists will only take appointments for female patients when a receptionist can be a chaperone, The Sunday Mail reported.
‘There’ve been a couple of times when I’ve felt unsafe with a woman patient,’ an unnamed specialist told the publication.
Australian Medical Association ethics committee chairman Dr Chris Moy added: ‘There are patients who will have a malicious intent, similar to the people putting needles in strawberries. The whole sexual boundaries issue is a bit of a moving feast because the ‘#metoo’ situation is changing the cultural norms a little bit.’
The draft guidelines advice that doctors should only conduct physical examinations if they are clinically warranted and that ‘unnecessary physical examinations may constitute sexual assault or abuse’.
A male doctor can choose to only treat female patients if an observer or chaperone is present under new guidelines (stock image)
‘There is a wide range of behaviours that breach sexual boundaries, from making unnecessary comments about a patient’s body or clothing to criminal behaviour such as sexual assault,’ the draft guidelines state.
‘Unnecessary physical examinations or touching during a consultation and examinations without informed consent are criminal offences.
Other breaches include asking a patient about their sexual history or preferences, when these are not relevant to the patient’s clinical issue.
Even the shaking of hands could ‘breach sexual boundaries’.
The medical board plans to publish its final guidelines in the coming months.
‘The whole sexual boundaries issue is a bit of a moving feast because the ‘#metoo’ situation is changing the cultural norms a little bit,’Australian Medical Association ethics committee chairman Dr Chris Moy (pictured) said
Many doctors and medical associations responded when the board called for public submissions on the guidelines earlier this year.
The Royal Australian College of General Practitioners believe the guidelines need to consider the broader context of a doctor-patient relationship to avoid unwarranted malpractice claims.
‘Guidance is needed to help protect patients from inappropriate behaviour and harm by doctors, but this should be approached in a manner that does not inflict unwarranted stress and concern to all individuals involved,’ its submission to the board states.
‘As currently written, the RACGP believes the guidelines might have the unwanted consequence of being misused to support unwarranted claims of sexual misconduct by doctors. Routine and important procedures, such as taking a sexual history, could be interpreted as harassment.’
The RACGP also expressed concerns about delayed diagnosis and ‘placing the patient at unnecessary risk’.
Rape and Domestic Violence Services Australia called for guidelines should include a medical professionals’ right to access support when they receive a disclosure of sexual assault.
‘Vicarious trauma refers to the deleterious effects upon people not directly affected by traumatic events, but nevertheless exposed to them in some way,’ executive director Karen Willis wrote.
‘Vicarious trauma is common among professionals who receive disclosures of sexual assault. Strategies which may assist with managing the risk of vicarious trauma include education, risk reduction, monitoring, early intervention and offsetting symptoms.’
She also recommended guidelines be amended to clarify the rights of medical practitioners who are subject to sexual harassment or sexual assault by a patient.
‘In particular, the guidelines must make clear a medical practitioner’s right to report these behaviours and access appropriate support,’ Ms Willis wrote.