Scott Farley D.C.
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Increase knowledge and understanding of
sexual boundaries and a chiropractic
physician's ethical and professional obligations
Consequences of sexual boundary violations
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The majority of reported sexual boundary
violations in healthcare involve male health
practitioners and female patients/clients
38-52 % of health professionals report knowing
a colleagues who has been/is involved with
patients
Greater awareness of professional guidelines
and sanctions reduce prevalence
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The impact on survivors of professional sexual
boundary violations/abuse shows considerable
and enduring harm
Symptoms include post traumatic stress
disorder, anger, sense of betrayal and
exploitation, guilt and self-blame
High levels of dependency on the offending
health professional, confusion and dissociation
are found
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Behavior that exploits the physician-patient
relationship in a sexual way
May be verbal or physical and may include
expressions of thoughts and feelings or
gestures that are sexual or that reasonably may
be construed by a patient/patient’s surrogate
as sexual
The practitioner responding to sexual
approaches made by a patient or client
especially as these may be indicative of
previous boundary violation or confusion
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Clinical interventions of an intimate nature
which are not warranted by the individual's
condition and/or are carried out
inappropriately
Clinical interventions such as intimate
examinations which are wrongly framed in
sexual terms or accompanied by sexual
comments
Mutual attraction that is acted upon while a
clinical or therapeutic relationship is still in
operation or recently terminated
1.
2.
Sexual Impropriety
Sexual Violation
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May comprise behavior, gestures or
expressions that are seductive, sexually
suggestive, disrespectful of patient privacy or
sexual demeaning to a patient
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Neglecting to employ disrobing or draping
practices respecting the patient’s privacy or
deliberately watching a patient dress or
undress
Subjecting a patient to an intimate examination
Performing an intimate examination or
consultation without clinical justification
Using the physician-patient relationship to
solicit a date or romantic relationship
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Inappropriate comments about or to the patient
including but not limited to, making sexual
comments about a patient’s body or
underclothing, making sexualized or sexually
demeaning comments to a patient, criticizing
the patient’s sexual orientation, making
comments about potential sexual performance
during an examination
Requesting details of sexual history/sexual
preferences when not clinically necessary
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Sexual violation may include physical sexual
contact between a physician and patient,
whether or not initiated by the patient, and
engaging in any conduct with a patient that is
sexual or may be reasonably interpreted as
sexual
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Sexual intercourse in any capacity
Kissing in romantic/sexual manner
Touching breasts, genitals or any sexualized
body part for any purpose other than
appropriate examination or treatment
Offering practice-related services (treatment,
drugs, etc.) in exchange for sexual favors
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Respect cultural differences.
Do not use gestures, tone of voice, expressions, or any
other behavior that a client could interpret as
seductive, sexually demeaning, or sexually abusive.
Refrain from treating a client that you have had a
previous intimate relationship with.
Do not make sexualized comment about a client’s body
or clothing.
Do not make sexualized or sexually demeaning
comments to a client.
Do not criticize sexual orientation.
Do not ask details of sexual history – unless it’s your
job.
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Do not engage in inappropriate ‘affectionate’
behavior with a client.
Do not talk about your own sexual preference,
fantasies, problems, etc.
Learn to detect and deflect seductive clients.
Do not request a date with a client.
Do not engage in any sexual contact.
Maintain good records that reflect any intimate
questions of a sexual nature and document any
and all comments or concerns made by a client
relative to alleged sexual abuse, and any other
unusual incident that may occur during the course
of, or after an appointment.