Our aim in this section is to try and clarify the meaning of everyday phrases used in the subject of patient abuse. As a healthcare professional you may know much of this already but we hope that it will be a useful resource to dip in and out of. If there is anything that we have neglected to explain, please feel free to contact us.
In order to assess the health of an individual, or to identify the cause of an ailment, a medical professional may need to take a background history, examine other parts of the body or ask a series of questions.
For the most part this is standard behaviour however it becomes inappropriate when/if the patient becomes uncomfortable and does not understand why particular questions are being asked or feels that a practitioner is touching their genitalia or other unrelated parts of the body. In this instance, a patient should feel free to declare that they are uncomfortable a) question why the practitioner is doing what they are doing and b) and ask for someone else to be present to observe the examination.
What is Bodily Integrity?
Bodily integrity is defined as being: able to move freely from place to place; being able to be secure against violent assault, including sexual assault; having opportunities for sexual satisfaction and for choice in matters of reproduction.
Ireland is in the unusual position of having protection of the well-being of our citizens built into our Constitution. The phrase “Bodily Integrity” might sound cumbersome but this is a very important phrase in the context of violation of boundaries. In Article 40 of Bunreacht na hÉireann/The Irish Constitution it sets down that you have a right not to have your body or person interfered with. This means that the State may not do anything to harm your life or health.
International Convention on Civil and Political Rights
states the following: “No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his free consent to medical or scientific experimentation.”
is defined “as the edge of appropriate or professional behavior, transgression of which involves the practitioner stepping out of the clinical role.” Boundary violations by the provider often occur when the healthcare professional displaces or confuses his or her own needs with the patient’s needs. More often than not, such violations begin small and develop gradually. Even minor boundary transgressions can have a major and/or long-lasting impact on the patient.
Boundary transgressions by patients are common but usually minor, such as asking personal questions, becoming verbally abusive, being overly affectionate, or attempting to socialise.
To make information known. In the case of patient abuse, it generally refers to the reporting of abuse or abusive incidents.
Healthcare Professional refers to any individual who has cause to be part of or responsible for care of a patient. This includes, but is not limited to, hospital personnel, institutional care personnel, General Practitioners and their staff, Specialist Consultants and their staff, personnel in geriatric homes or home visit carers, community nurses and midwives, physical or mental therapists, pediatric staff and, by extension, to those responsible for children in care.
A legal requirement that designates types of information acquired by professionals or institutions (in the course of their work) be reported to designated and appropriate authorities. CLARIFY???The HSE have a mandatory reporting policy on abuse but nothing designated to protect patients in a medical setting.
Is the act or fantasy on the part of an adult in engaging in sexual activity with a child or children. However not all people who commit child sex abuse exhibit all the symptoms of the disorder whilst some paedophiles never actually commit such abuse.
A person who receives care or treatment from a healthcare professional.
Secondary victimisation refers to further victimisation of the patient following on from the original incident. In the case of patient abuse, secondary victimisation occurs when those investigating, reporting on or responsible for the original abuse further victimise the subject by the way the matter is handled. This might include not believing the claim, not taking it seriously, not escalating or investigating the matter, belittling the subject matter in conversation or in the media, closing ranks around or sharing information with the accused. It can also include not following up with the victim or not informing them of the fact that others may have already made similar complaints.
The secondary victimisation of patients can sometimes be more traumatic than the original crime because it has taken so long to re-build the confidence and trust authority figures. This is also known as also known as post-crime victimisation. Dignity 4 Patients seeks at all times to prevent the occurrence of secondary victimization, which has a major impact on patient victims.
Is defined as behaviours, gestures or expressions that are sexually demeaning to a patient or that demonstrate a lack of respect for the patient’s privacy. This is an abridged version of the Medical Council of New Zealand definition. The full text is available to view here .
is defined as any inappropriate touching of a patient that is of a sexual nature, short of sexual assault, under current law. This includes manual internal examination without gloves, touching breasts or genitals (except for the purpose of appropriate physical examination or treatment), touching breasts or genitals when the patient has withdrawn or refused consent for examination, inappropriate touching of other parts of the body which many be construed as sexual transgression or propositioning a patient. (Source: Medical Council of New Zealand).
Pursing a sexual relationship with a patient is also considered to be inappropriate and a breach of professional boundaries.
Means a healthcare professional having sexual intercourse with a patient (whether or not contact is initiated by the patient), masturbation, clitoral, penile or rectal stimulation or other forms of genital or sexual connection. This includes circumstances where drugs or other services are exchanged for sexual favours.
Misuse of licensed drugs by a healthcare professional to render patients vulnerable to sexual assault or any sexually inappropriate behaviour is a crime.
This is a legal obligation on an individual or organisation.
This is the environment in which any therapeutic session may take place. The patient or client is in receipt of treatment by a healthcare professional or a complimentary therapist.
Examples include: private rooms used by practitioners in counselling (or any of the talking therapies) or physical therapies such as physiotherapy etc. It also includes hospitals, GP clinics, private consulting rooms and community residential facilities etc.
Often these therapies take place on a one-to-one basis with no observer. This can leave the patient vulnerable to inappropriate advances.