Sexual abuse can happen to anyone, and it is never a patient’s fault. This guide contains tips to help you protect yourself and others from sexual abuse by a healthcare provider, recognize abusive behaviors, and understand your options in responding to sexual abuse.
Sexual Abuse in Healthcare: A Guide for Patients
What is the purpose of this information?
The majority of healthcare providers are trustworthy and follow the rules of their profession and the law. However, research has found that some providers use their professional power to access and prey on trusting patients. You may have heard of the prominent case of Larry Nassar, an Olympic gymnastics doctor who sexually assaulted hundreds of patients under the guise of performing medical exams. Stories such as these make us question:
How can you protect yourself and your family from harmful healthcare providers?
This guide was produced by the Bioethics Research Center at Washington University, which studied 101 cases of sexual violation of patients. We aim to empower and prioritize patient safety.
Sexual abuse can happen to people of any age or gender, and it is never a patient’s fault. The information provided here is meant to help people who have questions or wish to report sexual misconduct by their healthcare provider
WHAT TYPES OF BEHAVIORS ARE SEXUAL MISCONDUCT?
- Offering to provide services or medicines in exchange for sexual favors
- Masturbation by the provider in front of the patient, or asking the patient to masturbate in front of the provider
- Deliberately watching a patient undress
- Sexually harassing comments or using the
provider-patient relationship to request a date - Touching genitals for any purpose other than appropriate exam or treatment, especially without wearing gloves, or when the patient has refused
- Kissing, oral sex, or sexual intercourse
INFORM YOUR EXPECTATIONS & CHOICES
Before going for a medical appointment…
Check what the guidelines say about what to expect. Know when a pelvic, breast, or testicular exam is appropriate, and ask for more information when you are not sure.
American Board of Internal Medicine Foundation
The American Board of Internal Medicine Foundation website has many patient resources to guide choices on a variety of medical procedures, treatments, and exams, including pelvic exams and pap tests.
Rape, Abuse, & Incest National Network (RAINN)
RAINN published Sexual Abuse by Medical Professionals, an article where you can read about what to expect in a medical setting, during a physical exam, and what to tell your child to prepare for an exam.
Bioethics Research Center (BRC)
The BRC published Before Your Visit, a resource guide that will help you learn more about your physician, find out about your medical conditions and appropriate treatments, advocate for yourself and others, and understand the importance of having a doctor you trust.
ASK QUESTIONS
If you have questions or concerns about when an exam is appropriate, ask.
Some people may feel shy or nervous about asking a question, but as a patient, you have the right to ask questions about things you do not understand. Healthcare providers are expected to explain why a physical exam is necessary. If you still don’t understand or aren’t comfortable with the provider’s recommendation, you may ask to speak with another healthcare professional before agreeing to the exam.
REQUEST OR SERVE AS A CHAPERONE FOR YOUR LOVED ONE
When a provider needs to perform a physical exam…
According to the American Medical Association, you may request that a chaperone be present, even if you have a loved one with you. Having a chaperone may make you feel more comfortable, prevent misunderstandings, and could protect you or a loved one from sexual misconduct. A provider should not refuse your request for a chaperone.
When acting as a chaperone for another person…
Understand what is routine and appropriate during physical examinations. Patients should always be given an explanation for what is occurring and why during physical examinations. They should also be given privacy while undressing and provided with gowns or draping. Reassure the patient if needed and respect the patient’s confidentiality.
WHERE TO GET HELP
In the case of sexual misconduct, it can be difficult to know what to do, especially when you suspect something isn’t right but aren’t quite sure.
Sexual assault or abuse can leave a survivor physically injured, emotionally drained, or unsure what to do next – but you don’t have to face this alone. If you suspect something is wrong, there are people you can talk to who can help you figure out if the situation is something that should be reported. Here are some resources from the Rape, Abuse, & Incest National Network (RAINN):
- RAINN maintains a State Law Database of laws around sexual violence by state, territory, or zip code. You can use this website to understand how terms describing sexual violence are defined and punished where you live.
- The free and confidential National Sexual Assault Telephone Hotline (800-656-HOPE) and Live Chat on the RAINN website can provide support for those processing abuse or mistreatment, guidance on reporting options, and can connect you with local support teams to guide recovery.
- The RAINN website includes many articles with guidance and tips for survivors. It also provides suggestions onhow loved ones can support survivors through the reporting and recovery process.
REPORT SEXUAL MISCONDUCT
Sexual abuse is caused by abusers. Reporting abusers is the best way to stop sexual abuse.
If you have experienced sexual misconduct by a healthcare provider, there are multiple reporting options available to address the mistreatment. Report sexual misconduct to:
- The State Medical Board
- Law Enforcement
It’s important to weigh your options and choose the reporting option that you are most comfortable with—even if that means reporting to both the State Medical Board and the police.
REPORT SEXUAL MISCONDUCT
STATE MEDICAL BOARDS
State Medical Boards protect patients by licensing physicians, investigating complaints, and disciplining physicians who break the law.
You can find the contact information for your State Medical Board on the Federation of State Medical Boards website
LAW ENFORCEMENT
Another option is to report suspected abuse or assault to the local police department.
To report a sexual assault or mistreatment by a physician, call or visit your local police department.
CONSIDERATIONS IN CHOOSING A REPORTING STRATEGY
POTENTIAL OUTCOMES
STATE MEDICAL BOARDS
- Boards may require additional physician training
- Boards may revoke a physician’s license, or impose fines
LAW ENFORCEMENT
- Law enforcement is the only way to ensure criminal investigation of a physician
- Courts may impose fines or prison sentences
SPEED
STATE MEDICAL BOARDS
- Boards can respond to cases quickly
LAW ENFORCEMENT
It can take a long time for an investigation and trial to be completed
BURDEN
STATE MEDICAL BOARDS
Patients file one report
LAW ENFORCEMENT
Patients may be required to recall or discuss events repeatedly
PRIVACY
STATE MEDICAL BOARDS
Board proceedings are private and patient’s identities are kept confidential
LAW ENFORCEMENT
When cases go to trial, names of accusers are frequently made public
REPORT SEXUAL MISCONDUCT
What if I experienced sexual misconduct by a healthcare provider other than my physician?
State Medical Boards are appropriate if you need to report a physician. If you need to report a different kind of provider, such as a physical therapist, dentist, or chiropractor, find the licensing board for their profession. For example:
The National Council of State Boards of Nursing (NCSBN) oversees licensure for nurses.
- The Federation of Chiropractic Licensing Boards oversees licensure for chiropractors.
- The Federation of State Boards of Physical Therapy oversees licensure for physical therapists.
- The American Dental Association offers a list of contact information you can use to contact your State’s Dental Board, which oversees licensure for dentists.
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QUESTIONS OR FEEDBACK?
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This guide will be updated as new patient resources and new information become available.
ACKNOWLEDGEMENTS
All contributors are affiliated with the Bioethics Research Center at Washington University School of Medicine
Meredith Parsons, BS, CHES
Heidi Walsh, MPH, CHES
Tristan McIntosh, PhD
Erin Solomon, PhD
Jessica Mozersky, PhD
James DuBois, DSc, PhD – Principal Investigator
OTHER CONTRIBUTIONS
Design by:
Meredith Parsons, BS, CHES
Patricia Curran, BFA
SUGGESTED CITATION
Bioethics Research Center (2019). Sexual Abuse in Healthcare: A Guide for Patients. Bioethics Research Center at Washington University School of Medicine. Retrieved from: www.PreventingSexAbuse.org.