Scott Farley D.C.

 Increase knowledge and understanding of sexual boundaries and a chiropractic physician's ethical and professional obligations  Consequences of sexual boundary violations

 The majority of reported sexual boundary violations in healthcare involve male health practitioners and female patients/clients  % of health professionals report knowing a colleagues who has been/is involved with patients  Greater awareness of professional guidelines and sanctions reduce prevalence

 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

 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

 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. Sexual Impropriety 2. Sexual Violation

 May comprise behavior, gestures or expressions that are seductive, sexually suggestive, disrespectful of patient privacy or sexual demeaning to a patient

 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

 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

 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

 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

 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.

 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.