CanMEDS Professional
Healthy Boundaries Take Effort

Healthy Boundaries Take Effort

  • Be familiar with professional boundaries and respect them.

  • Know the CPSO policy on mandatory reporting.

  • Know the CPSO policy on physician-patient dating.

  • Know the CPSO policy on professional responsibilities in postgraduate education.

  • Make opportunities to discuss the implications of these policies on your training and on clinical practice.

  • Model and reinforce professional behaviours during your training and reflect on breaches of professionalism in constructive ways.

  • Be ready to continue this discussion throughout training.


Although physicians have a legal and professional duty to keep information from a patient completely confidential, there are issues that must be reported to the CPSO.  When a physician has reasonable grounds, obtained in the course of practising the profession, to believe that another physician or regulated health care professional has sexually abused a patient, the physician must file a report in writing, with the Registrar of the College to which the alleged abuser belongs.  The RHPA (Regulated Health Professionals Act) was amended in 1994 where it became mandatory for all health professionals (physiotherapists, massage therapists as well as physician) to report sexual abuse of a patient/client.  There is a fine of up to $35,000 if there is suspicion or knowledge of sexual abuse of a patient/client by another health professional and reporting is not done.  Reporting must occur within 30 days of obtaining the information gave rise to the suspicion of sexual abuse.




Sexual Abuse of Patients

Sexual abuse of a patient is defined  (Schedule 2 of the RHPA)  as follows:

  1. sexual intercourse or other forms of physical sexual relations between the member and the patient,

  2. touching, of a sexual nature, of the patient by the member, or

  3. behaviour or remarks of a sexual nature by the member towards the patient.


1.A physical relationship with a patient is not sexual abuse if the patient has initiated the relationship.
True     False
2.Sexual relationships between any consenting adults (including patients and doctors) are personal and private information and should be kept that way.
True     False
3.If I witness a friend or colleague I know very well pursuing a sexual relationship with a patient I would likely keep that information to myself.
True     False
4.Even fantasizing about patient sexual relationships is reportable behaviour.
True     False
5.If a patient discloses a sexual relationship with a physician but you have no first hand knowledge of it you are not obligated to report it.
True     False
6.If a patient reports that a physician touched her breasts while anaesthetized, you must report it.
True     False



Professional Boundaries ...

  • are the "limits that protect the space between the professional’s power and the patient’s vulnerability."

  • are a matter of context rather than content

  • may apply to the workplace climate as well as the professional/patient relationship

  • apply equally to teachers and learners

  • overlap into personal spheres - you are a professional always !

  • are defined by CPSO policies


All references for this section