#Medical chaperone professional
Preferably, the chaperone should be a trained health professional familiar with the examination so that, if necessary, they can confirm the examination was appropriately conducted. The additional risk management steps discussed in the “Respecting boundaries” section of this article should be considered in these circumstances. If the physical examination is necessary to address an urgent or emergent condition and the patient does not consent to a chaperone being present, it is generally advisable to proceed with the urgent examination. If the patient does not consent to a chaperone and you decide to delay care or not provide care, the patient might complain to the College or human rights tribunal. You should pay particular attention to ensuring the patient understands the clinical consequences of delaying care.Ī referral should not delay required or urgent treatment. If you feel a chaperone is necessary despite the patient's contrary wishes, you might consider as a last resort deferring a non-urgent examination and referring the patient to another physician who is prepared to perform the examination without a chaperone. Patients should be assured that the chaperone will respect their privacy and confidentiality. For example, you may tell patients the chaperone is strictly an observer who is there to protect them and ensure they feel safe. Patients who are initially reluctant to have a chaperone may change their mind if you clearly explain the chaperone’s role. If the patient does not consent to a chaperone, you should also document this in the medical record. The patient’s consent and the chaperone’s presence should be documented in the medical record. However, a patient’s express consent is required if the chaperone’s only role is as an observer. When a member of the clinical team is both assisting with the examination and acting as a chaperone (e.g. Patient consent is necessary for a chaperone to be present. For example, some patients might not want a third party present during an examination. Other factors you will want to consider when deciding on a chaperone include such things as the type of examination, your relationship with the patient, and the patient’s disposition. If you are practising in a hospital, speak with the hospital administration about policies or procedures around the use of chaperones in the hospital. 4 Some Colleges also encourage physicians to strongly consider a chaperone for contentious examinations, such as independent medical examinations. Some Colleges recommend that physicians have a chaperone, or at least offer to have one, for sensitive examinations such as pelvic (rectal, vaginal, testicular) or breast exams. You will want to consider the expectations of your College. When deciding whether a chaperone is appropriate, you should consider several factors. At the same time, you might find that a chaperone can reduce College complaints or legal actions. Patients may feel less vulnerable and more comfortable with a chaperone present during a sensitive physical examination. Deciding whether to use a chaperoneĪ chaperone can offer protection and reassurance to you and your patients. When deciding whether using a chaperone might be prudent, you may want to consider the following. Even if you have previously decided you don’t need a chaperone with some or all of your patient examinations, now might be an appropriate time to reassess your approach, particularly with examinations of a sensitive nature. One solution is to have a chaperone present for some or all physical examinations, irrespective of your gender or the patient’s, or the fact that you and the patient have a longstanding professional relationship. This may be an appropriate time for physicians to ask: what can I do in my practice to ensure boundaries are respected and patients feel safe? For example, medical regulatory authorities (Colleges) and legislatures are enacting or reinforcing policies of zero tolerance for sexual abuse, 2 including redefining what constitutes sexual abuse, and increasing transparency and penalties for sexual abuse. 1 In this environment of heightened focus, some authorities and organizations are changing their policies around the issue. In Canada, the past few years have seen more attention focused on reports of sexual misconduct and abuse.
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