Defining " Sexual Assault " !

The Medical Board of Australia has seen fit to announce revised boundaries to regulate the physical examination of patients by doctors.  It seems that there is a fine line between what could be termed " unwarranted physical examinations " which could be defined as sexual assault.  These guidelines give clear parameters for physical examinations and social media use.

Many male doctors insist on the presence of a nurse when examining a female patient and it now explicitly requires the patient's consent if any other person is present.  Emergency room doctors face the dilemma of not being able to obtain that consent when an unconscious  patient is delivered by ambulance.  Frequently, such a patient is being attended by several medical people simultaneously.

The Royal College of General Practitioners warns that these guidelines could deter doctors from performing routine examinations, delaying diagnosis and putting patients at risk if they are misused to support unwarranted claims of sexual misconduct.   That " consent " obligation also applies to doctors doing rounds in hospitals accompanied by medical students which often involves the examination of wounds to determine the healing process.

The prevalence of sexual assault claims in the general community make safeguards necessary but a court just dismissed a sexual assault charge against an elderly patient suffering from dementia.
This 96 year old man had paid carers treating him in his own home and he was accused of sexually touching them inappropriately.  Dementia is an insidious disease that destroys both reasoning and guilt and sexual indiscretion is common in group homes caring for dementia patients..

In one recent case, two such patients clashed and this led to a physical confrontation in which a man in his nineties was attacked by a man in his seventies, causing the death of the older person.   It is most unlikely that a charge of either murder or manslaughter will proceed because of the diminished mental responsibility involved.  If death in a fist fight by those suffering dementia is so excused it is hard to see how sexual assault can not receive similar treatment. People suffering advanced dementia are clearly not responsible for their own actions.

Unfortunately, there are a small number of doctors in a highly regarded profession who misuse their examination of patients for sexual gratification.  As a consequence, the professional standards that apply to doctors are quite explicit and this Medical Board revision takes them further.  In conducting a physical examination the doctor must very carefully explain what he or she intends to do and why that is necessary.  Consent must be ongoing.

Perhaps the most important thing is the feeling of rapport between doctor and patient.  If that is missing the patient would be well advised to terminate the consultation - and seek the services of another doctor.