Standard of Practice: Prevention of and Zero Tolerance for Sexual Abuse

Patient Outcome

The patient is not sexually abused by an RMT/MT.

Registered Massage Therapist Outcome

The Registered Massage Therapist/Massage Therapist (RMT/MT) does not sexually abuse patients or engage in any activities of a sexual nature with patients and takes active steps to prevent sexual abuse.

Requirements

The RMT/MT must never:

1. Sexually abuse patients. Note that the Health Professions Procedural Code, being Schedule 2 to the Regulated Health Professions Act, 1991 (RHPA) defines “sexual abuse” of a patient as:
   • Sexual intercourse or other forms of physical sexual relations between the RMT/MT and the patient;
   • Touching, of a sexual nature, of the patient by the RMT/MT; or
   • Behaviour or remarks of a sexual nature by the RMT/MT towards the patient.
     • “Sexual nature” does not include touching, behaviour or remarks of a clinical nature appropriate to the care provided.

2. Touch the patient’s genitals or anus, as this is always considered sexual abuse.

The RMT/MT must:

3. Ensure any mirrors present in a treatment area are placed in a location that respects the patient’s physical/personal privacy.
4. File a mandatory report with the appropriate college if the RMT/MT has reasonable grounds, obtained while practising, to believe that an RMT/MT or regulated health professional has sexually abused a patient and the RMT/MT knows the registrant’s name.
5. Disable all audio, video or photographic transmitting and recording functions of all devices in the room, unless:
   1. The RMT/MT obtains informed consent for the use of audio, video or photographic recording equipment; and
   2. The recording functions are for assessment, treatment and/or educational purposes. (see also the Standard of Practice: Privacy and Confidentiality)
6. Be sensitive to each patient’s individual culture, experience, gender, age and history, which may influence sensitivity to touch and touching certain areas.

The RMT/MT may only assess/treat sensitive areas when:

7. Assessment/treatment is clinically indicated; and
8. The patient’s informed consent (written or electronic) is obtained prior to every assessment and/or treatment of sensitive areas including the upper inner thighs, chest wall muscles, and the breasts. The RMT/MT must not touch the breast except when assessing and/or treating the breast if the patient has requested that for a clinically indicated reason (for example, surgical intervention or perinatal care). The RMT/MT must also obtain informed consent (written or electronic) prior to assessing and/or treating the buttocks (gluteal muscles) at the first visit in a treatment plan, then verbally prior to every treatment within that same treatment plan (see also the Standard of Practice: Consent).

Important Information:

• “Sexual abuse” includes unwanted touching of a patient by an RMT/MT and any sexual relationship with a patient, even if the patient is a spouse or current sexual partner. The only time the RHPA permits an RMT/MT to provide Massage Therapy services to a person with whom the RMT/MT is in a current sexual relationship (including a spouse) is where the treatment is emergency treatment, or minor treatment and a referral is made to another practitioner.
• For the purposes of the sexual abuse provisions in the RHPA, a patient is someone who was the recipient of Massage Therapy treatment; that person will meet the definition of “patient” for one year after they ceased being the RMT’s/MT’s patient.
• Patient consent is never a defence for inappropriate or sexual touching or relationships of a sexual nature.
• CMTO recognizes the seriousness and extent of harm that sexual abuse and other forms of abuse cause the patient and others related to the patient. It has zero tolerance for any form of abuse: verbal, physical, emotional, financial or sexual, by an RMT/MT.

Bolded terms are found in the Glossary.