In response to Bill 87: Protecting Patients Act, a part of which is dedicated to protecting patients from sexual abuse by healthcare providers, The College of Massage Therapists of Ontario (CMTO) have set forward new Standards of Practice to put into practice.

For more detailed information please see below:

http://www.ontla.on.ca/web/bills/bills_detail.do?locale=en&BillID=4477

http://www.cmto.com/assets/Standard-for-Maintaining-Professional-Boundaries-and-Preventing-Sexual-Abuse.pdf

We assure you that even before Bill 87 was presented as a patient you have rights and we have always taken these rights seriously.

This may be new to some of you, and a friendly reminder to others.

As a patient of ours you always have the right:

To tell your story and to be listened to

This includes your medical history and anything else you feel is important. You can tell your story in whatever way you like and share only as much as you are comfortable. You may decline to answer certain questions. Be aware, however, there are certain pieces of information that we are required to collect.

To ask questions and receive satisfactory answers

You may ask questions at any time during our meeting(s). We will always do our best to answer in a clear, truthful way and in accordance with the current evidence as we understand it. We may have to say, “I don’t know, let me get back to you.”

To have the Massage Therapy Treatment explained to you

This includes: what we are going to do, why we are going to do it, and how we are going to do it. We aim to explain these things as simply and clearly as possible and questions are always welcome.

To understand the risks and side effects

Many of us see Massage Therapy as pretty risk-free. Most of the time this is true. But there are some techniques that may be riskier than others and there are underlying health issues or medications that can increase the risks. Side effects are not as serious as risks, but you should be made aware of those as well.

To say no to some or all of the treatment

When the treatment is explained to you you are free to say yes to all of it, some of it, or none of it. For instance, you may be OK with certain areas being touched, but not others. This is your opportunity to voice those preferences.

To be given alternatives

If you say no to any or all of the treatment proposal we will make some other suggestions. We have quite a few techniques available to use and we may be able to find something you would prefer. If we can’t find common ground on anything, we can refer you to another health care provider that can help.

 

To say no at any time

Consent is ongoing. Just because something might be OK during one treatment, you may not be OK with it at the next. Or just because you are OK with something before we start treatment, during treatment you may decide against it. You are also free to stop the treatment at any time.

To Speak to A Third Party About My Conduct

By choosing to be treated by a Registered Massage Therapist, you are assured that should you be harmed in any way during treatment you have the right to complain to the CMTO, the College that regulates my profession. This right extends to all harm, not just physical.

New Consent To Treatment Proposed By the CMTO

 

Treatment of Sensitive Areas must be discussed with the client and written Informed Consent must be obtained. This Standard requires that written consent (regardless of what may be required by the Health Care Consent Act, 1996) be obtained for the treatment of the sensitive areas which can be obtained in conjunction with the MT’s regular informed consent process.  An RMT must not proceed with treatment unless informed consent is obtained from the client in advance of the treatment being initiated and that the consent is documented in writing. Informed consent must be voluntary and is a process during which the following must be discussed with the client: 1) Nature of the treatment. 2) Expected benefits of the treatment. 3) Material risks of the treatment. 4) Material side effects of the treatment. 5) Alternative courses of action. 6) Likely consequence of not having the treatment.  Draping and positioning as well as the right to withdraw consent at any time must be discussed. Standards for Maintaining Professional Boundaries and Preventing Sexual Abuse – September 2017 11 Ensuring the client is aware of the nature of the treatment involving touching the sensitive areas. As with any client, if there is no response to the recommended intervention then treatment should be terminated and the client referred to the appropriate healthcare provider. A consent form (sample template is below) must be signed by the client after informed consent is obtained following the process described above and prior to treatment being initiated. The signed informed consent form must then be placed and kept in the client’s file. Changes to the plan shall also be recorded and if further treatment to sensitive areas is provided then further written consent is required to be obtained in advance of treatment. For the gluteal region, after written consent is obtained for the initial assessment and treatment, and when subsequent treatments fall within the same treatment plan with no changes, the RMT may proceed to treat the gluteal region on subsequent occasions after obtaining and recording verbal consent. Informed consent must be given voluntarily by an individual who is capable of providing consent.

 

Sample

Consent for Assessment and Treatment of Sensitive Areas I, ________________________ (name), have requested assessment and/or treatment by this Registered Massage Therapist (RMT) ________________________ (name) for treatment of the clinically relevant areas indicated below (please initial): ___Buttocks (gluteal muscles) ___Chest Wall Muscles ___Upper Inner Thigh(s) ___Breast (s) (RMT has discussed if areola will be included and why) The RMT has explained the following to me and I fully understand the proposed assessment and/or treatment:  The nature of the assessment, including the clinical reason(s) for assessment of the above area(s) and the draping methods to be used The expected benefits of the assessment The potential risks of the assessment The potential side effects of the assessment That consent is voluntary That I can withdraw or alter my consent at any time. I voluntarily give my informed consent for the assessment and/or treatment as discussed and outlined above.

 

Client Name (print): _____________________________________________________________ Client Signature: _________________________________________Date: _________________  

Ongoing Treatment: I am aware that the treatment of the above indicated area(s) is part of a treatment plan which has been discussed with me by my RMT. I confirm that, on the following date(s), the RMT has reviewed the treatment plan and I provide my informed consent.

Client Signature: ____________________________________Date: _______________

Client Signature: ____________________________________Date: _______________

Client Signature: ____________________________________Date: _______________

Client Signature: ____________________________________Date: _______________

Client Signature: ____________________________________Date: _______________