Regulation Matters 2018 - Issue 2

New Definition of ‘Client’ Within the Context of Sexual Abuse

On May 1, 2018, new sections of the  Protecting Patients Act, 2017, which amended the Regulated Health Professions Act, 1991 (RHPA), came into force. One of the new provisions which directly affects dietitians is the expanded definition of a patient specifically within the context of sexual abuse.

With regards to sexual abuse, the RHPA now stipulates that an individual remains a patient or a client for an entire year after the therapeutic dietitian-client relationship has ended. Having romantic or sexual relationships with a client during that time is strictly forbidden. It is considered sexual abuse, even if the client consents.

Criteria for determining who is a client

The amendments have also created a definition of “client” under Subsection 1 (6) of the Health Professions Procedural Code. Note that this definition only applies within the context of sexual abuse. for the purposes of sexual abuse. It states:

“1. An individual is a client if there is a direct interaction between the [dietitian] and the individual, and any of the following apply:
  1. The [dietitian] has, in respect of [dietetic] service provided by the [dietitian] to the individual, charged or received payment from the individual or a third party on behalf of the individual.
  2. The [dietitian] has contributed to a health record or file for the individual.
  3. The individual has consented to the health care service recommended by the [dietitian].
  4. The [dietitian] prescribed a drug (under a delegation) for which a prescription is needed for the individual.
2. Despite paragraph 1, an individual is not a [client] of a [dietitian] if all of the following conditions are satisfied:
  1. There is, at the time the [dietitian] provides the health care services, a sexual relationship between the individual and the member.
  2. The [dietitian] provided the health care service to the individual in emergency circumstances or in circumstances where the service is minor in nature.
  3. The [dietitian] has taken reasonable steps to transfer the care of the individual to another member or there is no reasonable opportunity to transfer care to another member.”
All the conditions listed in criteria 2 have to be true for an individual to be considered “not a client”.

Please note that a romantic or sexual relationship with a former client beyond the one-year period may still be inappropriate and considered professional misconduct depending on the circumstances and vulnerability of the client.