Sara Williams explores how using chaperones for particular consultations can protect your practice
The challenge for today’s doctors is to show their human face while maintaining clear professional boundaries. Using a chaperone is not only an effective safeguard against unfounded accusations; it will help put a patient at ease.
Respect for a patient’s autonomy is expressed in many different ways. On an overt level, it is conveyed by seeking consent, conducting open discussions and working in partnership with patients. On a more subtle level, it requires a sensitive recognition of the power differentials that exist between doctors and their patients, and the vulnerability patients may feel.
Using a chaperone is both an added layer of protection and an acknowledgement of a patient’s vulnerability. The Code of Health and Disability Services Consumers’ Rights provides that: “Every consumer has the right to have one or more support persons of his or her choice present, except where safety may be compromised or another consumer’s rights unreasonably infringed.”1
Defining the third person
For particular consultations, doctors may want another person present. The role they will play will depend on the individual circumstances of the consultation. The function of the third person should be clearly understood by all parties, so it is necessary to obtain informed consent beforehand. A third person may be present to participate in one of the following five roles as defined in this statement:
- A support person for the patient – Patients have the right to request one or more support people for consultations that might cause discomfort or confusion. Their presence focuses on the needs of the patient.
- An interpreter for the patient – This is the patient’s right under Right 5(1) of the Code of Health and Disability Services Consumers’ Rights. An interpreter may assist with translating a different language or with the understanding of someone with a disability or alternative form of communication (ie, sign language).
- An observer for the doctor – This person is present at the doctor’s request for a number of reasons, eg, part of CPD to assess the doctor.
- A student or trainee – Participation in teaching is covered by the Code of Health and Disability Services Consumers’ Rights. If a student or trainee is present during a consultation, an explanation should be provided before the consultation and consent obtained.
- The doctor’s chaperone – A chaperone is a person who, at the invitation of the doctor and with the patient’s informed consent, is present during a specific examination or treatment procedure. This could be part of an internal practice policy.2
If a patient or doctor refuses the attendance of a third person, they have the right to withdraw from the consultation until a mutually acceptable third person is available. Alternatively, the patient may be referred to another doctor.