Why is it important to talk about sexual harassment in healthcare?

Research shows that while the healthcare sector is held to extremely high standards of professionalism and ethics, sexual harassment is a significant problem experienced by healthcare professionals and patients. A study conducted in Germany in 2021 (a total of 2503 respondents) found that 4.5% of female respondents and 1.4% of male respondents had been sexually harassed by healthcare professionals. Due to the underreporting of sexual harassment, the true extent of the issue in the healthcare sector remains unknown. Researchers note that a significant number of both women and men who experience sexual harassment avoid seeking help due to personal vulnerability, lack of awareness, or fear of disapproval from medical professionals.

The doctor-patient relationship should be based on complete trust and respect, and any form of harassment is a serious breach of trust, medical ethics, and the law.

How do you spot sexual harassment in the healthcare sector?

Anyone can be sexually harassed in a healthcare setting, but it has been found that children, women, older people, and people with disabilities are the most vulnerable. Due to their particular vulnerability, people with disabilities or older people may experience sexual harassment in care homes or in their own homes.

While it is important to note that both men and women can be victims of sexual harassment, research shows that women are more likely to be victims of sexual harassment due to gender norms and stereotypes in society. According to the European Union Agency for Fundamental Rights, one in two women in the EU has experienced sexual harassment in her lifetime.

Sexual harassment in the healthcare sector can include:

1. Unwanted comments and remarks. Sexual harassment can take the form of sexually explicit comments, jokes or overly personal questions about the patient’s sex life, romantic relationships (e. g., the doctor(s) should not make comments about the patient’s body sexuality, ask about sexual partners or anything else that is not directly related to a health issue).
2. Inappropriate physical contact. The boundaries between professional and personal matters should be maintained during a medical examination and any unnecessary physical contact may be considered sexual harassment. The doctor should obtain the patient’s consent before proceeding with a medical examination where touching is necessary. Any touching that is not necessary for the examination (e. g., fondling, stroking, groping, touching of parts of the body and genitals) may be considered sexual harassment.
3. Non-professional communication. The relationship between the physician(s) and the patient should be limited to the provision of health care services, so soliciting personal contact (e. g., requesting sexual acts, asking to meet outside the medical facility, etc.) may constitute sexual harassment.

How can you distinguish between behavior from a doctor that is necessary and behavior that can be considered sexual harassment of a patient?

What should I do if I am sexually harassed in a healthcare setting?

The healthcare professional’s professional knowledge and skills place him or her in a position of authority in the provision of healthcare, which can make patients feel vulnerable and reluctant to say that comments, actions or behaviours of a sexual nature make them uncomfortable. Cultural norms, lack of knowledge about sexual harassment, victim blaming, and doubts that they will not be believed lead to a situation where victims of sexual harassment avoid seeking help.

Lithuanian legislation requires healthcare providers to ensure that patients are not subjected to sexual harassment during the provision of medical services. Therefore, if sexual harassment occurs, it is important to first report the situation to the head(s) of the relevant institution in order to prevent it from happening again.

If you feel that you have encountered sexual harassment within a healthcare setting, you can take the following actions:

• Inform the doctor that their behaviour is inappropriate. If you feel safe enough, first inform the healthcare professional that such behaviour is unacceptable to you. If necessary, follow the subsequent steps.
• Contact the management of the healthcare facility. Many healthcare institutions have procedures for addressing and investigating complaints of sexual harassment, so contacting the facility’s management is the first step in reporting an incident of sexual harassment within the healthcare setting.
• Document the evidence. In cases of repeated sexual harassment, for example, when a patient is in a nursing home, hospital, or regularly visits the same doctor, it is important to document the situation. This can be done through diary entries where the patient notes the date, time, and any details that might be important if they choose to report the incident later.
• Contact the Equal Opportunities Ombudsperson’s Office. If you experience sexual harassment from healthcare professionals and do not receive help from the facility’s management, you can contact the Equal Opportunities Ombudsperson. You can consult with the Ombudsperson’s legal advisors by email at lygybe@lygybe.lt , by phone on 0 706 63899, or by visiting the Ombudsperson’s Office in person.
• Legal assistance. Consulting a lawyer can help you better understand your rights and prepare for filing a claim against the healthcare professional. In Lithuania, initial legal consultations are provided free of charge. More information can be found at: https://vgtpt.lrv.lt/lt/.
• Emotional support. If you have experienced sexual harassment, you can seek help from counselling and emotional support services operating in Lithuania:
  • Women’s Support Line (Pagalbos moterims linija) : https://pagalbosmoterimslinija.lt/,
  • Men’s Support Line (Vyrų linija) : https://www.vyrulinija.lt/,
  • Support Line for victims of violence (Specializuotos kompleksinės pagalbos centras): https://www.specializuotospagalboscentras.lt/skpc-pagalba-telefonu/.

If necessary, you can contact a psychologist who can provide support in an emotionally difficult situation.

What can healthcare institutions do to prevent cases of sexual harassment?

To prevent sexual harassment in healthcare institutions, it is crucial to improve the culture of service provision and workplace environment, as well as implement an effective violence and harassment prevention policy.

1. Violence and harassment prevention policy. It is recommended that healthcare institutions have a clear and comprehensive policy in place to ensure a safe, respectful, and equality-based organisational culture. The policy should define the behaviour standards for staff, as well as establish guidelines for reporting sexual harassment by both staff members and patients. Both staff and patients should be aware of where to turn if they experience sexual harassment within the healthcare institution. Healthcare institutions are also encouraged to have a mechanism in place to determine responsibility for actions of sexual harassment within the institution. A well-implemented sexual harassment prevention policy can help prevent incidents of sexual harassment while reinforcing the institution’s commitment to a safe, respectful, and ethically sound environment.
2. Training and education. Regular training on sexual harassment prevention and professional conduct with patients should be organised to ensure the professionalism of the institution’s staff.
3. Improving workplace culture. Healthcare institutions should foster an environment where respectful behaviour towards colleagues and patients is valued. To ensure an equality-based organisational culture, the healthcare institution should ensure that all staff and patients, regardless of gender, race, religion, or other personal identity traits, feel safe within the institution. Regular staff and patient surveys are also important to gather feedback and detect any potential signs of sexual harassment.
4. Monitoring and control mechanisms. Healthcare institutions must respond quickly and professionally to complaints of sexual harassment, conduct regular audits, and ensure proper monitoring. If necessary, surveillance cameras can be installed in common areas of the healthcare facility.
5. General support. Healthcare institutions are advised to establish a clear support mechanism to assist those affected by sexual harassment. Such actions could include providing confidential channels for reporting sexual harassment, offering victims access to the necessary legal information or emotional support.