There is no 'gray area' around inappropriate health professional-client relationships, says lawyer
The recent discipline of a social worker who crossed the line of professional conduct by asking out a former client highlights the critical importance of formal boundaries for health professionals.
The ruling – Ontario College of Social Workers and Social Service Workers v. Sweet, saw the Discipline Committee of the Ontario College of Social Workers and Social Service Workers hearing the case of Patrick Sweet, a hospital social worker providing outreach housing support to a young single mother who struggled with depression.
Sweet’s services to her included suicide assessments and assistance with daily living, the college noted in its decision.
"Conduct of this nature reflects very poorly on the Registrant and is indicative of a moral failure on his part,” wrote Charlene Crews, College panel chair.
“Moreover, these actions bring shame not only to the Registrant himself but also upon the broader profession. This is conduct which the broader profession of social workers and social service workers would surely find disgraceful, dishonourable and unprofessional.”
Conflict of interest in employee/client relationships
In any workplace where there is a power imbalance between employees and clients or a conflict of interest, employers must have policies in place that govern those relationships, says Sari Feferman, health lawyer at Rosen Sunshine in Toronto.
“Health professionals have an obligation to look out for the best interest of their clients or their patients, and there's a conflict of interest that exists when they're not considering the best interest of their patients because it conflicts with their own interests or the interests of others,” she explains.
“Those are the things that come up when there's employee-client relationships: boundary-crossing, vulnerability, conflict of interests … it would be best just to have an internal policy, because it depends on the company, depends on the clients they're working on, depends on the staff, the demographics they reach.”
Ontario social worker panel decision ‘set the tone of the law’
The decision by the panel “set the tone of the law”, Feferman says, “that these kinds of relationships, in any kind of regulatory capacity, whether you're a social worker, which this person was, or a physician, or any other regulated health professional, engaging with patients in a sexual nature or even crossing boundaries is inappropriate. And what was specific about this one was that the patient was a vulnerable patient.”
Even though the formal professional relationship had ended, the panel determined that the power dynamic and the trust patient’s trust in Sweet remained, making his actions a significant breach of professional ethics.
"Conduct of this nature reflects very poorly on the Registrant and is indicative of a moral failure on his part. Moreover, these actions bring shame not only to the Registrant himself but also upon the broader profession. This is conduct which the broader profession of social workers and social service workers would surely find disgraceful, dishonourable and unprofessional,” the panel wrote.
Sweet admitted to all of the points of his misconduct, including his messages over Facebook to the client that included “I would like to keep chatting with you if that’s all right,” “Really enjoyed being around you,” “It was always good to see you,” and “I miss seeing you.”
Sweet also asked her what she had been doing ‘for fun’ and if she had been dating, and eventually asked her to go out with him.
The client then blocked him and showed the Facebook messages to another social worker, who reported Sweet to the College in November. Sweet failed to attend his first two hearings, and was finally stripped of his licence in February and given a five-year ban on reapplying.
Clear and enforced policies around employee-client relationships
“Policies serve as their own framework for what's allowable and what's not in the company … certain industries must have policies or procedures for dealing with clients, for taking clients for lunch, for budgeting with clients, for engaging with clients, speaking with clients.”
Sweet had been a social worker for over 10 years when these incidents occurred, illustrating the difficulty of preventing or anticipating misconduct of this nature and the importance of stringent policies in this area.
“You can never really prevent people from doing anything. You just try to defend what happens or protect yourself from these kinds of situations,” says Feferman.
“They can just create a culture or create policies, the procedures that they are expecting all employees to abide by while working at the company or the organization … and if you have them agree to this, then that's as blinding as you can get in terms of managing their conduct and behaviour while they're working at the firm.”
