Suppressing the voices of the survivors: Sexual exploitation by health practitioners

It has been speculated that the effects of sexual assault on victims are exacerbated by non-disclosure. It is therefore important to explore the reasons why survivors do not disclose or make formal reports. This paper looks at some of the factors that have stopped many survivors of sexual assault or exploitation by health professionals from reporting sexual assault. A sense of shame is the principal deterrent; this is coupled with other factors derived from the nature of the relationship - the inequality and trust inherent between the patient and practitioner and, in counselling contexts, possibly the added power inequity in transference. For those who do report, their experiences with complaints units, Medical Review Boards and the courts may prove to be less than satisfactory. The article looks in depth at an example of the latter, illustrating how interpretations of consent in sexual assault legislation can be particularly problematic with health practitioner perpetrators. The courts and boards may fail to understand the consent issue and delay in reporting from the point of view of survivors. Consequently, their voices will continue to be suppressed.