Sexual misconduct by health professionals in Australia, 2011-2016: a retrospective analysis of notifications to health regulators.

OBJECTIVES: To assess the numbers of notifications to health regulators alleging sexual misconduct by registered health practitioners in Australia, by health care profession. DESIGN, SETTING: Retrospective cohort study; analysis of Australian Health Practitioner Regulation Agency and NSW Health Professional Councils Authority data on notifications of sexual misconduct during 2011-2016. PARTICIPANTS: All registered practitioners in 15 health professions. MAIN OUTCOME MEASURES: Notification rates (per 10 000 practitioner-years) and adjusted rate ratios (aRRs) by age, sex, profession, medical specialty, and practice location. RESULTS: Regulators received 1507 sexual misconduct notifications for 1167 of 724 649 registered health practitioners (0.2%), including 208 practitioners (18%) who were the subjects of more than one report during 2011-2016; 381 notifications (25%) alleged sexual relationships, 1126 (75%) sexual harassment or assault. Notifications regarding sexual relationships were more frequent for psychiatrists (15.2 notifications per 10 000 practitioner-years), psychologists (5.0 per 10 000 practitioner-years), and general practitioners (6.4 per 10 000 practitioner-years); the rate was higher for regional/rural than metropolitan practitioners (aRR, 1.73; 95% CI, 1.31-2.30). Notifications of sexual harassment or assault more frequently named male than female practitioners (aRR, 37.1; 95% CI, 26.7-51.5). A larger proportion of notifications of sexual misconduct than of other forms of misconduct led to regulatory sanctions (242 of 709 closed cases [34%] v 5727 of 23 855 [24%]). CONCLUSIONS: While notifications alleging sexual misconduct by health practitioners are rare, such misconduct has serious consequences for patients, practitioners, and the community. Further efforts are needed to prevent sexual misconduct in health care and to ensure thorough investigation of alleged misconduct.

The Extension of the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 to the Children's Court: Opportunities and Shortfalls.

In 2014, the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997 in Victoria was extended to the Children's Court of Victoria. This article describes the processes that preceded this change and the changes that occurred. The potential opportunities consequent to the changes are described, with their corresponding ethical implications. The decision not to resource some of the changes as recommended by the Victorian Law Reform Commission is described, with reference to the lack of establishment of an adolescent forensic mental health facility. The shortfalls currently occurring and their ethical implications are also discussed. We note the need for data regarding the number of children whose matters are being heard under the Crimes (Mental Impairment and Unfitness to be Tried) Act 1997, and the resourcing implications that flow from this.