The Use of Chaperones in Clinics: Ethical Needs for Protection of the Patients and Health Care Providers

Abstract

Introduction: Chaperone is a third person in a clinical office who serves as a witness for both the patient who is being examined and the physician,  acting as a safeguard for both parties during a medical examination or procedure. This ensures that the relationship with the patient is well managed  and remains purely professional. Their presence also protects the physician against accusation of misconduct especially sexual assault by the patient, as  well as guarding the physicians against being physically assaulted by patients. Despite these significant benefits of the use of chaperones some  physicians do not practice the act and some patients also object to the presence of a third party when being seen by a physician, as this serves as  impedance to their free communication with the attending physician, and that their confidentiality is compromised. In this article, a review is therefore  made to assess the usefulness and ethical challenges of the practice or non-practice of the use of chaperones in our clinics.

Materials and methods: This review involved an extensive search of databases that included Medline, Elsevier, Medscape, Medicine and PubMed.  Literature on the subject was also researched using manual library searches of cited textbooks and articles in journals. The search covered a period of  1990 to 2013, but the literature included was from 1999 till 2013.

Results: Despite established guidelines and recommendations, the use of chaperones by clinicians is not consistent or universal, as both practice and  consumer opinion regarding their use varies widely within and across continents.

Conclusion: The role of the chaperone in several clinical contexts is  important and critical. Therefore, there should be a deliberate policy for the use of chaperones in every health facility, and efforts must be made to  counsel and educate patients and clients as well as attending physicians as to the ethical implications and imperatives of the use of chaperones.