Background
Sexual abuse of patients by caregivers is a serious problem in the healthcare system and has far-reaching implications for the health of the victims. Data on the phenomenon in Israel are sparse and limited. The Ministry of Health asked the Myers-JDC-Brookdale Institute to study the scope of the phenomenon in Israel, its characteristics, and its impact.
Objectives
To provide an initial assessment of the scope, characteristics, and impact of sexual abuse by health care providers of adult women in Israel (aged 21+).
Methods
The research was conducted in 2023 and included mixed research methods: (1) an online survey carried out among a representative sample of 963 adult women in Israel, (2) in-depth interviews with 10 patients who have experienced sexual abuse within the healthcare system and with 7 female professionals working in the field, and (3) analysis of the discourse on social media surrounding this topic.
Main Findings
About one-third (37%) of women who participated in the survey reported that they had experienced sexual abuse in the healthcare system at least once during their life. This is similar to the percentage who reported experiencing it outside the healthcare system (39%). For about 22% of all survey participants, such an incident had occurred within the five years prior to the survey.
The types of sexual abuse included inappropriate stares or looks (28% of the respondents) and remarks (26%). In about 70% of the cases, the source of the abuse was a physician, and almost half of those physicians were gynecologists. About three-quarters of the incidents (78%) occurred in the community.
Only 7% of the women who were abused reported the incident, and only 15% of the women sought some form of assistance. One-third of the victims abandoned medical treatment as a result of the incident. 20% of the survey participants reported fears and anxieties and 19% reported a loss of trust in healthcare providers and doctors.
Interviews with women in the profession revealed significant challenges in addressing the phenomenon, including organizational and bureaucratic barriers, the shortage of physicians, the tendency of some elements of the health system to protect offenders, and low prioritization of the issue within the healthcare system.
Analysis of the online discourse indicated that discussions about sexual abuse within the healthcare system primarily take place in online articles (50%) and on social networks (41%). The sentiment score, which measures the audience’s attitude towards the healthcare system, was highly negative, with lack of trust in the healthcare system expressed in approximately 53% of the discussions.
Conclusion and Recommendations
The research revealed that the phenomenon of sexual abuse of patients by caregivers is common in the Israeli healthcare system and has negative effects on the mental and physical health of the victim. Despite the high prevalence of the phenomenon, the number of complaints is low, an indication of underreporting. The research suggests the need for action in the following areas:
Training: Providing periodic training for healthcare system workers on the subject.
Awareness: Raising awareness among patients about their rights and launching a campaign to that end.
Authority and procedures: Expanding the authority of the designated official in the Ministry of Health and instituting a mandatory and expedited investigation process in these cases, alongside minimum penalties for those convicted of sexual abuse of patients during medical treatment.
In addition, consideration should be given to the possibility of limiting the right to privacy of offenders who move to another place of work. This would prevent cases in which an offending caregiver leaves his job after sexually abusing a patient but continues to sexually abuse patients in his new place of work.
Citing suggestion: Nissanholtz-Gannot, R., Fialco, S., Brosh, T., & Rosen, B. (2024). Sexual abuse in the caregiver-patient relationship in Israel’s healthcare system – Scope, characterization, and impact. RR-988-24. Myers-JDC-Brookdale Institute. (Hebrew)