Registrants’ Responsibility to Report Abuse

Added to Handbook: Prior to June 2004
Last updated: Feb 2015

PURPOSE

To provide guidelines on registrants' responsibility to report suspected child or vulnerable adult abuse/neglect.

CHILD ABUSE

BACKGROUND

Under section 14 of the Child, Family and Community Service Act (CFCS Act), a person who has reason to believe a child has been, or is likely to be, physically harmed, sexually abused or exploited, neglected, or in need of protection, has a legal duty to promptly report the matter. The duty to report applies even if the information is privileged or confidential.

Failure to report is an offence under section 14(6) of the CFCS Act, and could result in a fine and/or imprisonment.

POLICY

Registrants, who suspect that a child is being abused or neglected, are required by law to promptly report their suspicions to the Ministry for Children and Families. The free, province-wide telephone number to report suspected child abuse is 310‑1234 (no area code required). If a child is felt to be in immediate danger, the local police department should be contacted.

Where possible, documentation should be completed in the client's chart.

REFERENCES

VULNERABLE ADULT ABUSE

BACKGROUND

A vulnerable adult is defined by the Adult Guardianship Act and The Canadian Academy of Health Science as someone 19 years of age or older who may have reduced capacities as an individual (whether these are physical, cognitive, educational, financial or other). This may include (but is not limited to) populations such as seniors or individuals with diminished intellectual or cognitive capacity. Vulnerable adult abuse is commonly identified as a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to a person, and identifies that such abuse can also result from unintentional or intentional neglect. The harm associated with abuse of vulnerable adults can manifest in a number of ways, including physical, financial, psychological, and sexual abuse.

The Canadian population is retaining their dentition for longer than in previous generations and adults are seen regularly for dental hygiene care including head, neck, and intraoral examinations. Dental hygienists are ideally positioned to recognize the signs of abuse due to the nature of dental hygienists' relationships with clients and the regularity of care.

There is no mandatory reporting requirement for members of the general public in cases of suspected abuse of vulnerable persons in BC. However, health professionals such as dental hygienists have an ethical obligation to act in the best interests of their clients as outlined in the CDHBC Code of Ethics with specific attention given to statement 10:

"Report to their licensing body or other appropriate agencies any illegal or unethical professional decisions or practices by dental hygienists, or others. The dental hygienist is committed to safe and ethical care for clients…..A dental hygienist who believes the behaviour by another is not in the best interest of the client or public will report it to the appropriate agency. It is required by law to report cases of suspected child abuse."

If an adult is not of sound decision making capacity or is unable to seek assistance due to a physical handicap or physical restraint, the provisions of the Adult Guardianship Act indicate that any person may notify a "designated agency" of the suspected abuse or neglect. This Act encompasses abuse that may take place in a vulnerable adult's personal residence, a relative's home, a care facility, or in a public place. The "designated agencies" to which such cases may be reported are:

  • The five Regional Health Authorities
    • Fraser Health: 1-877-935-3669
    • Interior Health: 250-862-4200
    • Northern Health: 250-565-2649
    • Vancouver Coastal Health: 1-866-884-0888
    • Island Health: 250-370-8699
  • Community Living BC - for eligible adults with developmental disabilities
  • Providence Health Care Society - some hospital locations in Vancouver

Island Health has resource pages for Abuse and Neglect andGetting Help and Who to Call which would be helpful to keep on hand in the event of suspected abuse.

Beyond the provisions of the Adult Guardianship Act, additional legislation that may be applicable to cases of abuse includes the following:

  • The Federal Criminal Code - applies to abuse that takes the form of physical or sexual assault, failing to provide the necessaries of life, unlawful confinement, fraud and theft.
  • The Community Care and Assisted Living Act - The Residential Care Regulation (Section 77) requires licensed community care and assisted living facilities to investigate suspected cases of resident abuse and neglect, and to report findings to the resident's representative, the resident's attending physician or nurse practitioner, the resident's funding program (if applicable), and a medical health officer.
  • The Health Professions Act - requires regulated health professionals, including dental hygienists, to report suspected abuse by another health professional to the Registrar of the other health professional's regulatory College if:
    1. the suspected abuse constitutes a form of sexual misconduct (Section 32.4), or
    2. if the registrant believes that the other health professional may be a danger to the public (Section 32.2).

POLICY

If an emergency situation is suspected whereby a vulnerable adult's life or safety is at immediate risk, the dental hygienist should contact the police at 911. In a non-emergency situation, the dental hygienist should determine whether the vulnerable person is of sound decision making capacity to consent or refuse consent to having their circumstances reported to an outside agency or organization. The dental hygienist should also consider whether the provisions of the Adult Guardianship Act, the Community Care and Assisted Living Act, or theHealth Professions Act are applicable to the situation.

If a vulnerable adult of sound decision making capacity refuses to allow the dental hygienist to disclose their circumstances and the provisions of these Acts are not applicable, then the dental hygienist can offer supportive resources and information. This may include the provision of contact information for the office of the Public Guardian and Trustee (1-800-663-7867 or mail@trustee.bc.ca) which provides assistance to adults in need of support for personal and financial decision making. Alternately, the local Community Response Network (bccrns.ca) is a localized BC organization that provides a coordinated community response to cases of vulnerable adult abuse and neglect.

For further information on the detection and reporting of abuse of vulnerable adults please consult the Spring 2012 edition of Access titled "Elder Abuse: Detection and Reporting"; the expanded version of "Elder Abuse: Detection and Reporting" includes further information, along with a list of references and resources. In addition, please contact the CDHBC if you wish to discuss your particular scenario regarding suspicion of vulnerable adult abuse and possible next steps:

CDHBC
Email: cdhbc@cdhbc.com
Phone: 1-800-778-8277
Fax: (250) 383-4144
Website: www.cdhbc.com

REFERENCES

  • College of Dental Hygienists of BC. Elder Abuse: Detection and Reporting. Victoria: College of Dental Hygienists of British Columbia; 2012. Available from:
    ACCESS Spring 2012
  • Furnari W. Oral health professional alert: elder abuse concern in the United States and Canada. Can J Dent Hygiene. 2011; 45(2): 98-102.
  • Government of British Columbia. Adult Guardianship Act. Victoria; Queen's Printer; 2014. Available from: 
    [RSBC 1996] Chapter 6
  • Government of British Columbia. Community Care and Assisted living Act. Victoria: Queen's Printer; 2014. Available from: 
    [SBC 2002] Chapter 75
  • Government of British Columbia. Health Professions Act. Victoria: Queen's Printer; 2014. Available from: 
    [RSBC 1996] Chapter 183
  • Government of Canada. Criminal Code [Internet]. Justice Laws Website; 2014. Available from: 
    Criminal Code R.S.C, 1985, c. C-46
  • Government of Canada. National Seniors Council. Report of the national seniors council on elder abuse. Ottawa; 2007.
  • CDHBC Code of Ethics. Victoria: College of Dental Hygienists of British Columbia; 2013.
  • The Canadian Academy of Health Sciences. Improving Access to Oral Health Care For Vulnerable People Living in Canada [Internet]. 2014. Available from: 
    CAHS Access to Oral Care (pdf)
  • World Health Organization. Elder abuse [Internet]. 2012. [cited 2014 Nov 25]. Available from:
    WHO Elder Abuse