This chapter governs all optometrists licensed by the State Board of Examiners in Optometry to practice in the State. In this chapter, the following terms have the meanings indicated. Terms Defined. “Board” means the Board of Examiners in Optometry. “Inappropriate sexual language” means: A sexualized harassing comment; An eroticized or sexually provocative comment not reasonably associated with a health care matter; or An inappropriate discussion of a sexually related matter. “Patient” means the individual to whom the licensee is rendering professional service. “Sexual behavior” means: A sexual act as specified in Criminal Law Article, §3-301(e) and (g), Annotated Code of Maryland; and Sexual contact as specified in Criminal Law Article, §3-301(f), Annotated Code of Maryland. “Sexual exploitation” means a situation in which the licensee takes advantage of the unequal relationship between the licensee and a patient, a student, or an employee to obtain sexual favors. “Sexual harassment” means a deliberate or repeated comment, advance, gesture, solicitation, request, or physical contact of a sexual nature. The licensee shall: Apprise the patient of the risks, opportunities, and obligations associated with services available to the patient; Make the fee for service clear, maintain adequate financial records, and confirm arrangements for financial reimbursement with the patient; Notify the patient promptly and seek the transfer, referral, or continuation of service in relation to the patient's need or preference if the licensee anticipates the termination or interruption of service to the patient; Obtain voluntary and informed consent from a patient for participation in research, without direct or implied deprivation or penalty for refusal to participate; Inform the Board of unethical conduct by a licensed optometrist; and Inform the Board about an individual who is not licensed by the Board but who represents that the individual is an optometrist and is practicing, attempting to practice, or offering to practice optometry. In the capacity of or identity as a licensed optometrist, the licensee may not: Participate or condone dishonesty, fraud, deceit, or misrepresentation; Misrepresent professional qualifications, education, experience, or affiliation; Exploit a relationship with a patient for personal advantage or satisfaction; Practice, condone, facilitate, or collaborate with discrimination on the basis of race, color, sex, sexual orientation, age, religion, national origin, marital status, political belief, mental or physical handicap, or other preference or personal characteristic, condition, or status; Engage or participate in an action that violates or diminishes the civil or legal rights of a patient; or Share a fee or accept or give something of value for receiving or making a referral. An optometrist may not engage in sexual misconduct in the practice of optometry. Sexual misconduct includes, but is not limited to: Sexual behavior with a client or patient in the context of a professional evaluation, treatment, procedure, or service to the client or patient, regardless of the setting in which the professional service is provided; Sexual behavior with a client or patient under the pretext of diagnostic or therapeutic intent or benefit; Requesting sexual favors of a client or patient; Inappropriate touching of a client or patient in a sexual manner; Therapeutically unnecessary discussion of sexual matters or other verbal conduct of a sexual nature while treating a patient; Taking photographs or video tapes of a client or patient for sexual purposes; Sexual harassment of staff or students; Sexual exploitation; or Inappropriate sexual language. Concurrent Sexual Relationships. The licensee may not engage in either consensual or forced sexual behavior with: A patient; A student or supervisor over whom the licensee exercises professional authority or with whom the licensee maintains direct supervision or education while the professional relationship continues to exist; or An individual with whom the patient has a close personal relationship, including but not limited to a relative or a significant individual in the patient's life, if there is a risk of exploitation or potential harm to the patient. Relationships with Former Patients. Except as set forth in §D(3) of this regulation, the licensee may not engage in sexual behavior with a former patient. The licensee may not terminate professional services or a professional relationship with a patient in order to enter into a nonprofessional, social, or sexual relationship with the patient or an individual with whom the patient has a close personal relationship. The licensee may enter into a relationship with an individual with whom the licensee's prior professional contact was of a brief, peripheral, consultative, or indirect nature, and did not constitute a therapeutic relationship. Prior Sexual Relationships. The licensee may not provide professional services to an individual with whom the licensee has previously engaged in sexual behavior. Sexual Harassment. The licensee may not sexually harass a: Patient; Student; or Employee. If sexually harassed by a patient, the licensee shall: Seek professional consultation with another licensed health professional; Document all action taken in the patient's record; and Terminate treatment and assist in a referral to another health care provider. Deceit During Evaluation, Treatment, Procedure, or Service. The licensee may not suggest, recommend, or encourage the patient to engage in a sexually provocative act, including but not limited to: Sexual contact with the licensee; Genital stimulation by or of the patient or licensee; Undressing by or of the licensee in the presence of the patient, or of the patient in the presence of the licensee; and Discussion or disclosure of a sexually provocative or erotic nature, not necessitated by treatment or treatment protocol. Violation of this chapter may result in the Board taking action to reprimand a licensee, place the licensee on probation, or suspend or revoke the licensee's license. The Board may also impose a penalty not exceeding $5,000. Health Occupations Article, §§1-212 and 11-205, Annotated Code of Maryland Effective date: June 26, 2000 (27:12 Md. R. 1140) Chapter revised effective July 31, 2006 (33:15 Md. R. 1281)