After 6 weeks in hospital, on the day of his planned discharge, he was accidentally given another patient's medication. Factors such as whether the professional relationship has ended and whether the doctor is caring for any of their prospective lover's family would also have a bearing. It is also easy to think of examples that verge on the absurd; should junior doctors treating fellow medics in accident and emergency be forever precluded from dating them? Thirdly, a discussion of the role of autonomous choice and consent is presented. Would you be interested in meeting sometime for coffee? However, some areas of debate do still remain. Online resources have reduced the information gap between doctors and patients, patient autonomy is greater than ever before, and not everyone who walks through a consulting room door is a shrinking violet. Traditional teaching of informed consent emphasizes the importance of autonomous choice, i. There is little doubt that a relationship between a doctor and patient is fraught with complications.
This is why flirting has such a positive effect on people. However, the crossing of boundaries per se does not necessarily mean that an unethical act occurred: after all, the crossing or erosion of boundaries is a normal part of the evolution of intimate relationships between human beings. It could be that he is just an extremely caring professional. About 20 percent resulted in disciplinary action. The validity of consent of a former patient, as opposed to a current one, is a little more debated, but evidence is against that being a former patient materially alters the situation. Clearly the focus is on vulnerable patients. Autonomous choice and consent How should a claim be judged that a former patient gave his or her free consent before entering into the relationship? I also work in the healthcare field and am very aware of the unwritten rules and boundaries of the physician-patient relationship.
There is a lot more detail to this, but long story shortened. And face it: the power that these men hold over these women is an aphrodisiac. As the patient as consumer comes of age, and the power and status of professionals wanes, is Graeme Catto right or is the doctor-patient relationship now a meeting of equals? Behind the guidance can be felt the pressure of the inquiries into Clifford Ayling, William Kerr, and Michael Haslam. Dating your boss can be tricky business. Appelbaum and his colleagues, for example, propose three to six months. In his book The Healer's Power, Brody outlines three sources of medical power: Aesculapian, Charismatic and Social. On the other hand, it is possible that the medical care your doctor provided was not beyond what he provides all his patients.
In particular, doctors must not use their professional position to establish or pursue a sexual or improper emotional relationship with a patient or someone close to them. We have perhaps seen your private parts. However, there is also the question of whether this type of power would be accentuated further in a fee-for-service situation, as exists in general practice in Australasia, as opposed to free public hospital treatment. Boundaries and boundary violations Many boundaries exist in the doctor—patient relationship. Nor do all boundary transgressions between doctor and patient ultimately lead to sexual misconduct.
Some criticised the guidance for not being precise enough. Some commentators have suggested that the way to deal with sexual relationships with former patients is to impose a minimum waiting period following the termination of the patient-physician relationship. It has also been suggested that another source of power —Hierarchical power, the power inherent by one's position in a medical hierarchy e. Consent is not a defense to a charge of statutory rape or sexual imposition on a minor. Irrespective of the pressure that the softening of traditional hierarchies of authority is bringing to bear, the doctor-patient relationship remains a kind of exemplar.
I have not acted on my feelings of interest because of this. Legally, the shortest permissible gap is a 2-year period with no patient contact of any sort which is acceptable only in Californian courts. Currently, it strongly advises doctors against dating patients. They have correctly identified several situations where the likelihood of significant and persistent transference—counter-transference, and the perpetuation of a significant power imbalance in the relationship, is very high. Other health professionals already operate under sexual-misconduct rules similar to the new policy for doctors and physician assistants.
Suppose a state medical board seeks to discipline a physician for having an affair with a patient, but both the patient and the physician insist that the patient consented to the relationship. The Medical Quality Assurance Commission has considered such a rule for about six years. Are you interested in dating a rich single doctor, nurse or patient? However, acting on these feelings often means crossing lines that create complications. On the face of it, a romantic relationship between a doctor and a former patient should pose no objection. Doctors should only start a relationship with a former patient if they have used their 'professional judgement' to decide if it is appropriate and are still banned from 'improper' relationships with current patients file picture Patient groups welcomed the change saying it was about time the watchdog moved into the 21st century. Thus in recent times there has been a debate whether doctors can date patients under special circumstances — like when the professional relationship between them has ceased.
Is the idea that the more intimate the former patient-physician relationship, the less ethical a subsequent sexual relationship? But what if the patient is a competent adult? The risk of sexual misconduct increases with age by a risk ratio of 1. Family Practice 2001; 18: 511—515. Are these now subject to suspicion? The policy lists 11 prohibited acts, and those who violate the rules could lose their licenses. The American Medical Association's code of ethics doctors fully terminate the physician-patient relationship before pursuing a romantic one. To decide whether any instance of a boundary crossing is a boundary violation, the analysis has to examine other factors. It is vital proper boundaries are maintained in relationships between doctors and patients. However, what is the relevance of this analysis to relationships with former, not current patients? It is for the interpretation of such information as much as for its provision that we rely on professionals.
Secondly, given the strength of Hierarchical power in determining one's overall power in the doctor—patient relationship as illustrated by the case history , it is hard to see how a relationship of equals could develop from such unequal beginnings. In falling short of a blanket ban, in recognising that there will always be exceptions, it has made a wise choice. What about sexual relationships after the patient-physician relationship has ended? If you want to up the ante a little, make yourself a little available for him to run into. Consider the general practitioner in a remote rural practice. A number of the 7,500 doctors who responded to the survey said that the context of the situation is key to determining whether a relationship with a patient crosses an ethical line.
Patients are often vulnerable when they visit doctors. To explain why this is always the case, even with former patients, it is useful to consider the sources of medical power in light of a framework suggested by family practitioner and ethicist, Howard Brody. Coercion can arise from imposed restraints on any or all of three types of autonomy: autonomy of thought or the ability to think for oneself, autonomy of will or the freedom to make a choice based on one's own deliberations, and autonomy of action or the freedom to enact one's choice physically. However, I have noticed subtle displays of body language that indicate he is also interested in me. Dating or engaging in a sexual relationship with the patient thus becomes a highly sensitive issue in this case. . If this were to be the case, it could also mean that while you are reading up on body language, there is a possibility that you are misreading his verbal and non-verbal communication.