Virtual Mentor. January 2005, Volume 7, Number 1.
Case 6.4: Treatment of Family Members and Significant Others—All in the Family
Objectivity plays an important part in good clinical judgment. Previous sections of this chapter have identified how financial considerations can compromise physician objectivity; personal relationships may also undermine physician objectivity and, consequently, diminish the quality of patient care. Clinical relationships with family members and romantic and/or sexual relationships with patients are especially likely to jeopardize patient care. The Code addresses both of these:
See also Opinion 8.145, "Sexual or Romantic Relations between Physicians and Key Third Parties."
Physician expertise and collaborative decision making are cornerstones of contemporary medical practice. Strong emotional connections to family members or significant others can alter physician judgment in ways the physician may be unable to recognize.
A second concern is that the power imbalance of the patient-physician relationship may be intensified in close personal relationships, inhibiting the family member or significant other from challenging, questioning, or disagreeing with the physician.
The ethical prohibition against romantic relationships or sexual contact with patients is not meant to be a bar to other kinds of non-sexual touching of patients by physicians. In addition to its role in physical examination, non-sexual touching may be therapeutic or comforting to patients. However, even non sexual contact with patients (beyond the appropriate touching of the physical examination) should be approached with caution.
It is of course possible for a physician and a patient to be genuinely attracted to or have genuine romantic affection for each other. However, any relationship in which a physician is (or risks) taking advantage of the patient's emotional or psychological vulnerability is unethical. Therefore, before initiating a dating, romantic, or sexual relationship with a patient, a physician's minimum duty is to terminate his or her professional relationship with the patient. These restrictions are more strict for psychiatrists, but all physicians should be aware of possible problems that can arise from these relationships.
The people and events in this case are fictional. Resemblance to real events or to names of people, living or dead, is entirely coincidental. The viewpoints expressed on this site are those of the authors and do not necessarily reflect the views and policies of the AMA.
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