A study of physicians disciplined for sex-related offenses in the United States, found that they were more likely to be in psychiatry, family medicine, and obstetrics and gynecology. One theory is that the nature and length of doctor—patient relationships in these disciplines increases the chances of boundary violations.
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There are, however, characteristics about the practice of medicine in general that may make a physician susceptible to violating a boundary with a patient. Historically, notes Gupta, doctors have been expected to deal with all stress that occurs in the context of their work and not show they need help. That can increase vulnerability, compromise judgment and lead doctors to engage in behaviour that, in retrospect, they recognize as inappropriate. This could lead to a patient seeking more from a doctor than health care.
Psychiatrists are trained to understand that this behaviour is a reflection of what the patient may be going through, says Gupta. When a patient becomes a former patient, things become less clear. Well, that may be true, but these situations can still be tricky. The discussion moves, however, from the realm of sexual abuse into the world of ethics. In the United Kingdom, the General Medical Council once discouraged physicians from having romantic relationships with any former patient. That changed in , however, though the council did update its guidelines to include factors a doctor should consider before going down that path.
The problem with rules by regulatory bodies, is that they tend to be broad easy-to-communicate norms that leave little room for nuance.
Doctors allowed to date former patients
In the real world, each relationship is unique and complex and such rules, however well intentioned, may not apply to all cases. One scenario often mentioned in discussions of possible exceptions is the dilemma of the rural doctor. What if, for instance, you are the only doctor in a remote community? Should you forgo romantic relationships and marriage and a family?
It is generally less frowned upon when a rural doctor falls in love with a patient, though ethicists still suggest that the professional relationship be terminated and, barring an emergency, that care be transferred to a doctor in a different community. The rule of thumb, however, is generally agreed upon in the medical profession. Romantic relationships between doctors and patients are fraught with hazards and best avoided. But doctors are people, too.
Black and white rules
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