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Doctor sexually attracted to patient


Katherine H Hall; Sexualization of the doctor—patient relationship: Whilst having sexual relationships with current patients is clearly unethical, the ethics of such a relationship between a doctor and former patient is more debatable. In this review of the current evidence, based on major articles listed in Medline and Bioethicsline in the past 15 years, the argument is made here that such Doctor sexually attracted to patient are almost always unethical due to the persistence of transference, the unequal power distribution in the original doctor—patient relationship and the ethical implications Doctor sexually attracted to patient arise from both these factors especially with respect to Doctor sexually attracted to patient patient's autonomy and ability to consent, even when a former patient.

Only in very particular circumstances could such relationships be ethically permissible. Sexualization of the doctor—patient relationship: Family Practice ; All codes of ethics set up by medical professional bodies prohibit sexual relationships between a doctor and a current patient. Although this stance initially provoked a degree of controversy within the country, 2— 6 the deleterious effects of such relationships upon patients have become increasingly recognized and condemned by the medical community.

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However, some areas of Doctor sexually attracted to patient do still remain. One such area is whether sexual relationships with former patients are ever ethically permissible and, if so, under what circumstances. This paper presents evidence from international medical and ethical literature to examine the validity of this position taken by the New Zealand Medical Council regarding the sexualization of relationships with Doctor sexually attracted to patient patients.

First, the concepts of boundaries and transference are discussed and a profile of the medical practitioner at risk of offending is drawn. Secondly, three aspects of the doctor—patient relationship are explored: Thirdly, a discussion of the role of autonomous choice and consent is presented. Many boundaries exist in the doctor—patient relationship. These include boundaries of role, time, Doctor sexually attracted to patient and space, money, gifts and services, clothing, language and physical contact.

Not all stages will take place in any one relationship, but the general stages include: Doctor sexually attracted to patient does not mean that no such type of relationship may exist, but it has not been researched. This suggests that the overwhelming outcome for most, if not all, patients is negative. However, the crossing of boundaries per se does not necessarily mean that an unethical act occurred: Nor do all boundary transgressions between doctor and patient ultimately lead to sexual misconduct.

Clues as to what these other factors should be can be gleaned from examining the profiles of offending doctors. A key factor in the identification of doctors at risk of violating boundaries is the enhanced vulnerability of a doctor to the transference—counter-transference dyad which occurs in varying degrees in every doctor—patient relationship.

Doctors can mistake the Doctor sexually attracted to patient of love that arise in a therapeutic relationship as being the same as love that arises elsewhere; it is not. Therefore, unmet emotional needs of the doctor, overidentification with the patient and particularly intimate areas of medicine associated with long-term professional relationships with patients can all potentially enhance the strength of the transference—counter-transference relationship between doctor and patient.

Transferences per seDoctor sexually attracted to patient with boundary crossings, also occur in normal love relationships, 12 and therefore are also a necessary but not sufficient condition for ethical unacceptability. However, it is the existence and persistence of this type of transference, linked with the fiduciary relationship and unequal power structure, which makes most relationships with former patients ethically unacceptable see following sections.

The fiduciary relationship relationship of trust is a crucial aspect of the doctor—patient relationship. In turn, to build such a relationship, the unequal power distribution between doctor and patient has to be acknowledged and contained in an ethically correct manner. The onus of responsibility for this last task falls on the person who has the most power in the relationship which, as I will argue, is always the doctor.

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.


In his book The Healer's Power20 Brody outlines Doctor sexually attracted to patient sources of medical power: Aesculapian, Charismatic and Social. It has also been suggested that another source of power —Hierarchical power, the power inherent by one's position in a medical hierarchy e.

To help understand these four types of power, and the relationships between each type, consider the following incident from my personal experience as a first year house surgeon in Australia in the mids. Although it does not involve the sexualization of the doctor—patient relationship, it clearly illustrates the Doctor sexually attracted to patient of recognizing all four types of power, and, in particular, the prominence of Hierarchical power: A consultant specialist was admitted to hospital with a severe multi-system disease causing severe renal impairment.

After 6 weeks in hospital, on the day of his planned discharge, he was accidentally given another patient's medication. Instead of receiving his azathioprine and corticosteroids, he was given a high dose of frusemide and captopril.

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Despite having the Aesculapian power of a doctor, and the Social power of a hospital specialist, in addition to considerable Charismatic power he was a well-liked and respected colleaguenone of these were sufficient to counteract his lack of Hierarchical power by being a patient. Simply by the sheer nature of taking on the role of patient, regardless of any other type of power, there is always an unequal power differential between the doctor and patient. This applies in both general practice and hospital-based medicine, although it Doctor sexually attracted to patient be accentuated by the latter's institutional culture.

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. This differential is exacerbated further by any imbalances arising from the other three sources of power.

Charismatic power may not always be less on the patient's side depending Doctor sexually attracted to patient the personalities of patient and doctor. Equally, Social power may vary in doctor— patient relationships depending on the social status of the individuals. This may also relate to the gender roles of the patient and doctor. The large majority of cases of sexualization occur between female patients and male doctors. Doctor sexually attracted to patient, the onus of responsibility for controlling the power imbalance in an ethically correct manner is always on the doctor.

However, what is the relevance of this analysis to relationships with former, not current patients? Several points can be made. Information gained in such a power imbalance can be artificially intimate—one does not normally begin to discuss details of sexual function within a few minutes of meeting a stranger, for example, but this frequently happens in general practice consultations.

Secondly, given the strength of Hierarchical power in determining one's overall power in the doctor—patient relationship as illustrated by the case historyit is hard to see how a relationship of equals could develop from such unequal beginnings. How should a claim be judged that a former patient gave Doctor sexually attracted to patient or her free consent before entering into the relationship? 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.

Transferences can persist indefinitely and Doctor sexually attracted to patient it the perpetuation of the potential or real incompetence of the patient to recognize these feelings for their true nature and the same for doctors with respect to counter-transference: There is no empirical research to demonstrate that transference disappears for the patient or even simply decreases with cessation of the doctor—patient relationship or counter-transference for the doctor although this is less studied: Not all authors condemn sexual relationships with previous patients however.

Zelas is a little less prohibitive.

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Even with this broad guideline, however, Zelas also states that: In the earlier discussion, it was argued that the power imbalance Doctor sexually attracted to patient the doctor—patient relationship would Doctor sexually attracted to patient into the sexualized relationship. Meaningful consent to a sexualized relationship cannot be given in a situation of unequal power: Other arguments support the idea that meaningful consent is an impossibility in this situation.

Traditional teaching of informed consent emphasizes the importance of autonomous choice, i. Leaving aside the provision of information presumably such information should include a review of the current known research in this area, although this apparently rarely, if ever, happens 12this discussion will concentrate on coercion and impaired capacity.

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Coercion can arise from imposed restraints on any or all of three types of autonomy: However, an alternative definition of autonomy which centres upon the importance of one's social relationships demonstrates a more subtle source of coercion.

Brody argues that the distinguishing characteristic of general practice ethics, as opposed to hospital-based ethics which involves a time-limited decisional focusis the longitudinal relationship which develops between doctor and patient. From both these arguments, then, it can be seen that attention to relationship is particularly important when considering general practice ethics.

It could be argued, therefore, that general practice has a particular duty of fostering the autonomy of the patient and that a GP's actions should be evaluated in the light of this duty.

Sexual misconduct with a former patient does not, by any established evidence, foster patient autonomy, and a doctor participating in such a relationship is thus breaching this duty. It would be the minority of consultations, especially in general practice, where the above conditions of persistent transference and power imbalance did not exist. Certainly the onus of proof, in any disciplinary hearing, would lie with the doctor to demonstrate how these ethical issues were of minimal impact in the subsequent sexualized Doctor sexually attracted to patient. Only in situations where there was a minimal potential for transference—counter-transference to arise, together with an unusual equality of power, could the former patient be in a position to exercise true autonomy and choice when entering into a sexualized relationship with the doctor.

In general, the criteria by which the New Zealand Medical Council will judge the ethical acceptability of sexual relationships with former patients 7 appear to be necessary, but not sufficient. 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. However, other situations may well occur which fall beyond these criteria but nevertheless have a similar degree of transference—counter-transference and residual power imbalance so that a sexualized relationship is equally as abusive as the listed criteria.

It is these underlying factors, rather than any more superficial descriptors, by which the ethical acceptability should be judged. This being the case, relationships with former patients should not be regarded as ethically permissible except under such rare circumstances. The author wishes to thank Dr Chrys Jaye for reviewing an earlier draft of this paper and for her very helpful comments and suggestions. Oxford University Press is a department of the University of Oxford. It furthers the University's objective of excellence in research, scholarship, and education by publishing worldwide.

Sign In or Create an Account. Close mobile search navigation Article navigation. Boundaries and boundary violations. Profiles of doctors who violate Doctor sexually attracted to patient. Abstract Whilst having sexual relationships with current Doctor sexually attracted to patient is clearly unethical, the ethics of such Doctor sexually attracted to patient relationship between a doctor and former patient is more debatable.

Morality, physicianpatient relationship, sex offences, social dominance, standards. New Zealand Medical Council. New Zealand Medical Council website: Medical discipline and sexual activity between doctors and patients. Sexual activity between doctors and patients [letter]. Medical discipline and sexual activity between doctors and Doctor sexually attracted to patient [letter]. The concept of boundaries in clinical practice: From boundary violations to sexual misconduct.

Psychiatr Clin N Am. American Psychiatric Press, Transference in therapist—patient sex: Fahy T, Fisher N. If you find yourself attracted to a patient, accept your feelings as important Every physician knows the ancient proscription against romantic or sexual liaisons.

GMC advice to doctors whose patient has pursued a sexual or improper to send her messages telling her he found her very attractive. Whilst having sexual relationships Doctor sexually attracted to patient current patients is clearly unethical, the is that if the sexual attraction and desire for a relationship Doctor sexually attracted to patient in the.

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Developing romantic feelings suited for a patient may be a mark of burnout. of the utmost disconcerting experiences a physician can compel ought to is realizing that he or she is strongly attracted to a lenient. Many physicians conjecture they should be above such emotions or that their professional objectivity should neutralize these feelings. What many physicians don't realize is that being attracted to a resigned is often a symptom of burnout. A physician whose work has consumed his or her life may have on the agenda c trick few, if any, healthy relationships away from the appointment, and the intimacy of the doctor-patient relationship can inaugurate to fill requirements that should be filled elsewhere.

As a psychologist, I've treated many physicians whose burnout has manifested in crowd-puller to a tenacious, and while there is no vaccination to prevent it, there is a protocol of disquiet. If you remark yourself attracted to a patient, permit your feelings as important information nearby your overall well-being. Often, people are attracted to qualities in others they wish they could more fully age in themselves.

Look over to determine what it is on every side the patient that attracts you. It may help you to confide in someone. A physician colleague may be best equipped to empathize and sympathize, but you can talk to anyone who can pay attention to and be sympathetic without judging.

Criticism about your sentiment for the self-possessed may also utility. For example, aside keeping a album, one doctor noticed that her attractant for a established patient was stronger on days when she saw varied chronically ill geriatric patients. She recognized her neediness was fueled by her feelings of depletion and helplessness.

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At Monday, August 13, 5: To see the full article, log in or purchase access. These young male medical students from the middle-east had never even seen their sister's ankles.

Valid research on this topic would account for such things as the different socialisation of men and women for example the fact that women are taught to pay more attention to others than themsleves , the greater numbers of female patients and male doctors, and the likelihood that female doctors are not reporting what amounts to sexual harassment by their male patients. Medical schools find that the need to educate students regarding how to deal with the seductive patient an important topic.

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  • If you are asking if doctors are “aware” of attractive patients, then the answer is 1% of the respondents felt it was permissible to have sex with a current patient”.
  • If you find yourself attracted to a patient, accept your feelings as important Every physician knows the ancient proscription against romantic or sexual liaisons.
  • It was encapsulated in the form of a topic for discussion in small group, to which we had to prepare a paragraph of response:.
  • What is sexual contact between the patient and the physician? It may be normal for a patient to feel attracted to a physician who is attentive. I have yet to meet a single doctor that actually hit it off with a patient, male or 2) iirc, the key factors associated with psychiatrist/patient sexual.
  • On my other threads on patient modesty and why doctors are hated, there is much for physicians to deal with is the sexually seductive patient. . and even simple loneliness and mutual attraction of people with common. Whilst having sexual relationships with current patients is clearly unethical, the is that if the sexual attraction and desire for a relationship commenced in the.

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I am sure that they do! For them to state differently would be a lie trying to cover up the fact that they have. Just becuz they have the doctor title has nothing to do with where or what they look at on a female or masculine patient.

Don't pretend the white fool you. Be smarter than that. Male doctors are no different from other men.

What have you been reading, hearing or TV viewing that has provoked some feelings of comfort or concern round what is happening in the star of medicament, medical fret, treatment or science?

Ethics is all about doing the convenient thing. Are you conscious of any issues in medicine or biologic realm which are being all over right, could be improved or in fact reproduce totally unethical behavior? Belittle delete about them here.. How Should Doctors React? On my other threads on patient modesty and why doctors are hated, there is lots concern and worry around sexually attractive doctors. Such concerns are warrented impartial though I am reliable most doctors will consider patients professionally and confine to the professional and legal boundaries of behavior.

However, physicians have their own concerns. One of their concerns is the behavior that the long-suffering will influence a rear into the office.

There are the angry, disruptive and frankly belligerant patients.

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How soon is too soon for "i love you"? If you find yourself attracted to a patient, accept your feelings as important Every physician knows the ancient proscription against romantic or sexual liaisons. I have yet to meet a single doctor that actually hit it off with a patient, male or 2) iirc, the key factors associated with psychiatrist/patient sexual..

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