Added: Codie Dupuy - Date: 15.01.2022 00:44 - Views: 34221 - Clicks: 612
Most doctors are aware of the doctor-patient boundary line and do not cross it. However, some relationships will fall into a grey area and in these circumstances it is easier for a boundary violation to occur inadvertently. In one such case, a doctor was reprimanded for violating professional boundaries with a former patient after becoming Facebook friends. However, he later agreed and terminated the doctor-patient relationship.
The patient had been seeing Dr B at the clinic for several years, when she saw Dr A for a mole check. Over the next 18 months, she saw Dr A numerous times until she contacted him on Facebook, admitting her feelings for him.
The pair met in person and exchanged text messages, until it escalated into a sexual relationship. During the month relationship, they continued to communicate through Facebook and text messages. The patient then attended the Emergency Department and asked Dr A if he could recommend a specialist for her.
He sat with her in the waiting room, but left before she saw the specialist. The next day, Dr A contacted another colleague requesting a referral for a pathology screen for her. About a week later, he informed her via text that her blood tests were normal. She then saw Dr B complaining of stress and disclosed her sexual relationship with Dr A after the conversation turned to her sexual abuse history, marriage breakdown and recent sexual activities. A few days later, she texted Dr A to apologise for disclosing their sexual relationship to Dr B.
Although Dr A did not have an obligation to self-report, if doctors recognise they have crossed a boundary of the doctor-patient relationship, they should seek legal advice about making a report to AHPRA themselves. The Board noted a decision in which the New South Wales Medical Board had spoken of the absolute rule that a medical practitioner who engages in sexual activity with a current patient is guilty of professional misconduct. In this case, the regulator said the evidence supported the conclusion she was a current patient in the sense there was an ongoing medical relationship.
The Board also noted that if the patient was regarded as a former patient, his conduct should also be viewed as professional misconduct. The Board submitted his conduct warranted a finding of professional misconduct. In addition, conditions on his registration around education and no non-clinical communication were proposed. Dr A was also ordered to complete an education program including a reflective practice report around maintaining professional boundaries and ethical decision-making. Although the doctor in this case was not an Avant member, our experience is the regulators universally consider it unethical and unprofessional for a doctor to have a sexual relationship with a patient, regardless of whether the patient has consented to the relationship.
In this case, despite Dr A formally ending the doctor-patient relationship before entering a sexual relationship, the boundaries had already blurred and the doctor-patient relationship re-established. While there is no set rule for how long a doctor should wait before they engage in a sexual relationship with a patient after the therapeutic relationship ends, there will always be an element of risk of falling foul of the regulator. Doctors also need to be aware that boundary violations can occur as a result of engaging in a sexual relationship with a person close to their patient, such as their carer, guardian or spouse or the parent of patient.
Download our factsheet, Unhealthy relationships with patients. Doctor-patient relationship blurs The patient had been seeing Dr B at the clinic for several years, when she saw Dr A for a mole check. Patient discloses relationship She then saw Dr B complaining of stress and disclosed her sexual relationship with Dr A after the conversation turned to her sexual abuse history, marriage breakdown and recent sexual activities.
The degree of dependence in the doctor-patient relationship.
The manner in which and reason why the professional relationship was terminated and the context in which the sexual relationship was established. Disciplinary orders Ultimately, the tribunal found Dr A guilty of professional misconduct. Maintaining professional boundaries Although the doctor in this case was not an Avant member, our experience is the regulators universally consider it unethical and unprofessional for a doctor to have a sexual relationship with a patient, regardless of whether the patient has consented to the relationship.
Key lessons Boundary violations can have devastating consequences for your reputation and career. The Board and regulators are strongly of the view it is unethical and unprofessional for a doctor to have a sexual relationship with a patient, regardless of whether the patient has consented to the relationship. Boundary transgressions can occur in relationships with not only patients, but former patients where the doctor-patient relationship has been terminated and circumstances such as vulnerability of the patient in misconduct.
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Medical Board of Australia consulting on revised sexual boundaries guidelines