Doctor dating former patient

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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 relationships are almost always unethical due to the persistence of transference, the unequal power distribution in the original doctor–patient relationship and the ethical implications that arise from both these factors especially with respect to the patient's autonomy and ability to consent, even when a former patient.

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. Simply by the sheer nature of taking on the role of patient, regardless of any other type of power, there is an unequal power differential between the doctor and patient.

In his book Brody outlines three sources of medical power: Aesculapian, Charismatic and Social. (This applies in both general practice and hospital-based medicine, although it may be accentuated by the latter's institutional culture.

Secondly, three aspects of the doctor–patient relationship are explored: the general characteristics which promote health care; the importance of trust and the fiduciary relationship; and the role of power and authority in the relationship.personality disordered doctors), this group is very unlikely to re-offend with appropriate treatment.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.However, the crossing of boundaries 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. Clues as to what these other factors should be can be gleaned from examining the profiles of offending doctors.Nor do all boundary transgressions between doctor and patient ultimately lead to sexual misconduct. 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.

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