Doctors allowed to date former patients - Telegraph
Until now, the General Medical Council has discouraged doctors from having relationships with former patients deemed vulnerable at the time. A physician must terminate the patient-physician relationship before initiating a dating, romantic or sexual relationship with a patient. At a minimum, a physician must terminate the patient-physician relationship before initiating a dating, romantic, or sexual relationship with a.
Has the GMC got the balance right?
Traditionally the doctor-patient relationship has been seen as characterised by an imbalance of power, with the doctor in the position of authority. In this way, the power of the doctor is harnessed to the good, engendering trust and maximising therapeutic outcomes. Professionalism demands that both parties are protected by clear and mutually recognised boundaries.
The ethics department of the British Medical Association has advised doctors on how to manage intrusive patients—how to deal with stalkers and those who shower doctors with declarations of undying love. But isn't such a take on the doctor-patient relationship out of date, even paternalistic?
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Online resources have reduced the information gap between doctors and patients, patient autonomy is greater than ever before, and not everyone who walks through a consulting room door is a shrinking violet. Some doctors feel that the shoe is now firmly on the other foot. The classic paradigm, with the single handed usually male practitioner exploiting vulnerable female patients is less likely today because doctors work in multidisciplinary teams, where such behaviour would be exposed.
It is also easy to think of examples that verge on the absurd; should junior doctors treating fellow medics in accident and emergency be forever precluded from dating them? As the patient as consumer comes of age, and the power and status of professionals wanes, is Graeme Catto right or is the doctor-patient relationship now a meeting of equals?
As with so many questions that arise in ethics, the honest answer must be, it depends.
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Recent history is sadly strewn with sobering examples of doctors abusing their power—Rodney Ledward, Harold Shipman, Peter Green.
If so many doctors had not abused their power in the past, calls for restraint would not be as loud. Irrespective of the pressure that the softening of traditional hierarchies of authority is bringing to bear, the doctor-patient relationship remains a kind of exemplar.
Patients are often vulnerable when they visit doctors. They can be sick, distressed, and disorientated, even if they express their need in an aggressive or overconfident way. Patients may need to reveal the most private information. A mere six months after the divorce, in February ofSimon married Ellen, and they remain together today.
There are, however, a few complicating factors about this story, beyond the regular emotional turmoil that so often accompanies failed romantic endeavors. He got to know his first wife, identified in court hearings as Patient A, while treating her for depression.
And he got to know his second wife, identified in court hearings as Patient B, while counselling her over relationship troubles with her former husband. After these details eventually came to light, a medical disciplinary panel suspended Holmes from practising for three months for failing to maintain professional boundaries.
This case, of course, is a rather exceptional one. British newspapers had a field day with it, more than one going all caps in their headlines to note Holmes had married not one but TWO of his patients. Though instances of doctors and patients entering romantic relationships are indeed rare, it does sometimes happen. Physicians sometimes have sexual relationships with patients, or with former patients. Sometimes the initiator is the physician, and sometimes it is the patient. Often times these are clear-cut cases of unethical behaviour on the part of doctors — perhaps even criminal behaviour.
But sometimes, in certain contexts, considering certain factors, these affairs of the heart are a little more complicated. This includes not only sexual contact, but also behaviour or remarks of a sexual nature.
There are typically two types of doctors who commit sexual abuse of patients, says Leet. 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.
Doctors allowed to date former patients
One theory is that the nature and length of doctor—patient relationships in these disciplines increases the chances of boundary violations. 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.