Medical Ethics - Relationships with Patients

Most ethical codes forbid doctors and nurses to have sexual relationships with patients. Professional bodies view these relationships as 'serious misconduct' and erstwhile professionals may be expelled from professional bodies and thus stopped from practicing their profession. The untoward consequences of sexual relationships therefore deter most practitioners from 'unprofessional' conduct.

Why are such relationships frowned upon? The professional is in a privileged position and there is a profound power differential between the patient and the doctor. Although current 'politically correct' thinking dictates that the doctor and patient are 'partners' in diagnosis and treatment, in reality the patient is very dependent and vulnerable. In this aspect, the professional could be seen to be responsible for the conduct of the relationship, in something almost of a parental role.

A sexual relationship based on this power differential could be viewed as abusive, in which there is ill-informed consent leading to a lack of autonomy. The doctor would not be respecting the patient's autonomy is proceeding with the relationship, however they chose to frame their behaviour.

In avoiding such relationships the professional is acting non-maleficently.

Summary Points

• Maintaining the professional relationship shows a respect for autonomy, beneficence towards the patient and a desire to act non-maleficently
• Sexual relationships with patients cannot be justified, are abusive and inherently harmful for the patient involved.

Adapted from: Dr Ben Green, http://www.priory.com/ethics.htm

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Written by: Michael Harris

Last updated: 16 September 2006