Book contents
- Frontmatter
- Foreword
- Contents
- List of tables
- Preface
- Preface to the 1997 edition
- Acknowledgments
- About the authors
- Table of cases
- Table of statutes
- 1 Ethical principles for the medical profession
- 2 Ethical and legal responsibilities of medical students
- 3 Communication skills
- 4 Consent and informed decision making
- 5 Confidentiality, privacy and disclosure
- 6 Medical records, reports and certificates
- 7 Negligence, professional liability and adverse events
- 8 The regulation of the medical profession
- 9 Health care complaints systems
- 10 The doctor and sexual boundaries
- 11 Personal health of the doctor: illness and impairment
- 12 Maintenance of professional competence
- 13 Ethics and the allocation of health-care resources
- 14 The Australian health-care system
- 15 The doctor and interprofessional relationships
- 16 Entering and leaving practice and practice management
- 17 Clinical research
- 18 Prescribing and administering drugs
- 19 Diagnosing and certifying death and the role of the coroner
- 20 Births, reproductive technology, family law and child protection
- 21 Termination of pregnancy and related issues
- 22 Withholding or withdrawing treatment in the seriously or terminally ill
- 23 The law and the mentally ill
- 24 The law and courts of law in Australia
- 25 Medico-legal examinations and reports, court procedures and expert evidence
- 26 Other legislation relevant to medical practice
- APPENDIX 1 AMA CODE OF ETHICS – 2004
- Index
- References
This chapter is part of a book that is no longer available to purchase from Cambridge Core
10 - The doctor and sexual boundaries
Book contents
- Frontmatter
- Foreword
- Contents
- List of tables
- Preface
- Preface to the 1997 edition
- Acknowledgments
- About the authors
- Table of cases
- Table of statutes
- 1 Ethical principles for the medical profession
- 2 Ethical and legal responsibilities of medical students
- 3 Communication skills
- 4 Consent and informed decision making
- 5 Confidentiality, privacy and disclosure
- 6 Medical records, reports and certificates
- 7 Negligence, professional liability and adverse events
- 8 The regulation of the medical profession
- 9 Health care complaints systems
- 10 The doctor and sexual boundaries
- 11 Personal health of the doctor: illness and impairment
- 12 Maintenance of professional competence
- 13 Ethics and the allocation of health-care resources
- 14 The Australian health-care system
- 15 The doctor and interprofessional relationships
- 16 Entering and leaving practice and practice management
- 17 Clinical research
- 18 Prescribing and administering drugs
- 19 Diagnosing and certifying death and the role of the coroner
- 20 Births, reproductive technology, family law and child protection
- 21 Termination of pregnancy and related issues
- 22 Withholding or withdrawing treatment in the seriously or terminally ill
- 23 The law and the mentally ill
- 24 The law and courts of law in Australia
- 25 Medico-legal examinations and reports, court procedures and expert evidence
- 26 Other legislation relevant to medical practice
- APPENDIX 1 AMA CODE OF ETHICS – 2004
- Index
- References
Summary
From the time of Hippocrates, the medical profession has acknowledged that the special relationship of trust between patient and doctor must not be abused by the doctor establishing any type of improper or sexual relationship. As stated in the Hippocratic Oath:
Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations, with both female and male persons, be they free or slaves.
This prohibition has been widely restated in recent times and is enforced by the threat of suspension or removal of the name of the doctor from the medical register if found guilty of such unprofessional conduct [2–6]. For example, the Medical Practitioners Board of Victoria states: ‘It is always wrong for a doctor and a patient to enter into a sexual or an improper emotional relationship. It is also wrong for a doctor to enter into a relationship with a former patient or a close relative of a patient, if this breaches the trust the patient placed in the doctor’. Despite this clear prohibition, there is considerable evidence from North America, Europe and Australia that sexual boundary violations remain a problem [7–11].
This chapter defines sexual misconduct and summarises what is known of the incidence of sexual misconduct. It discusses the apparent causes of boundary violations, emphasising the psychological dynamics for the patient/complainant, who is usually female, and the doctor, who is usually male.
- Type
- Chapter
- Information
- Good Medical PracticeProfessionalism, Ethics and Law, pp. 156 - 168Publisher: Cambridge University PressPrint publication year: 2010
References
The Hippocratic Oath: Text, Translation and Interpretation, Johns Hopkins University Press, Baltimore, 1943.Google Scholar
. AMA Code of Ethics – 2004 (editorially revised 2006). http://www.ama.com.au/codeofethics
. Sexual Misconduct. Policy Statement. New South Wales Medical Board, 1992. http://www.nswmb.org.au/index.pl?page=74
, other Health Practitioner Registration Boards and Queensland Nursing Council's statement on sexual relationships between health practitioners and their patients, 2000. http://www.medicalboard.qld.gov.au/resources/index.html
Professional Boundaries: A Guide for Patients and Doctors. http://medicalboardvic.org.au/pdf/Professional_Boundaries.pdf
Crossing the Boundaries: The Report of the Committee on Physician Sexual Misconduct. College of Physicians and Surgeons of British Columbia, 1992.
Sex in the Forbidden Zone. When Men in Power – Therapists, Doctors, Clergy, Teachers and Others – Betray Women's Trust. Harper Collins, London, 1995.Google Scholar
, , , , . Psychiatrist-patient sexual contact: results of a national survey, I: Prevalence. Am J Psychiatry 1986; 143: 1126–31.Google ScholarPubMed
, , , . Sexual contact in the doctor–patient relationship in the Netherlands. BMJ 1992; 304: 1531–4.CrossRefGoogle ScholarPubMed
. Professional misconduct in psychiatry: sexual behaviour with patients. A report of recent New South Wales finding. Aust NZ J Psychiatry 1994; 28: 197–204.CrossRefGoogle Scholar
. A survey of Australian psychiatrists' attitudes and practices regarding physical contact with patients. Aust NZ J of Psychiatry 1994; 28: 488–97.CrossRefGoogle ScholarPubMed
, . Evaluation of sexual misconduct complaints: The Oregon Board of Medical Examiners, 1991–1995. Amer J Obs and Gyn 1997; 176: 1340–8.Google Scholar
. Post-termination sexual boundary violations. Psychiatr Clin North America 2002; 25: 593–603.CrossRefGoogle ScholarPubMed
. Sexual relationships between doctors and former patients. BMJ 2006; 333: 1132.CrossRefGoogle ScholarPubMed
. Annual Report 2007. http://www.medicalboard.qld.gov.au/pdfs/medical-annual-report-2006-07.pdf
. Annual Report 2007. http://medicalboardvic.org.au/pdf/AR_2007.pdf
, . Analysts who commit boundary violations: a lost cause?J Am Psychoanal Assoc 2003; 51: 617–36.CrossRefGoogle ScholarPubMed
. Sex and gender and the impaired therapist. Aust NZ J Psychiatry 1992; 26: 346–63.CrossRefGoogle ScholarPubMed
. Crossing professional boundaries: the slippery slope to patient sexual exploitation. Med J Aust 2004; 181: 380–3.Google ScholarPubMed
. Update to the Profession – Sexual Offences. June 2008, pp. 11–12. http://medicalboardvic.org.au/pdf/Vol2_2008.pdf
. Borderline personalty disorder, boundary violations and patient therapist sex: medico-legal pitfalls. Am J Psychiatry 1989; 146: 597–602.Google Scholar
, . False allegations of sexual misconduct: clinical and institutional considerations. Psychiatr Serv 1995; 46: 160–3.Google ScholarPubMed
. Sexual abuse in therapy: gender issues. Aust NZ J of Psychiatry 1996; 30: 124–33.CrossRefGoogle ScholarPubMed
. Fantasies during sedation with intravenous midazolam or diazepam. Med Leg J 1990; 58: 29–34.CrossRefGoogle ScholarPubMed
. Benzodiazepine sex fantasies: acquittal of dentist. Lancet 1990; 335: 403.CrossRefGoogle ScholarPubMed
. Setting and maintaining boundaries: an educational strategy. Med Educ 2004; 38: 903–10.CrossRefGoogle Scholar
, . A curriculum on physician–patient sexual misconduct and teacher–learner mistreatment. Part 2: Teaching method. Can Med Assoc Journal 1996; 154: 1021–5.Google ScholarPubMed
. Physical Examinations, including Intimate Examinations. Medical Practitioners Board of Victoria, 2007. http://www.medicalboardvic.org.au/content.php?sec=54
, , . Chaperones in ENT outpatients: the patients' perspective. J Laryngol Otol 2007; 121: 684–6.CrossRefGoogle ScholarPubMed
, , (eds). Physician Sexual Misconduct. American Psychiatric Press, Washington, 1999.
, (eds). Sexual Exploitation of Patients by Health Professionals. Praeger, New York, 1986.
(ed), Sexual Exploitation in Professional Relationships. American Psychiatric Press, Washington, 1989.Google Scholar
Out of Bounds: Sexual Exploitation in Counselling and Therapy. Sage Publications, London, 1993.Google Scholar
Sex in the Forbidden Zone, When Men in Power – Therapists, Doctors, Clergy, Teachers and Others – Betray Women's Trust. Harper Collins, London, 1995.Google Scholar
, , , , . Psychotherapists; Sexual Involvement with Clients: Intervention and Prevention. Minneapolis Walk-in Counselling Center, Minneapolis, 1989.Google Scholar