This article asks whether it is ever acceptable for a psychiatrist to form an intimate relationship with a former patient. It explores the tensions that arise between the freedom of autonomous adults, the need to protect vulnerable individuals, and the public interest in maintaining trust in the doctor–patient relationship. It argues that although a complete ban on all sexual relationships between doctors and former patients would be excessively restrictive, a special case can be made for relationships with former psychiatric patients. The particular vulnerability of psychiatric patients, and the resulting need to ensure the highest standards of trust in the profession, strengthen the case for a complete ban.