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Sexual Relationships Between Physicians and Patients

Sexual Relationships Between Physicians and Patients Abstract In the face of evidence suggesting that there is a substantial incidence of sexual contact between physicians of all specialties and their patients, the medical profession and the courts have not yet reached a consensus regarding appropriate responses. Some commentators, including the American Medical Association, have urged bans on sexual contact during treatment and extensive restriction of posttreatment sexual relationships. Others favor looser restrictions, particularly after termination of the physician-patient relationship. These differences in approach stem from the varying importance given the two conflicting values involved: (1) protecting patients from being harmed by unfair manipulation by physicians and (2) insulating choices about intimate relationships from intrusion by society. We propose a model for balancing these interests that would bar sexual contact during the physician-patient relationship and for a fixed period after termination; thereafter, in most cases, sexual relationships would not be proscribed. A waiting-period approach of this sort is likely to diminish most of the harms that might result from physician-patient sexual contact and may constitute a template for the resolution of similar issues elsewhere in society. (Arch Intern Med. 1994;154:2561-2565) References 1. Campbell ML. The oath: an investigation of the injunction prohibiting physician-patient sexual relations . Perspect Biol Med. 1989;32:300-308. 2. American Medical Association Council on Ethical and Judicial Affairs. Current Opinions of the Council on Ethical and Judicial Affairs . Chicago, III: American Medical Association; 1989. 3. American Medical Association Council on Ethical and Judicial Affairs. Sexual misconduct in the practice of medicine . JAMA . 1991;266:2741-2745.Crossref 4. College of Physicians and Surgeons of Ontario. Final Report of the Task Force on Sexual Abuse of Patients . Toronto, Ontario: College of Physicians and Surgeons of Ontario; 1991. 5. College of Physicians and Surgeons of British Columbia. Crossing the Boundaries: The Report of the Committee on Physician Sexual Misconduct . Vancouver, British Columbia: College of Physicians and Surgeons of British Columbia; 1992. 6. Atienza v Taub, 194 Cal App3d 388, 393 (Cal App 1987). 7. Pons v Ohio State Med Bd, 614 NE2d 748, 753 (Ohio 1993). 8. Kardener SH, Fuller M, Mensh I. A survey of physicians' attitudes and practices regarding erotic and nonerotic contact with patients . Am J Psychiatry. 1973;130:1077-1081. 9. Gartrell N, Herman J, Olarte S, Feldstein M, Localio R. Psychiatrist-patient sexual contact: results of a national survey, I: prevalence . Am J Psychiatry . 1986;143:1126-1231. 10. Gartrell NK, Milliken N, Goodson WH, Thiemann S. Physician-patient sexual contact: prevalence and problems . West J Med. 1992;157:139-143. 11. Wilbers D, Veenstra G, van de Wiel HBM, Weijmar Schultz WCM. Sexual contact in the doctor-patient relationship in the Netherlands . BMJ . 1992;304:1531-1534.Crossref 12. Herman JL, Gartrell N, Olarte S, Feldstein M, Localio R. Psychiatrist-patient sexual contact: results of a national survey, II: psychiatrists' attitudes . Am J Psychiatry . 1987;144:164-169. 13. Holroyd JC, Brodsky AM. Psychologists' attitudes and practices regarding erotic and non-erotic physical contact with patients . Am Psychol. 1977;32:843-849.Crossref 14. Pope KS, Keith-Speigel P, Tabachnick BG. Sexual attraction to clients . Am Psychol. 1986;41:147-158.Crossref 15. Bouhoutsos J, Holroyd J, Lerman H, Forer B, Greenberg M. Sexual intimacy between psychotherapists and patients . Prof Psychol Res Pract. 1983;14:185-196.Crossref 16. Jorgenson L, Randles R, Strasburger L. The furor over psychotherapist-patient sexual contact . William Mary Law Rev. 1991;32:645-732. 17. Schoener GR, Milgrom JH, Gonsiorek JC, Luepker ET, Conroe RM. Psychotherapists'Sexual Involvement with Clients: Intervention and Prevention . Minneapolis, Minn: Walk-In Counseling Center; 1989. 18. Feldman-Summers S, Jones G. Psychological impacts of sexual contact between therapists or other health care practitioners and their clients . J Counsel Clin Psychol. 1984;52:1054-1061.Crossref 19. Odegard v Finne, 500 NW2d 140, 141 (Minn App 1993). 20. Parsons T. The Social System . Glencoe, Ill: Free Press; 1951. 21. Smith S. The seduction of the female patient . In: Gabbard GO, ed. Sexual Exploitation in Professional Relationships . Washington, DC: American Psychiatric Press; 1989. 22. Greenberg v McCabe, 753 F Supp 765 (ED Pa 1978), aff'd, 594 F2d 854 (3d Cir), cert denied, 444 US 840 (1979). 23. Burgess A. Physician sexual misconduct and patients' responses . Am J Psychiatry . 1981;138: 1335-1342. 24. Norberg v Wynrib, 1992 SCJ No 60 (Can file 21924). 25. Estate of McRae, 522 So2d 731, 737 (Miss 1988). 26. Butler v Gleason, 101 NE 371 (Mass 1931). 27. Dillon v Callaway, 1993 WL 42346 (Ind App 1993) (Westlaw cit). 28. Jorgenson L, Randles R. Time out: the statute of limitations and fiduciary theory in psychotherapist sexual misconduct cases . Okla Law Rev. 1991;44:181-225. 29. Sealy LS. Fiduciary relationships . Cambridge Law Rev. 1962;62-140. 30. Ontario Medical Association Section on Psychiatry. Position statement . Ontario Med Rev. (September) 1992:17-24. 31. NY Judicial Law Appendix, Code Prof Resp, Canon 1, DR 1-102(7) (1993). 32. Ore Code Prof Resp, DR 5-110 (1992). 33. Cal Bus Prof Code §6106.9 (1993). 34. Jorgenson L, Sutherland P. Fiduciary theory applied to personal dealings: attorney-client sexual contact . Ark Law Rev. 1992;45:450-503. 35. Kramer v Union Free School District, 395 US 621, 627 (1969). 36. Griswold v Connecticut, 381 US 479 (1965). 37. Aptheker v Secretary of State, 378 US 500 (1964). 38. Hawaii Rev Stat §453-8(a)(9) (1992). 39. Kan Rev Stat Annot §311.597(4) (1993). 40. Johnson SH. Judicial review of disciplinary action for sexual misconduct in the practice of medicine . JAMA . 1993;270:1595-1600.Crossref 41. Second Interim Report of the Legal and Internal Change Subcommittee of the Review and Implementation Committee, College of Physicians and Surgeons of Ontario, Concerning the Report of the Task Force on Sexual Abuse of Patients . Toronto, Ontario: College of Physicians and Surgeons of Ontario; (May) 1992. 42. American Psychiatric Association. The Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry . Washington, DC: American Psychiatric Association; 1992; §2.1. 43. Appelbaum PS, Jorgenson L. Psychotherapistpatient sexual contact after termination of treatment . Am J Psychiatry . 1991;148:1466-1473. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Sexual Relationships Between Physicians and Patients

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Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1994.00420220053006
Publisher site
See Article on Publisher Site

Abstract

Abstract In the face of evidence suggesting that there is a substantial incidence of sexual contact between physicians of all specialties and their patients, the medical profession and the courts have not yet reached a consensus regarding appropriate responses. Some commentators, including the American Medical Association, have urged bans on sexual contact during treatment and extensive restriction of posttreatment sexual relationships. Others favor looser restrictions, particularly after termination of the physician-patient relationship. These differences in approach stem from the varying importance given the two conflicting values involved: (1) protecting patients from being harmed by unfair manipulation by physicians and (2) insulating choices about intimate relationships from intrusion by society. We propose a model for balancing these interests that would bar sexual contact during the physician-patient relationship and for a fixed period after termination; thereafter, in most cases, sexual relationships would not be proscribed. A waiting-period approach of this sort is likely to diminish most of the harms that might result from physician-patient sexual contact and may constitute a template for the resolution of similar issues elsewhere in society. (Arch Intern Med. 1994;154:2561-2565) References 1. Campbell ML. The oath: an investigation of the injunction prohibiting physician-patient sexual relations . Perspect Biol Med. 1989;32:300-308. 2. American Medical Association Council on Ethical and Judicial Affairs. Current Opinions of the Council on Ethical and Judicial Affairs . Chicago, III: American Medical Association; 1989. 3. American Medical Association Council on Ethical and Judicial Affairs. Sexual misconduct in the practice of medicine . JAMA . 1991;266:2741-2745.Crossref 4. College of Physicians and Surgeons of Ontario. Final Report of the Task Force on Sexual Abuse of Patients . Toronto, Ontario: College of Physicians and Surgeons of Ontario; 1991. 5. College of Physicians and Surgeons of British Columbia. Crossing the Boundaries: The Report of the Committee on Physician Sexual Misconduct . Vancouver, British Columbia: College of Physicians and Surgeons of British Columbia; 1992. 6. Atienza v Taub, 194 Cal App3d 388, 393 (Cal App 1987). 7. Pons v Ohio State Med Bd, 614 NE2d 748, 753 (Ohio 1993). 8. Kardener SH, Fuller M, Mensh I. A survey of physicians' attitudes and practices regarding erotic and nonerotic contact with patients . Am J Psychiatry. 1973;130:1077-1081. 9. Gartrell N, Herman J, Olarte S, Feldstein M, Localio R. Psychiatrist-patient sexual contact: results of a national survey, I: prevalence . Am J Psychiatry . 1986;143:1126-1231. 10. Gartrell NK, Milliken N, Goodson WH, Thiemann S. Physician-patient sexual contact: prevalence and problems . West J Med. 1992;157:139-143. 11. Wilbers D, Veenstra G, van de Wiel HBM, Weijmar Schultz WCM. Sexual contact in the doctor-patient relationship in the Netherlands . BMJ . 1992;304:1531-1534.Crossref 12. Herman JL, Gartrell N, Olarte S, Feldstein M, Localio R. Psychiatrist-patient sexual contact: results of a national survey, II: psychiatrists' attitudes . Am J Psychiatry . 1987;144:164-169. 13. Holroyd JC, Brodsky AM. Psychologists' attitudes and practices regarding erotic and non-erotic physical contact with patients . Am Psychol. 1977;32:843-849.Crossref 14. Pope KS, Keith-Speigel P, Tabachnick BG. Sexual attraction to clients . Am Psychol. 1986;41:147-158.Crossref 15. Bouhoutsos J, Holroyd J, Lerman H, Forer B, Greenberg M. Sexual intimacy between psychotherapists and patients . Prof Psychol Res Pract. 1983;14:185-196.Crossref 16. Jorgenson L, Randles R, Strasburger L. The furor over psychotherapist-patient sexual contact . William Mary Law Rev. 1991;32:645-732. 17. Schoener GR, Milgrom JH, Gonsiorek JC, Luepker ET, Conroe RM. Psychotherapists'Sexual Involvement with Clients: Intervention and Prevention . Minneapolis, Minn: Walk-In Counseling Center; 1989. 18. Feldman-Summers S, Jones G. Psychological impacts of sexual contact between therapists or other health care practitioners and their clients . J Counsel Clin Psychol. 1984;52:1054-1061.Crossref 19. Odegard v Finne, 500 NW2d 140, 141 (Minn App 1993). 20. Parsons T. The Social System . Glencoe, Ill: Free Press; 1951. 21. Smith S. The seduction of the female patient . In: Gabbard GO, ed. Sexual Exploitation in Professional Relationships . Washington, DC: American Psychiatric Press; 1989. 22. Greenberg v McCabe, 753 F Supp 765 (ED Pa 1978), aff'd, 594 F2d 854 (3d Cir), cert denied, 444 US 840 (1979). 23. Burgess A. Physician sexual misconduct and patients' responses . Am J Psychiatry . 1981;138: 1335-1342. 24. Norberg v Wynrib, 1992 SCJ No 60 (Can file 21924). 25. Estate of McRae, 522 So2d 731, 737 (Miss 1988). 26. Butler v Gleason, 101 NE 371 (Mass 1931). 27. Dillon v Callaway, 1993 WL 42346 (Ind App 1993) (Westlaw cit). 28. Jorgenson L, Randles R. Time out: the statute of limitations and fiduciary theory in psychotherapist sexual misconduct cases . Okla Law Rev. 1991;44:181-225. 29. Sealy LS. Fiduciary relationships . Cambridge Law Rev. 1962;62-140. 30. Ontario Medical Association Section on Psychiatry. Position statement . Ontario Med Rev. (September) 1992:17-24. 31. NY Judicial Law Appendix, Code Prof Resp, Canon 1, DR 1-102(7) (1993). 32. Ore Code Prof Resp, DR 5-110 (1992). 33. Cal Bus Prof Code §6106.9 (1993). 34. Jorgenson L, Sutherland P. Fiduciary theory applied to personal dealings: attorney-client sexual contact . Ark Law Rev. 1992;45:450-503. 35. Kramer v Union Free School District, 395 US 621, 627 (1969). 36. Griswold v Connecticut, 381 US 479 (1965). 37. Aptheker v Secretary of State, 378 US 500 (1964). 38. Hawaii Rev Stat §453-8(a)(9) (1992). 39. Kan Rev Stat Annot §311.597(4) (1993). 40. Johnson SH. Judicial review of disciplinary action for sexual misconduct in the practice of medicine . JAMA . 1993;270:1595-1600.Crossref 41. Second Interim Report of the Legal and Internal Change Subcommittee of the Review and Implementation Committee, College of Physicians and Surgeons of Ontario, Concerning the Report of the Task Force on Sexual Abuse of Patients . Toronto, Ontario: College of Physicians and Surgeons of Ontario; (May) 1992. 42. American Psychiatric Association. The Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry . Washington, DC: American Psychiatric Association; 1992; §2.1. 43. Appelbaum PS, Jorgenson L. Psychotherapistpatient sexual contact after termination of treatment . Am J Psychiatry . 1991;148:1466-1473.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Nov 28, 1994

References