OBJECTIVE: Psychiatrist-patient relationships after termination of treatment .. a romantic involvement with a patient created a duty to defend the psychiatrist as. The relationship is not equal. The psychiatrist knows all about the patient but not the other way az-links.info psychiatrist is in a position of power over the patient. Love and relationships often form the main issues that patients take to their psychologists. As such these professionals are privy to deepest recesses of their .
Sexualization of the doctor—patient relationship: Family Practice ; Introduction All codes of ethics set up by medical professional bodies prohibit sexual relationships between a doctor and a current patient. Although this stance initially provoked a degree of controversy within the country, 2— 6 the deleterious effects of such relationships upon patients have become increasingly recognized and condemned by the medical community.
Can Psychologists Date Patients or Former Patients?
However, some areas of debate do still remain. One such area is whether sexual relationships with former patients are ever ethically permissible and, if so, under what circumstances. First, the concepts of boundaries and transference are discussed and a profile of the medical practitioner at risk of offending is drawn.
Secondly, three aspects of the doctor—patient relationship are explored: Thirdly, a discussion of the role of autonomous choice and consent is presented. Boundaries and boundary violations Many boundaries exist in the doctor—patient relationship.
Can Psychologists Date Patients or Former Patients? | Futurescopes
These include boundaries of role, time, place and space, money, gifts and services, clothing, language and physical contact. This does not mean that no such type of relationship may exist, but it has not been researched.
This suggests that the overwhelming outcome for most, if not all, patients is negative. However, the crossing of boundaries per se does not necessarily mean that an unethical act occurred: Nor do all boundary transgressions between doctor and patient ultimately lead to sexual misconduct.
Clues as to what these other factors should be can be gleaned from examining the profiles of offending doctors. Profiles of doctors who violate boundaries A key factor in the identification of doctors at risk of violating boundaries is the enhanced vulnerability of a doctor to the transference—counter-transference dyad which occurs in varying degrees in every doctor—patient relationship.
Doctors can mistake the feelings of love that arise in a therapeutic relationship as being the same as love that arises elsewhere; it is not. Transferences per se, as with boundary crossings, also occur in normal love relationships, 12 and therefore are also a necessary but not sufficient condition for ethical unacceptability.
However, it is the existence and persistence of this type of transference, linked with the fiduciary relationship and unequal power structure, which makes most relationships with former patients ethically unacceptable see following sections. In turn, to build such a relationship, the unequal power distribution between doctor and patient has to be acknowledged and contained in an ethically correct manner.
When the doctor–patient relationship turns sexual
The onus of responsibility for this last task falls on the person who has the most power in the relationship which, as I will argue, is always the doctor. To explain why this is always the case, even with former patients, it is useful to consider the sources of medical power in light of a framework suggested by family practitioner and ethicist, Howard Brody.
Apart from all these factors, if a psychologist of therapist makes any statements or actions during the course of therapy suggesting or inviting the possibility of a post-termination sexual or romantic relationship with the patient, that is also deemed unethical according to the Ethics Code of the APA. Psychologists are not only prohibited from engaging in romantic or sexual relationship with a current patient and in most cases former patient but it is also unethical for a psychologist to terminate the therapeutic relationship established with a patient in order to pursue a social or sexual relationship with the patient.
When the doctor–patient relationship turns sexual
Possible Consequences The Consumer information page of Association of State and Provincial Psychology Boards ASPPB — an alliance of state, provincial, and territorial agencies responsible for the licensure and certification of psychologists throughout the United States and Canada — states that sexual contact of any kind between a psychologist and a patient, and in most cases even a former patient, is unethical and grounds for disciplinary sanctions3.
Additionally, in some jurisdictions, such activity may constitute a criminal offense. All psychologists are trained and educated to know that this kind of behavior is inappropriate and can result in license revocation.
Why are such relationships considered unethical? To begin with a sexual involvement makes the work of psychotherapy or analysis impossible. 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. 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.Effective Communication Skills to Optimize the Patient-Provider Relationship
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. Well, that may be true, but these situations can still be tricky.
The discussion moves, however, from the realm of sexual abuse into the world of ethics. That changed inhowever, though the council did update its guidelines to include factors a doctor should consider before going down that path.
The problem with rules by regulatory bodies, is that they tend to be broad easy-to-communicate norms that leave little room for nuance. In the real world, each relationship is unique and complex and such rules, however well intentioned, may not apply to all cases.