Exclusive Ethics Survey: Is It Ever Okay to Date a Patient?

Paul Cerrato, MA

Disclosures

December 14, 2010

Still, Temptations Abound

There's no doubt that physicians, both male and female, are often tempted to become involved with patients. Also, physicians are well aware that patients often try to initiate such a relationship. Many of our respondents freely admitted to such temptations with comments, such as the following: "Although there would be temptations, you would know you had crossed the line you were never supposed to cross"; "There is always a temptation with the 'right' patient, but that is always the wrong thing"; and "I'm married! I have been tempted but have never strayed in 48 years of medical practice and marriage."

Once again, the theme in many of these comments was simply: Being tempted is one thing, but you cannot cross that line. One doctor, for instance, said that getting romantically involved with a patient would be a disaster, and went on to state: "Even in my 35 years of practice going way back, temptations and approaches were always there to deal with, but I believe that if one crosses that line, they compromise their ability to deliver the best care to the patient." Another took a similar tone: "I would strictly guard against any entanglement, and if I felt tempted would resign as that person's physician."

"It Depends on Circumstances"

Several respondents said that it may be acceptable to have a romantic or sexual relationship with a patient in certain situations. Medical specialty was a key factor, according to several physicians. One respondent believes that it would never be appropriate for a psychiatrist, but "for general surgery, potentially at a time greater than 6 months and depending on the nature of the professional relationship."

Some believe that specialties, such as dermatology, radiology, and emergency medicine, may likewise be exceptions to the rule if the care provided was brief. One physician said: "If the physician-patient relationship were of a very minor nature (removal of a skin lesion or writing a prescription) and only occurred once or twice, then the social relationship might be OK...."

The issue of how long to wait before getting involved with a former patient was on the minds of several physicians. Almost 12% of respondents considered it acceptable to start a romantic relationship after 6 months.

However, many believed that the cutoff period was too short. Several said that 1 or 2 years was more reasonable, whereas others referred to their state's guidelines on the matter. Once again, the nature of the professional relationship dictated to some extent the amount of time that seemed appropriate. The example that Dr. Goodman mentioned was that of a pathologist who simply reads a slide but has no contact with the patient: "Waiting 6 months before getting romantically involved with such a patient might be standing on ceremony."

A few respondents seemed to have no moral scruples about having a sexual relationship, even with a current patient. One stated that it would be ethically acceptable "if I were single and lived and practiced in a rural setting in which companionship was very limited."

There apparently are situations in which such a relationship works out to have a happy ending. One physician wrote, "I did, and 30 years later, we are together and happy."

Self-interest Is Also a Factor

In a similar vein, a few respondents that said they would avoid romance with a patient because they would get into too much trouble. One doctor commented, "Doing so risks your medical license, so I don't see how this is a gray area."

Despite these infrequent comments, the position taken by the vast majority of respondents reflects the keen moral sense of the vast majority of physicians, as these remarks indicate:

A patient is like family, so it's never right." "It is unfair to take advantage of your social position." "The patient is a patient is a patient. That is the only relationship a physician should have with any patient. This should involve agape, but never Eros.

All of which is another way of stating what Dr. Francis W. Peabody once said: "The secret of the care of the patient is in caring for the patient."

See also:

Exclusive Ethics Survey Results: Doctors Struggle With Tougher-Than-Ever Dilemmas

Physicians' Top 20 Ethical Dilemmas - Survey Results Slideshow

Exclusive Ethics Survey: "Should I Keep This Patient Alive?"

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