The Pros and Cons of Hugging Patients
The physician/patient relationship is intrinsically intimate. During the course of clinical exams, doctors may touch and palpate their patients, ask sensitive personal questions, and sometimes present them with gut-wrenching news. Despite all of that—or perhaps because of it—doctors still debate a simple question.
Is it okay to hug your patients? The answer: It depends.
Given recent months’ numerous accusations leveled at prominent people for alleged sexual harassment and inappropriate behavior, there is a new tone affecting personal interactions. While instances of assault are pretty clear, it’s important to note that behavior which one person considers innocent could be distressing to someone else. More self-scrutiny is required now than in the past.
Doctors care about their patients. A hug is a fundamental physical expression of caring. Ergo it can be appropriate to offer a hug. That's the opinion of Dr Lucy Hornstein, a family physician in Phoenixville, Pennsylvania.
"How much more viscerally and subliminally can you express that you care about someone?" asks Dr Hornstein. "You can say, 'I care about you,' and touch them on the arm or shake their hand, but that's not the same as putting your arms around someone. It's the most primal way of expressing care."
Arguments on the con side of the debate are far more varied. Some worry that a gesture of caring might be misconstrued as a romantic overture or sexual advance, exposing them to charges of harassment or misconduct. Others say that it's unprofessional, may be culturally offensive to some patients, or may be damaging to those who have suffered trauma or abuse. Many of these arguments nibble around the edges of a core objection: Hugging violates the patient's right to not want such contact.
"I guess I'm always the Grinch on this," says Mark Kuczewski, director of the Neiswanger Institute of Bioethics at Loyola University in Chicago, "but it's really a question of thinking about the normal standards of informed consent."
Patients Want to Please Their Doctors
In a clinical exam, patients consent to being touched. They haven't consented to any other intimate contact, however. Although some patients might welcome a hug, others might consider it an invasion of their personal space or a sign of attraction. Despite their discomfort, they're likely to submit to the embrace.
"There's a power imbalance," Kuczewski says. "Patients want to please their doctors. A patient is not going to say, 'Please don't do that.' They are going to go along with it."
Doctors who advocate hugging are aware of the arguments against it, but insist that common sense can alleviate the risk that the gesture might be unwelcome or misconstrued.
"I have been seeing some of my patients for 20-plus years," says Dr Robert Lee, a family physician in Johnston, Iowa. "It would be odd to see someone you've known for 20 years and not give some sort of embrace."
Although Dr Lee says he generally offers a side-by-side shoulder hug, an arm squeeze, or a simple pat on the knee rather than a full embrace, he's conscious about being sure to touch a patient in some way.
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Cite this: Shelly Reese. Should Doctors Hug Their Patients? - Medscape - Jan 03, 2018.