Are You Scared to Show Warmth to a Patient?

Arthur L. Caplan, PhD


February 06, 2018

Hi. I am Art Caplan at the Division of Medical Ethics at the New York University School of Medicine. The #MeToo movement is all over the place these days. Women are saying, "I am going to show some unity with my friends. I have been harassed in the workplace." Obviously, many celebrities, notable people, politicians, media figures (men, in general) have been, if you will, outed for sexual misbehavior—some many decades ago, some more recently.

It has clearly made the workplace a heightened sensitivity zone and it raises interesting ethics questions for physicians and other healthcare workers: How do you deal with patients? How do you deal with patients' families? What is appropriate? What is inappropriate when it comes to dealing with sexual boundaries, whether you are talking to a woman or whether you might be talking to a man?

My own view is that while we want to be sensitive and aware that women have had a lot of reasons to complain about sexual contact, people basically treating them as nothing but sexual objects, times have changed. Certainly in the 1940s and 1950s, what people thought was okay in the workplace is not okay today. Still, the idea that physicians and healthcare workers would not be able to ever touch a patient, or that they would not be able to compliment a patient, is going a bit too far.

What I mean is, there are times when someone loses a loved one and you are thinking, can I hug that patient, the patient's family? I think it is appropriate. It is never wrong to ask if it is okay, if you are worried about it. The idea that you are not going to have any physical contact with the people you are caring for, or their family members and friends, is setting the boundary too tightly.

Part of the way we get emotional contact and show empathy and sympathy for others is to give them a hug or to put a hand on their shoulder. Not every context is sexual. People will understand what is going on when you are doing something in front of others in a hospital setting. I am not saying that we should be dishing out hugs in the office with the door closed. That is clearly not appropriate. When you are in situations in which you are trying to use contact and physical interaction as a way to show concern and empathy, that should be preserved.

I think the idea of complimenting people ought to be preserved as well. People—both men and women—dress to try to elicit compliments, to try to make themselves look good in front of others. There is nothing wrong with that. It's how you do it. Let's face it: If you are leering and making suggestive comments, that is not a compliment. If somebody says, "I like the way your dress looks today. I like the way your jewelry looks," I think that is ordinary social discourse and there ought not to be offense taken.

I know that some will still say that it makes it dangerous when there are power differences. But if you say, "I would like to give you a compliment just because I think the bracelet you are wearing is pretty," you are opening the door again to saying, " I am just trying to be sociable; I am just trying to make sure that we have human interactions as well, and I recognize something about you, that you are presenting yourself in an interesting, attractive manner."

I am the first person in line to say, "Look, we have to change attitudes about how men treat women in the workplace. We have to be sure that women do not feel coerced, that they do not feel manipulated, that they do not feel abused, that they do not feel like people are taking advantage of power differentials between, say, older docs and younger docs."

I do not think we want to go as far as to say that there should be no touching, no talking at all in the physician, healthcare, or hospital workplace. That is just taking things too far. It is removing, if you will, a style of contact that I think brings a doctor and patient closer together. It should not always be seen as something that drives them apart or raises a question about moral propriety.

I am Art Caplan at the Division of Medical Ethics at NYU. Thanks for watching.


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