Is It Becoming Okay to Date a Patient?

Shelly Reese

Disclosures

December 23, 2018

In This Article

Emphasis Placed on Consent and Intent

The debate over the ethics and professionalism of physician-patient romance is far-ranging and complex, and age and gender appear to be important factors in determining individuals' views. Male physicians are far more likely than female doctors to say that dating a current or former patient is or might be acceptable (40% vs 28%). Older physicians—who are more likely to be male—likewise showed greater openness to the idea of dating a former patient. Midcareer doctors (between the ages of 40 and 54 years) were the least likely to condone doctor-patient romance, whereas older doctors were the most likely to accept the practice. Roughly 3 out of 10 survey respondents older than 65 years said dating a current or former patient was acceptable.

Are female physicians more attuned to the #MeToo movement and more sensitized to power imbalances in relationships? Are older doctors more open to dating former patients because they may not have seen those patients in a clinical setting for decades, or do their responses reflect a generational difference? Although it's impossible to draw specific conclusions, many physicians' comments seem to reflect trends playing out in society as a whole.

For many years, respondents to the Medscape ethics surveys cited the lack of potential romantic contacts in rural practice settings, an extended period between treatment and an eventual romance, and episodic care (such as a trip to the emergency department for a broken arm) as reasons why romance with a patient might be acceptable in some circumstances. Those arguments are still the most prominently cited in the 2018 results, but they're accompanied by numerous comments that focus more on the would-be romantic partner's consent.

A number of respondents felt that because becoming romantically involved with a patient is a serious matter, consent is not enough. They qualified their answers by noting physicians should be single; relationships should not be based solely on sexual attraction; and, as one wrote, "the intent is courting with the hope or expectation of marriage."

Ethicists and Lawyers Weigh In

Ethics are important, but so is the specter of being reported and called before a medical disciplinary board. For most physicians, that threat trumps any issues of romance or ethical boundaries.

Arthur Caplan, PhD, head of the Division of Medical Ethics at NYU School of Medicine, suggests that the emphasis on consent and intent in this year's responses may be a reaction to events playing out on the national stage.

The past 2 years have been dominated by the #MeToo movement, the Brett Kavanaugh hearings, the Access Hollywood tape featuring President Donald Trump, high-profile celebrity controversies, and sex abuse scandals surrounding team doctors for USA Gymnastics and Ohio State. In focusing on consent and intent, respondents are probably trying to clarify their positions and differentiate the scenarios they are describing from the controversies being played out in the headlines.

"Their focus is on sincere and legitimate relationships," Caplan says. "They want to make it clear that it's not acceptable to take advantage of someone, so they're saying, 'If your intent is noble and pure, you're probably okay.'"

But the matter is not that simple, he says. Not by a long shot.

"Sex and romance is probably one of the most complicated areas of moral life for doctors—and everyone else, for that matter," Caplan says. "I think we are more willing to talk about this than we were before."

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