Former patient dating
Thirdly, a discussion of the role of autonomous choice and consent is presented.
To create the necessary conditions of a safe, therapeutic haven for a patient, a strong fiduciary relationship has to be built. the personality characteristics of the physician independent of the disciplinary knowledge and skill that give rise to Aesculapian power”. Instead of receiving his azathioprine and corticosteroids, he was given a high dose of frusemide and captopril.Whilst having sexual relationships with current patients is clearly unethical, the ethics of such a relationship between a doctor and former patient is more debatable.In this review of the current evidence, based on major articles listed in Medline and Bioethicsline in the past 15 years, the argument is made here that such relationships are almost always unethical due to the persistence of transference, the unequal power distribution in the original doctor–patient relationship and the ethical implications that arise from both these factors especially with respect to the patient's autonomy and ability to consent, even when a former patient.Transferences of transference, linked with the fiduciary relationship and unequal power structure, which makes most relationships with former patients ethically unacceptable (see following sections). [the] special confidence reposed in one who in equity and good conscience is bound to act in good faith and with due regard to the interests of one reposing the confidence”. It has also been suggested that another source of power —Hierarchical power, the power inherent by one's position in a medical hierarchy (e.g. To help understand these four types of power, and the relationships between each type, consider the following incident from my personal experience as a first year house surgeon in Australia in the mid-1980s.
It is important in the doctor–patient relationship that a ‘neutral, safe space' is established which allows a therapeutic alliance to grow. Three salient features describe the circumstances in which this type of relationship occurs: there is an expectation of trustworthiness, an unequal power relationship exists and the interaction occurs under conditions of privacy. Although it does not involve the sexualization of the doctor–patient relationship, it clearly illustrates the importance of recognizing all four types of power, and, in particular, the prominence of Hierarchical power: A consultant specialist was admitted to hospital with a severe multi-system disease causing severe renal impairment.Sexual misconduct usually commences with violations of more minor boundaries:“The road to therapist–patient sex is paved with progressive boundary violations.