Former patient dating
Sexual misconduct usually commences with violations of more minor boundaries:“The road to therapist–patient sex is paved with progressive boundary violations.Except when a patient is raped, the therapist who eventually sexually abuses a patient follows a remarkably predictable ‘natural history' of sexual misconduct.” Not all stages will take place in any one relationship, but the general stages include: gradual erosion of therapist neutrality; socialization of therapy; the patient is treated as ‘special'; doctor's self-disclosures begin; physical contact begins (e.g.Thirdly, a discussion of the role of autonomous choice and consent is presented.
These include boundaries of role, time, place and space, money, gifts and services, clothing, language and physical contact.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.This does not mean that no such type of relationship may exist, but it has not been researched.This suggests that the overwhelming outcome for most, if not all, patients is negative. the specific impact of a particular boundary crossing can only be assessed by careful attention to clinical context”., the analysis has to examine other factors.
First, the concepts of boundaries and transference are discussed and a profile of the medical practitioner at risk of offending is drawn.