Guidelines
Sexuality in the Physician/Patient Relationship
Any sexualization of the relationship between the physician and the patient is not acceptable. This reaffirms tenets of the Code of Ethics:
Consider first the well-being of the patient.
Treat all patients with respect; do not exploit them for personal advantage.
Physicians should recognize that this relationship is one of trust. All patients should have confidence in the physician's integrity and empathy. Furthermore, a breach of this trust by one physician can adversely affect later therapeutic relationships.
Without limiting the generality of the following, it is considered improper for a physician to undertake any self-gratifying behaviour including sexual intercourse, touching for a sexual purpose, sexual conversation, dating or suggestions of sexual involvement or sexual romantic contact during the course of the physician/patient relationship. It could also include a failure on the part of the physician to show reasonable sensitivity for a patient's need for privacy/territoriality.
The physician/patient relationship is considered to begin at the first attendance of the patient. It is considered to continue at least until there is evidence that the physician is no longer attending. This may be when explicitly stated or implied by the patient seeking and attending alternate sources of care. Nevertheless, the relationship will be considered to remain extant so long as the patient remains vulnerable for a period of time afterward. This period will depend on the potential for the physician to use or exploit the trust, knowledge, emotions or influence derived from the previous relationship. In other words, the physician will remain accountable, in the event such a relationship is questioned, for:
- The patient's perception of events; Whether or not the doctor/patient relationship had ended;
- Any residual emotional dependence from the doctor/patient relationship.
If a physician provides care to a patient with whom there is a pre-existing social/sexual relationship, the conduct is considered analogous to the treatment of family members. As a consequence, it was deemed unethical to provide any care other than in short-term minor or emergency situations only. Medical Act definition:
"sexual abuse" includes
(a) sexual intercourse or any other form of physical sexual relations between the member and the patient,but does not include touching, behaviour or remarks of a clinical nature appropriate to the service provided;
(b) touching, of sexual nature or in a sexual manner, of the patient by the member, and
(c) behaviour or remarks of a sexual nature by the member towards a patient,
6/94; am. 9/99