Sexual Boundaries Between Doctors and their Patients - 1994. Revised 2012
Doctors have an ethical and legal duty to maintain appropriate professional boundaries with their patients. The Position Statement on Sexual Boundaries Between Doctors and their Patients 2012 provides guidance to doctors on maintaining appropriate boundaries with patients, former patients, and patients' carers and close family members.
1. Doctors have an ethical and legal duty to maintain appropriate professional boundaries with their patients. Professional boundaries facilitate trust, support good care, and protect both doctors and patients. Doctors should not use their professional position to establish or pursue a sexual, exploitative, or other inappropriate relationship with patients.1 A doctor who breaches the professional boundary may risk the patient’s trust in the doctor, cause psychological damage to the patient, compromise the patient’s medical care, and undermine the trust and confidence that other patients and the wider community have in the medical profession. Doctors should familiarise themselves with relevant guidelines of the Medical Board of Australia, as published from time to time.
2. Sexual boundaries are an important component of wider professional boundaries. In order to maintain appropriate boundaries, a doctor should not engage in sexual activity with a current patient (regardless of whether or not the patient has consented), make sexual remarks, touch patients in a sexual way, or engage in sexual behaviour in front of a patient.1
3. Effective, culturally appropriate communication between doctor and patient is essential to avoid any misunderstanding that might be misconstrued as inappropriate sexual behaviour by the doctor (in some circumstances, an interpreter may be required). Before conducting an examination, particularly an intimate examination, the doctor should ensure the patient has given consent. The patient should understand the reason for the examination and how the examination will be conducted. The patient should be provided with a private space to undress.
4. A doctor should not conduct an examination if the patient does not consent or where consent is uncertain. In these circumstances, the doctor should reiterate the importance of the examination with the patient. If practical, and with the patient’s consent, the doctor may offer the patient a chaperone or support person. If the patient continues to refuse to consent to the examination, the doctor should defer the examination or refer the patient to another doctor. The patient’s refusal to undertake the examination should be included in the medical record along with any relevant discussion between doctor and patient. The doctor should record the recommended course of action.
5. If an examination is in progress and the patient withdraws consent, the doctor should cease the examination immediately. The doctor may wish to defer the examination or refer the patient to another doctor. The patient’s withdrawal of consent should be recorded in the medical record along with any relevant discussion between doctor and patient. The doctor should record the recommended course of action.
6. Doctors should allow for a chaperone to accompany the patient during an intimate examination (where the patient has consented to this). When not possible or appropriate, a support person may be used. Doctors should note in the patient’s record the chaperone’s name or the support person’s name and relationship to the patient.
7. There may be circumstances where a patient displays inappropriate sexual behaviour towards the doctor. The doctor should attempt to re-establish appropriate professional boundaries; however, in certain circumstances the doctor may decide to end the therapeutic relationship and transfer care to another doctor. The doctor should note the patient’s behaviour and any decisions regarding the therapeutic relationship in the patient’s medical record.
8. A doctor should not solicit or engage in a sexual relationship with a patient’s carer or close family member (such as a spouse or parent of a child patient) as this may compromise the patient’s trust in the doctor.
9. It may be inappropriate for a doctor to engage in a sexual relationship with a former patient if this breaches the trust the patient had in the doctor at the time of the therapeutic relationship.1
10. Doctors who breach sexual boundaries with their patients, their patients’ carers or close family members, or their former patients may be in breach of the Health Practitioner Regulation National Law Act (the National Law) and subject to investigation by the Medical Board of Australia.1
* The references are contained in the attached PDF.
Published: 05 Jun 2012