Guidelines for doctors on boundaries with patients

Puts emphasis on sexual relationships

April 06, 2019 10:11 pm | Updated 10:11 pm IST - NEW DELHI

Subject: A stethoscope in dramatic lighting.

Subject: A stethoscope in dramatic lighting.

Recognising patients as a particularly vulnerable group and understanding the need for specific guidelines on sexual boundaries for doctors, the Indian Psychiatry Society (IPS) along with the Bangalore Declaration Group (a team of doctors across various medical specialties in India) have come up with a set of guidelines, for the first time, to direct doctors on what is ethically right and wrong.

Posted on the Medical Council of India’s (MCI) website, the guidelines, initially meant for the IPS’ members, specify that doctors “must not enter into unhealthy relationships with patients, particularly in the sexual context.

Finalised in 2016, they are now available to doctors across India, and seek to protect family members of patients, too. “It is important for the doctors to know their boundaries in being intimate with a patient, both physically and mentally. Non-consensual sexual activity is a crime but doctors agree that even consensual sexual activity in a power-imbalanced relationship like that of a doctor and patient is not truly consensual,” explained Dr. Ajit. V. Bhide, chairperson of the task force that framed the guidelines.

Trust important

The 15-point guidelines begin with: “The ethical duty of all doctors is to ensure effective care for their patients. This would mean that their own conduct should in no way harm their patient. Sexual relationships between doctors and patients invariably harm both the patient and the doctor. Trust, which is central to an effective doctor-patient relationship, is inevitably damaged. In view of the power gradient that invariably exists in the doctor-patient relationship, the onus is on the doctor to ensure he or she does not enter into a romantic or sexual relationship with a patient.”

The guidelines, which aim to be gender neutral and serve both doctors and patients of all genders, further state, “Doctors are reminded that even a relationship with a former patient is discouraged and could be construed as unethical, as the previous professional relationship can influence the current relationship.”

Doctors should use social media responsibly, the guidelines add

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