Respecting Boundaries

by College of Physicians and Surgeons of Prince Edward Island on Apr 30, 1999

Respecting Boundaries


Introduction

The vast majority of medical doctors are caring men and women who try to serve their patients with respect.

Medical doctors have a professional Code of Ethics which has been developed to guide the behaviour of all members of the profession.  One serious violation of the Code is the sexual exploitation of a patient by a medical doctor.  Sexual exploitation occurs when the medical doctor is involved with a patient in any sexual manner.

Patients may see the medical doctor as a helper or as a focus of authority and as a result may feel an emotional dependence or physical attraction to their medical doctor.  It is never "OK" for  a medical doctor to respond in a sexual way.  It makes no difference if you, the patient agree to any act or actively participate in any act; the medical doctor is always responsible to stop the development of any romantic or sexual relationship.

Inappropriate involvement may include (but may not be limited to) acts such as:
  • sexually suggesting or demeaning language;
  • dating or "romancing" (e.g. gifts or other special treatment);
  • sexual touching, kissing;
  • ending the medical doctor/patient relationship in order to become romantically involved;
  • suggesting that sex with him/her is a solution to the patient's problems; and
  • sexual relations.

Respecting Boundaries

In a sound medical doctor/patient relationship, both the medical doctor and patient have the need to preserver their "private space."  Both have boundaries to their space.  These boundaries are different for each person and the medical doctor should be sensitive to your boundaries.  For example, you have the right to ask the medical doctor to have a chaperone present.

There are some warning signs which may alert both the medical doctor and the patient that boundary crossing has occurred.  Both the medical doctor and the patient should be aware of them.

Warning Signs

Crossing professional boundaries usually recedes deliberate sexual impropriety.  Conduct which may suggest boundary crossing includes:

Medical doctors giving the patient special status by:
  • scheduling appointments or arranging meetings -
    • after hours or outside the office;
    • when others are not aware, or
    • when it is not the usual procedure;
  • using the patient as a confidant or for personal support;
  • giving or accepting gifts;
  • inviting the patient to social engagements;
  • borrowing money or getting involved in business deals with patients;
  • confiding a secret to the patient or making secrecy a part of the medical doctor/patient relationship; or
  • inappropriate prescribing of drugs or giving samples of drugs which may not be appropriate for the patient's condition.

Behaviour which may feel sexual:
  • suggesting, demeaning comments;
  • dirty jokes;
  • unnecessary discussion of a patient's sex life;
  • ogling (eyeing up and down); or
  • discussing the medical doctor's sex life.

What Can Be Done

If you are concerned about what you are experiencing, trust your intuition/judgment if you have been subjected to sexual exploitation.

If you are uncomfortable with any comment or behaviour, then tell the medical doctor.  If you are too embarrassed to do so, then tell the nurse.  It is important for the medical doctor to know how you feel.  Do not hesitate to discuss your concerns with other trusted individuals.

You have the right to ask the medical doctor to have a chaperone present (usually the practice nurse) during an examination.  If your medical doctor does not have a chaperone available, then you may prefer to supply your own or not proceed with the examination.  The medical doctor may also prefer that a chaperone be present during an examination.  If the presence of a chaperone is waived, a notation of same should be made in the chart.

A sound medical doctor/patient relationship requires mutual trust and respect.  The patient should not expect to promote a personal relationship with the medical doctor.  As a patient you can increase your power by becoming familiar with the warning signs and by trusting yourself.  Question any acts which don't feel right to you...your medical doctor wants you to be informed and secure in the medical doctor/patient relationship.

If Exploitation Occurs

Depending on the circumstances, you may wish to file a complaint with:
  • the College of Physicians and Surgeons of Prince Edward Island,
  • the Police or RCMP detachment in your area, or
  • the civil courts (through a lawyer).

How to Complain to the College

You may contact the Registrar at our office by telephone.  The Registrar will talk with you about your concerns and assist you in filing a written complaint.  A personal interview can be arranged and you may bring a support person with you.  You do not need a lawyer to file a complaint with the College.