The Physician-Patient Relationship
Tahira Duncan
Drexel University
Abstract
Sexual contact that occurs concurrent with the patient-physician relationship is considered to be sexual misconduct. The Hippocratic Oath prohibits such relationships. The Oath is deeply rooted in first do no harm. By violating beyond the boundaries in a patient-physician relationship it cause harm to the patient.
Boundaries: The limits of appropriate behavior by a professional toward his/her client.
Transference: Of which a patient is usually unaware and/lacking insight into its significance.
Undue Influence: A judicially created defense to transactions that have been imposed upon weak and vulnerable persons that allows the transactions to be
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Patients often don’t know they have been violated usually until after interactions between patient and physician either fail or don’t work out in favor of the patient.
Sexual Misconduct Scenario:
I 've been involved with my physician for a couple of months now. There are a lot of factors which make the relationship wrong - mostly on his side: a huge age gap, his marriage & family, the fact that he 's a doctor. He also knows my father, who is a fellow doctor, and the relationship started right when I practically committed suicide. It might be a stupid question, but did he take advantage? I am fully in my right mind and did not feel abused in any way, but I suppose psychology would show that there must be some part of me that was taken advantage of. We started the relationship and after a few days, it dwindled. Now I feel abandoned and used.
The fact that the patient noted that she was fully in her right mind brings into play informed consent. Can a patient truly give consent to a sexual relationship with their physician? Considering “undue influence” a patient can’t soundly give consent to having sexual intercourse with a doctor. They lack the knowledge due to transference. Next, non-maleficence and beneficence, the Hippocratic Oath teaches, do no harm. There is a great risk to do potential harm to a patient especially by entering into a sexual relationship with them. Much of
Exploiting patients is also discussed and can be called into question. When presenting examples or discussing patient’s certain information should never be disclosed due to HIPPA laws as well as confidentiality.
The resident physician violated confidentiality, because when he left the patient’s room and made a comment about “She-male,” everyone in that vicinity may have overheard him. Only the health care professional taking care of him should know about the patient being
The doctors in this story preyed on the ignorance and emotions of others when consent was necessary. For
The proper tort for complete failure of consent is called battery. Battery is intentional unpermitted touching. It boils down to is the healthcare professional needs to discuss with patient and get consent.
Moreover, the physician liaison would be responsible for regular and steady communication with providers concerning how our hospital can assist their practice. The liaison will also entice referring physicians that are rank high with communication appointments over a meal paid for by the hospital. Finally, the liaison will arrange thoughtful and appropriate gifts for referring physicians during specific and fitting times of the year.
De Bord, J. (2014). ETHICS IN MEDICINE University of Washington School of Medicine. Retrieved from https://depts.washington.edu/bioethx/topics/consent.html
This information must be easy for the patient to understand and must also be correct and truthful (RCN 2013). The Department of Health define consent as allowing a capable individual to make their own decisions about their health care without being pressured into making any decisions from others such as friends, family and health care professionals. In the adult nursing field it is legal and ethical to gain valid consent before starting a medical procedure, or providing care. This shows that the individuals rights have been respected which is good practice. If a healthcare professional did not respect an individual’s choices they could be accountable to legal proceedings. In common law touching or performing an act of care on a patient without valid consent can be classed as a criminal offence or battery. If a healthcare professional was not following the legal practice regarding consent then the individual may be faced with a criminal offence and disciplinary action will take place (Dimond 2009). The Human Rights Act states that all healthcare professionals should never judge an individual on their sex, race, religion, social origin, language or any other status.
There are many social factors that can impact on the Doctor Patient relationships everything from race to gender. To break it down and find five, I started with Doctors personal views he is under pressure to be ethical when he may not entirely be accepting of a person’s beliefs or sexuality. For instance a doctor may be homophobic and have a patient attend surgery asking for advice on practicing safe sex and being HIV aware. Following on from this may be a patients confidence in doctors due to race for example a person who has racist issues would not feel comfortable attending a foreign doctors surgery. To find a third I would have to say gender being a female I tend to talk easier to a female doctor, which persists problems as my female doctor only works three days a week so I put off going to see the male doctor so therefore remain ill longer. My fourth factor is age, as the doctor could be old and the patient adolescent. This would impact on different generations living different lifestyles and changing societies. “Adolescence is indeed a tempestuous period”, (Thorne, B & Lambers.1998). Finally I find language barriers a major social factor as if you can’t understand what your doctor is saying to you it has complications in treatment and there is not always a translator available.
When confidential patient information is disclosed without consent it is a violation of the HIPAA Title II Security Rule. This rule was enacted in response to private information being leaked to the news and emails containing privileged information were read by unauthorized people. Identity theft is a real concern so patient privacy should be taken seriously. This is a rule can easily be broken without the
According to the Oxford Dictionary consent is defined as ‘giving permission for something to happen or agreeing to do something’. They define confidentiality as ‘entrusted with private information and if something is intended to be kept secret or in confidence’ (Soanes and Hawker, 2005). As a healthcare professional consent and confidentiality are in place as protective vices, by gaining consent and keeping a patients confidentiality it protects both the patient and the healthcare professional. There are three types of consent: Verbal consent, consent in writing and implied consent. Depending on the situation each type of consent may not be acceptable. For example if a procedure is putting a patient at risk, is complex or invasive for example an operation, written consent is
In our report we show the importance of patient provider relationships and the impact of the patient centered relationships.
“ I will pass my life and practice my art, into whatever house I enter, I will go in to them for benefit of the sick, will abstain from every voluntary act of mischief and corruption and from the seduction of females or males of freeman and slaves.” (Surg,2) This should be pretty much self explanatory, the physician should treat all patients regardless to their background and should refrain from using their position to gain benefits and to satisfy sexual desire.
Doctor/patient confidentiality is a long-held tradition. The Hippocratic Oath, which dates back to the 4th century B.C.E., recognizes this belief. The Hippocratic Oath is a pledge that many medical school students recite upon their graduation. The traditional version of the oath states: "Whatever I see or hear in the lives of my patients, whether in connection with my professional practice or not, which ought not to be spoken of outside, I will keep secret, as considering all such things to be private."[1] The statement means that a doctor will keep the patient 's healthsecrets.
Medical conduct is a crucial part of the industry so much that some health professionals who take the Hippocratic Oath. Although this is not mandatory for all health staff, the basis of the pledge should be essential for members of the healthcare field. According to Stonehouse (2015), It’s significant to always maintain a high standard of care by exemplifying good judgment and competency always. Although medical professionals are aware of the importance of appropriate medical conduct, some individuals who will violate the code of conduct. Anyone who does not abide by the guideline will suffer the repercussion of his or her behavior. Possible consequences may include termination, inability to obtain future employment and the more severe litigation.
In William Carlos William’s short story, “The Use of Force”, the plot is unassuming. A physician is telling the story about his efforts to save a child, named Mathilda, from herself in addition to his efforts to protect an entire community from the tragic and fatal effects of diphtheria. In the story, Mathilda seeks to avoid seeing a physician or risking any type of exam or diagnosis. Upon deeper examination, the story is much more multifaceted than a simple appraisal of two characters’ motivations. “The Use of Force” portrays a character contest between a stubborn child, Mathilda, and the devoted physician who is narrating the story; the prize, won by the physician, is control, health, and perhaps even