Professional Boundaries in the Physician-Patient Relationship
Gabbard, Glen O.
JAMA. 1995 May 10; 273(18): 1445-1449.
The subject of professional boundaries (and boundary violations) has received a great deal of recent attention in the psychiatric literature. The emphasis on defining guidelines for professional conduct has expanded beyond the confines of ethics committees and has worked its way into licensing boards charged with disciplining physicians whose behavior jeopardizes the well-being of patients. The Massachusetts Board of Registration in Medicine, for example, has recently issued detailed guidelines on such matters as self-disclosure, dual relationships, sexual relationships with patients, and other professional boundaries to help define for the public and for the profession the parameters of professional conduct in the practice of psychotherapy by physicians. While specialists in psychiatry have been debating the pros and cons of issuing such guidelines, nonpsychiatric physicians have yet to involve themselves so extensively in similar discussions. In this article, we will provide a conceptual framework for discussion of professional boundaries in the physician-patient relationship and offer our view of measures the profession can take to prevent serious violations of these boundaries. We will use instances from our own clinical experiences or those of our trainees to illustrate the relevant issues.
Communication; Disclosure; Education; Ethics; Ethics Committees; Females; Fraud; Gifts; Guidelines; Literature; Males; Medical Education; Medicine; Misconduct; Organizational Policies; Organizations; Patients; Physician Patient Relationship; Physicians; Professional Organizations; Professional Patient Relationship; Psychiatry; Psychotherapy; Sexuality; Social Dominance; Social Interaction; Trust;
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