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Year : 2019  |  Volume : 8  |  Issue : 5  |  Page : 1809  

Sexual boundaries in the doctor–patient relationship

Department of Psychiatry, Iqraa International Hospital and Research Centre, Calicut, Kerala, India

Date of Web Publication31-May-2019

Correspondence Address:
Dr. N A Uvais
Department of Psychiatry, Iqraa International Hospital and Research Centre, Calicut, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jfmpc.jfmpc_312_19

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How to cite this article:
Uvais N A. Sexual boundaries in the doctor–patient relationship. J Family Med Prim Care 2019;8:1809

How to cite this URL:
Uvais N A. Sexual boundaries in the doctor–patient relationship. J Family Med Prim Care [serial online] 2019 [cited 2020 Jul 4];8:1809. Available from: http://www.jfmpc.com/text.asp?2019/8/5/1809/259435

Dear Editor,

I read the editorial titled “Physicians and healthcare professionals in the era of #Metoo” with interest.[1] The authors discussed possible areas of gender-based violence (GBV) in the healthcare setting and recommended preventive strategies. As the authors correctly pointed out, primary prevention is the most cost effective and efficient method in addressing this complex problem. Preparation of proper guidelines and educating healthcare professionals regarding the various aspects of GBV and sexual boundary violation are essential steps in prevention. Recently, Indian Psychiatry Society along with the Bangalore Declaration Group - a team of doctors across various medical specialties in India - has come up with a set of guidelines for doctors on sexual boundaries to train them on what is ethically right and wrong.[2] The guideline specifically addresses unhealthy relationships with patients, particularly in the sexual context. The guideline highlights the power gradient that exists in the doctor–patient relationship and put the onus on the doctor to ensure that he or she does not enter into an romantic or sexual relationship with a patient and exploit the doctor–patient relationship for sexual gain.[3] The guideline also remind doctors 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.[3] The guideline also recommend that sexual history taking and relevant physical examination should be done sensitively and documented properly in the notes. During intimate examination or when the patient need to be sedated, a nurse or a chaperone should be present.[3] It also demands doctors to ensure that they use social media responsibly, as it can inadvertently lead to a blurring of professional boundaries.[3] The guideline also lists the legal provisions when someone fail to follow these guidelines. Toward the end, the guideline also addresses the importance of showing similar care when interacting with students, colleagues, or anyone who is in a “power imbalanced relationship” with the doctor. Finally, the guideline also recommends doctors to be aware of false allegations, warning signals, and risk situations and highlights the importance of reaching out to a colleagues for support if the doctor finds him/herself in the midst of an allegation.[3] To conclude, having such a guidelines helps medical professionals to realize that boundary violations are unacceptable and it could work at least as a deterrent in Indian context.

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There are no conflicts of interest.

  References Top

Khubchandani J, Kumar R, Bowman SL. Physicians and healthcare professionals in the era of #Metoo. J Family Med Prim Care 2019;8:771-4.  Back to cited text no. 1
[PUBMED]  [Full text]  
Kurpad SS, Bhide A. Sexual boundaries in the doctor-patient relationship: Guidelines for doctors. Indian J Psychiatry 2017;59:14-6.  Back to cited text no. 2
[PUBMED]  [Full text]  
Indian Journal of Psychiatry [Internet]. Guidelines for doctors on Sexual boundaries Version 3.4. IPS Task Force on Boundary Guidelines, 2016. Available from: www.indianjpsychiatry.org/documents/Guidelines.docx.  Back to cited text no. 3


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