There are a number of guidelines, developed for the medical profession by the global regulatory authorities, which embed ethical concerns and dilemmas in the event of personal intimacy in doctor-patient relationship.According to Bernstein, ethical concern arises because of potential conflict of interest and loss of objectivity on the part of physicians leading to a compromise in patient care.In our already fragile health care system, would it not prevent a number of adverse social issues resulting from deviant relationship between the care giver and the recipient? I shouldn't have been surprised that the most read posts on this blog have been about doctor-patient sex.Lengthy closed door consultation should be avoided as much as possible especially while dealing with patients from opposite gender. At times, such consultations are unavoidable in psychiatric review, therefore, a family member or a nurse should be present. Beyond adversity: physician and patient as friends? It is important that the Pakistan Medical and Dental Council (PMDC) should devise guidelines for the doctors. The American Psychiatric Association offers some guidelines: If it becomes imperative to terminate the treatment responsibility, a number of steps should be taken: a discussion session with the patient focusing termination, this discussion should include reasons, termination date, availability for emergencies only until date of termination, willingness to provide names of other appropriate therapists and arranging referrals.
Stephen Post describe a number of challenges that are met with in this relationship. Action around Bethlehem Children with Disability (ABCD) is dedicated to improving the quality of life of those children and young adults who suffer from physical, mental and psychological disabilities in Palestine/The Occupied Territories and the Gaza Strip.Omissions by patients can be in the form of not sharing correct information with doctors and by doctors not inquiring about relevant psychological or sexual problems. ABCD sponsors treatment for those in need regardless of gender, race or creed, helping them to reach their full potential, to live life with dignity and to take their rightful place in their community.Confidentiality breaches especially in rural communities is also a major problem, assumptions about patients and counter transference, loss of objectivity especially by heightened emotional involvement and blurred boundaries are few other major challenges. ABCD works through local Palestinian partners, the Bethlehem Arab Society for Rehabilitation (BASR) based in Beit Jala, The Sheepfold in Beit Sahour and two UNWRA Refugee Camps in Jalazone and Nour Shams.Empathy is good for better doctor-patient communication but friendly relationship can lead to ethical complications and hence should be avoided. Specific precautions should be observed in even addressing the patient as the 'terms of endearment' must be avoided, exchange of gifts is another grey area that is widely debated.