This is an ethical question that arises for surgeons who develop romantic feelings for a patient. There are no universal rules prohibiting surgeons from dating former patients, but there are ethical concerns due to the power imbalance in the prior doctor-patient relationship. Surgeons are expected to maintain professional boundaries, and dating a former patient could be seen as violating those boundaries. However, with the right precautions, a romantic relationship may be possible after sufficient time has passed since the end of the professional relationship.
Quick Answers
– There are no universal laws prohibiting surgeons from dating former patients, but medical ethics discourage it due to the power imbalance in the prior relationship.
– Romantic relationships with former patients are frowned upon until a reasonable amount of time has passed since the end of the doctor-patient relationship.
– Surgeons must be sure there is no longer a power imbalance or appearance of one before pursuing a romantic relationship with a former patient.
– It is advisable for surgeons to consult their institution’s ethics guidelines or get an ethics consultation before dating a former patient.
– Surgeons who date former patients must be prepared to address scrutiny from colleagues and the public over whether it was ethical.
Medical Ethics on Doctor-Patient Romance
Medical ethics discourage but do not strictly prohibit romantic relationships between physicians and patients. The American Medical Association’s (AMA) Code of Medical Ethics offers guidance in Opinion 8.14, “Sexual Misconduct in the Practice of Medicine.” The opinion states that “romantic or sexual interactions between physicians and patients that occur concurrently with the patient-physician relationship constitute sexual misconduct.”
This is due to the inherent power imbalance between doctors and patients. Patients are in a vulnerable position and dependent on physicians for care. There is concern that patients may have difficulty refusing romantic advances from someone they depend upon. Physicians are expected to maintain appropriate professional boundaries.
However, the AMA does not prohibit physicians from eventually developing romantic relationships with former patients. The same opinion states that “sexual or romantic relationships between a physician and a former patient may be unethical if the physician uses or exploits trust, knowledge, emotions, or influence derived from the previous professional relationship.”
So while not categorically prohibited, romantic or sexual relationships with former patients are discouraged. Doctors must be sure there is no longer any evidence of exploitation resulting from the prior patient-physician relationship.
Other Medical Organizations’ Positions
The American College of Physicians’ (ACP) Ethics Manual states that “relationships with former patients may be unethical, depending on the individual circumstances.” The ACP advises physicians to seek guidance from a medical ethics committee in such situations.
The American Psychiatric Association specifically prohibits psychiatrists from having sexual relationships with former patients, even many years after termination of care. This stricter stance is due to the uniquely intimate nature of the psychiatrist-patient relationship.
The American College of Surgeons states in its Statements on Principles that “surgeons should avoid romantic relationships with patients under their care.” They do not offer definitive guidance on former patients.
Factors to Consider on Surgeon-Former Patient Romance
There are several factors surgeons should carefully consider when evaluating the ethics of pursuing a romantic relationship with a former patient:
– **Time since treatment ended** – Sufficient time should have elapsed since the doctor-patient relationship ended. This reduces likelihood of residual influence, power imbalance, or feelings arising from the patient’s vulnerability during care. At minimum, a year or two should have passed, but longer may be advisable.
– **Circumstances of professional relationship** – The context of the prior doctor-patient relationship affects ethical considerations. For instance, a brief surgical procedure involves less intimate knowledge and trust than a psychiatrist seeing a patient for therapy over many years.
– **Who initiated romance** – If the surgeon initiates romance soon after care ends, it raises concerns about exploitation of the former professional relationship. It is less ethically problematic if the former patient initiates romance long after the professional relationship has ended.
– **Policies at institution** – Surgeons should check if their hospital or practice has specific policies governing romance with former patients and adhere to those policies. Violating institutional ethics policies could put the surgeon’s job at risk.
– **Power differential** – Surgeons should carefully evaluate whether there is still an inherent power imbalance based on their position that could influence the former patient’s choices.
– **Public perception** – Surgeons should consider how the public and their peers would perceive a relationship with a former patient, even if all guidelines were strictly followed. Public scrutiny is possible.
– **Former patient’s needs** – While consenting adults, surgeons should evaluate if a former patient has recovered fully from any conditions that caused vulnerability, so a relationship is not inadvertently exploitative.
Getting an Ethics Consultation
Given the complex considerations involved in initiating a romantic relationship with a former patient, it is advisable for surgeons to seek guidance from their hospital or practice ethics committee. An ethics consultation can help objectively assess the context and make recommendations on whether pursuing the relationship would be ethical or not.
Documenting that an ethics consultation took place also helps demonstrate the surgeon’s thoughtfulness and desire to adhere to ethical principles before entering such a relationship.
Addressing Scrutiny of Surgeon-Former Patient Romance
Surgeons who decide to enter romantic relationships with former patients must be prepared for scrutiny from colleagues and the public:
– **Be transparent when questioned** – Avoid appearing evasive or unethical. Explain the steps taken to ensure an appropriate interval of time passed and that no power differential exists.
– **Consider public perception** – Accept that some may find the relationship inherently questionable, even if performed ethically. Weigh the potential professional reputation effects.
– **Highlight former patient’s consent** – Make clear the former patient enthusiastically consents to the romance without any pressure or inducement from the power of your prior role.
– **Share details judiciously** – Be cautious in sharing private details about the relationship widely in the interest of the former patient’s confidentiality wishes.
– **Mention ethics consult** – Volunteer that guidance was sought proactively through an ethics consultation prior to dating the former patient.
– **Have a thick skin** – Those who frown upon surgeon-former patient relationships may still criticize or gossip about the decision. Try not to take it personally.
– **Focus on current role** – Demonstrate full commitment to fulfilling current duties as a surgeon, without letting scrutiny over your personal life hinder your professionalism.
Establishing Boundaries as a Romantic Partner
To ethically date a former patient, the surgeon must establish clear boundaries in the new romantic role:
– **Keep medical advice professional** – Refrain from offering any medical opinions or advice in the context of the romantic relationship, even informally. Refer them to their current physician.
– **Do not access medical records** – Respect the former patient’s privacy and refrain from looking up their medical charts or records without specific consent.
– **Maintain confidentiality** – Keep all medical and personal details learned during care confidential. Do not share these with new romantic partner without permission.
– **Avoid special treatment** – Do not grant special perks or advantages in medical care to a romantic partner at the institution where you work.
– **Disclose to avoid conflicts** – If the former patient still receives care at your practice or hospital, disclose the romantic relationship to avoid any conflicts.
– **Do not flaunt publicly** – Be discreet about public displays of affection at work to maintain professional boundaries.
– **Raise issues tactfully** – If medical issues come up related to conditions or history the surgeon is privy to, tread very carefully in discussing these and defer to the current treatment team.
Scenario Where Surgeon Dates Former Patient
Here is a hypothetical scenario where a surgeon ethically dates a former patient:
John is a 50-year old orthopedic surgeon who performed a routine knee surgery on Jane, a 48-year old patient at his practice, two years ago. The surgery went smoothly, after which John had no direct contact with Jane, who continued follow-up care with her primary physician.
Two years after her surgery, John and Jane are unexpectedly reunited at a mutual friend’s party. They are instantly attracted to each other and spend the entire party talking off to the side. In the weeks after, John asks his hospital ethics committee for an ethics consult about potentially asking Jane out on a date.
The ethics committee thoroughly reviews the details. Jane only saw John for the one-time knee surgery and has not been his patient for two years. The committee agrees there is no longer a power differential or exploitative influence from the prior physician-patient relationship.
Six months after the party, John asks Jane out. She happily accepts and does not feel any pressure whatsoever from John’s prior role as her surgeon. They begin dating exclusively. When word spreads that John is dating a former patient, he is transparent about going through a proper ethics evaluation before initiating any romance. While some gossip occurs, John focuses on upholding his duties as a surgeon and supporting Jane’s emotional needs in the context of their fairytale romance born out of a fateful mutual friend’s party.
Conclusion
Dating a former patient is an ethically gray area, but not expressly prohibited provided proper precautions are taken. The key considerations are allowing enough time to pass, eliminating any power differential, and undergoing an ethics consultation to get objective guidance. While some may frown upon relationships between surgeons and former patients, they can be ethical and lead to meaningful romances if approached thoughtfully. The former patient’s enthusiastic consent and comfort is paramount. With prudence, a surgeon can potentially date a former patient without violating ethical obligations from the prior professional relationship.
