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The physician as perpetrator of abuse
1Dissociative Disorders Program, Institute of Pennsylvania Hospital, Philadelphia.
Abstract:
Although the exploitation and abuse of patients is forbidden by every code of medical ethics, physicians are in a power position vis-a-vis their patients, and this power may be misused. The spectrum of abusive physician behaviors includes doctors functioning as agents of control, exploiting physicianly perogatives, acting out personal problems in the medical setting, allowing subversion of their judgment, deliberately delivering suboptimal care, dehumanizing care, and sexually exploiting patients. Guidelines for the treatment of patients with such prior experiences are offered.
Insights
Physician misconduct, including exploitation and abuse, violates medical ethics. This study outlines abusive behaviors and offers guidance for treating patients affected by such experiences.
Area of Science:
- Medical Ethics
- Patient-Physician Relationship
- Clinical Psychology
Background:
- Physicians hold a position of power over patients.
- This power imbalance can be exploited, leading to patient abuse.
- Various forms of physician misconduct violate ethical standards.
Purpose of the Study:
- To define the spectrum of abusive physician behaviors.
- To explore the misuse of physician power in patient interactions.
- To provide guidelines for managing patients with histories of abuse.
Main Methods:
- Literature review of medical ethics codes.
- Analysis of documented cases of physician misconduct.
- Development of treatment guidelines based on ethical principles and clinical experience.
Main Results:
- Identified spectrum of abusive behaviors: control, exploitation, personal issues, compromised judgment, suboptimal care, dehumanization, sexual exploitation.
- Confirmed that physician power can be misused despite ethical prohibitions.
- Established a framework for patient care following abuse.
Conclusions:
- Physician abuse is a serious ethical violation.
- Understanding the range of abusive behaviors is crucial for patient safety.
- Guidelines are essential for supporting patients who have experienced physician misconduct.