Physician-patient sexual contact: ethical and legal issues and clinical guidelines

Although sexual relationships between mental health professionals and patients have been the subject of research, ethical writing, and legislation during recent years, there has been comparatively little attention given to this problem in primary care medicine. An estimated 11% of family physicians have had sexual contact with at least one of their patients. Recently, the American Medical Association presented ethical guidelines addressing this issue. Acceptable conditions under which a physician may become involved with a former patient are not well addressed by these guidelines. Although sexual involvement with patients appears to exist on an ethical continuum, it inevitably results in diminished patient autonomy. Sexual contact between patients and mental health professionals is now explicitly illegal in many states, but comparable legislation has not been enacted for nonpsychiatric physicians. There is evidence that when sexual contact between a physician and a patient occurs, the patient suffers long-term psychological consequences.