PHYSICIAN-PATIENT SEXUAL CONTACT - ETHICAL AND LEGAL ISSUES AND CLINICAL GUIDELINES

Although sexual relationships between mental heal professionals and pa tients have been the subject of research, ethical writing, and legisla tion during recent years, there has been comparatively little attentio n given to this problem in primary care medicine. An estimated 11% of family physicians have had sexual contact with at least one of their p atients. 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 addre ssed by these guidelines. Although sexual involvement with patients ap pears to exist on an ethical continuum, it inevitably results in dimin ished patient autonomy. Sexual contact between patients and mental hea lth professionals is now explicitly illegal in many states, but compar able legislation has not been enacted for nonpsychiatric physicians. T here is evidence that when sexual contact between a physician and a pa tient occurs, the patient suffers long-term psychological consequences .