FIDUCIARY DUTY AND BOUNDARIES - ACTING IN THE CLIENTS BEST INTEREST

The task of defining boundaries and boundary violations in the therape utic relationship is examined from several perspectives. This paper re views the ethical rules of the major mental health associations and th e American Medical Association to determine the professions' ethical p ositions with regard to boundary maintenance and boundary violations. It also analyzes judicially sanctioned causes of action for recovery b y clients for damages suffered as a result of boundary violations. The authors examine the ways in which fiduciary theory is used in the for mulation of the ethical rules and to support the imposition of civil l iability for boundary violations. The authors conclude that fiduciary theory provides a useful paradigm for setting and evaluating boundarie s that acknowledge and address the fiduciary nature of the therapist-c lient relationship. The authors point out that measuring boundary viol ations with the yardstick of fiduciary duty serves the interests of bo th the client and the therapist. (C) 1997 by John Wiley & Sons, Ltd.