Doctor-Patient Romantic Relationships: Is There a Line, and Should It Be Crossed?

They say you can’t help who you become attracted to. Believe it or not, sometimes even a doctor may find themselves becoming strongly attracted to a patient. Though many believe their principles should counter such emotions, recent studies on doctor responses clearly indicate some doctors aren’t exactly willing to denounce every romance:

• 68% responded “no” when asked if they believed it is ever acceptable to become involved in a relationship with a patient, whether it be sexual or romantic
• 22% said a romantic relationship with an ex-patient may be acceptable as long as more than six months have passed since the professional relationship ended
• 9% said ethical behavior depends on the particular situation in question
• 1% approved of having a romantic or sexual relationship with a patient

When it comes to the intimacy of the doctor-patient relationship, there are a few factors that come into play. Such factors include the personal information disclosed, the degree of trust, and the nature of the patient’s medical issue or medical history. Moreover, the extent of the doctor’s general knowledge of the patient (their past, home situation, and current emotional state) is also a factor that may depict the romantic or sexual relationship with a patient as unethical.

There are times when doctors may go beyond their job description in providing quality care, and they may find themselves crossing the line between the doctor-patient relationship. Such romantic or sexual interactions, whether they are portrayed as ethical or otherwise, tend to detract from the overall goals of the doctor-patient relationship. For one, the doctor has what is known as a “position of power,” over the patient; they are educated and trained to provide answers to medical issues and possible treatment options. So, when a doctor becomes attracted to a patient, their professional judgment is compromised. In such instances, it is likely they will give in to their temptations and jeopardize the patient’s well-being, either by withholding treatment or treating the patient in a way that is not in their best interest. This type of behavior violates all principles of medical ethics.

When a patient visits a doctor, it is presumably because they are not feeling well. Hence, they are vulnerable to whatever the doctor says or tells them to do. From the moment a patient’s physical and mental abilities are compromised, any relationship formed is usually from a position of weakness. For this reason, professionalism demands both parties be protected by clear and mutually recognized boundaries. A useful checklist to help you respect boundaries and identify any risky behavior is to ask yourself:

• Is this in the best interest of the patient?
• Is what I am doing causing me anxiety, guilt, or worry?
• Am I taking advantage of the patient?
• Am I portraying unethical behavior?
• Am I revealing too much about my personal life?
• Am I putting myself in a risky position?
• Would I be content to share this type of behavior with my partner, family, friends, or colleagues?

If you find you are becoming attracted to a patient, then, to start with, you must learn to accept your feelings. Most of us become attracted to qualities in others which we wish we could fully develop in ourselves. Dig deep and try to figure out what it is exactly about the patient that has drawn you to them. It may even help to confide in someone, such as a colleague. They may be better equipped to empathize with your situation and provide insight, without judging you. 

One way in which you can maintain a professional boundary is to avoid being constantly available to your patients, such as by email or phone. In other words, by limiting contact, you are reassured of the established boundaries. Always be aware of a patient’s vulnerability, which may be displayed through their gratitude and affection. While feelings of attraction cannot always be helped, self-control and rationality need to step in.

We do not live in a perfect world, and sometimes, professional relationships don’t always remain professional. We may act out of love rather than reason. A romantic attraction is like a strong magnet that can pull any two individuals close together—even a doctor and their patient. Inevitably, there may be times when you find yourself in danger of crossing the line between a professional and personal relationship. Determine how emotionally involved you have become with a patient and use this experience to reassess your priorities. If you continue to reflect on providing quality healthcare, you should be able to look at each situation from an objective standpoint. 

Remember, the doctor-patient relationship is based on trust. A neutral, safe space needs to be established, thus allowing the therapeutic alliance to grow. Your ethical obligations need to be put above your own self-interest to advocate for your patients’ welfare. When a patient becomes an ex-patient and the professional relationship has ended completely, things become a little less clear; after all, you can’t violate the doctor-patient relationship if it no longer exists. While this is true, it may be possible to date an ex-patient, provided the new relationship starts off on an equally balanced and emotionally healthy level.