Sexual Boundaries and Physicians

Swiggart W, Starr K, al. e. Sexual boundaries and physicians: overview and educational approach to the problem. Sexual Addiction & Compulsivity 2002;9:139-48.

William Swiggart, M.S., Karen Starr, M.S.N., R.N., Reid Finlayson, M.D., Anderson Spickard, Jr., M.D.
The Center for Professional Health
Vanderbilt Medical Center
Contact Information:
William Swiggart, M.S.
The Center for Professional Health
1107 Oxford House, 1313 21st Avenue South
Nashville, TN 37232-4300
Phone: (615) 936-0678
Fax: (615) 936-0676
From at least the time of Hippocrates, sexual involvement between patient and healer has been proscribed. Sexual involvement with a patient not only impairs the judgment of the clinician, but also is harmful to the patient. (Federation 1994, JAMA 1991) Growing awareness of physician improprieties prompted the American Medical Association's Council on Ethical and Judicial Affairs to make a public statement concerning sexual or romantic relationships with patients or former patients. The Council concluded that sexual or romantic involvement within the physician patient relationship is unethical. Sexual relationships with former patients are also unethical if the physician uses or exploits trust, knowledge, emotions, or influence derived from the previous professional relationship. (JAMA 1991) The report also stated, "The issue of sexual misconduct and sexual or romantic attraction to patients is not adequately covered in many medical training programs."

This paper defines sexual boundary violations in physicians; emphasizes that a comprehensive evaluation of the physician is necessary when sexual impropriety or violation is suspected; and describes an educational intervention for physicians who need education and training in sexual boundaries.