Policy Statement: Medical Practitioners and Sexual Misconduct
In late 1995, the Medical Board's Division of Medical Quality established the Committee
on the Classification of Sexual Offenses. The Committee was comprised of three Board
members, Chairperson Philip Pace, Karen McElliott, and Alan Shumacher, M.D. A product
of that Committee is the following Medical Board of California sexual misconduct
policy statement. The Committee believes strongly, and the full Board concurs, that
sexual misconduct is unacceptable and that it is vitally important for the Medical
Board to adopt a public position and disseminate its policy to the medical community.
- It is the policy of the Medical Board of California that a medical practitioner
who engages in sexual activity with a current patient is guilty of unprofessional
- While not detracting from the fundamental impropriety of such activity, the sanctions
applied, as a result of a finding of misconduct, may vary according to the circumstances
of each case.
- Factors to be considered include the degree of dependence in the doctor/patient
relationship, evidence of exploitation, the duration of the professional relationship
and the nature of the medical services provided.
- The policy refers to current patients. The termination of the doctor/patient relationship
prior to sexual activity may be raised as a defense, but its strength will be dictated
by consideration of the factors referred to in paragraph 3, as well as by the time
lapse after the end of the professional relationship.
- The rationale for the Board's position has been supported by medical disciplinary
- Reasons for the policy include the following:
- The doctor/patient relationship depends upon the ability of the patient
to have absolute confidence and trust in the doctor.
- The doctor is in a unique position regarding physical and emotional
proximity. Patients are expected to disrobe and to allow doctors to examine them
- The doctor/patient relationship is not one of equality. In seeking
treatment, the patient is vulnerable. Exploitation of the patient is an abuse of
- The doctor's role is one of authority, by virtue of the patient seeking
assistance and guidance.
- Breaches of the doctor/patient relationship have often caused severe
psychological damage to the patient.
- The community expectation of the medical professional is one of utmost
integrity. The community must be confident that personal boundaries will be maintained
and that patients are not at risk.
- Improper sexual conduct by doctors promotes community criticism and
damages the credibility of the medical profession as a whole.
- The onus is on the doctor to behave in a professional manner. It
is unacceptable to seek to blame the patient if a sexual relationship develops.
- Personal involvement with the patient will often cloud clinical judgement.
- The guiding principle is that there be no exploitation of the patient or abuse of
the doctor's power. Each case must be examined in relation to the degree of dependency
between patient and doctor and the duration and nature of the professional relationship.
- The Board rejects the view that changing social standards require a less stringent
approach. The nature of the professional doctor/patient relationship must be one
of absolute confidence and trust. It transcends social values and only the highest
medical standard is acceptable.