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 conduct.
• 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 authorities.
• 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 intimately.
• The doctor/patient relationship is not one of equality. In seeking treatment, the patient is vulnerable. Exploitation of the patient is an abuse of power.
• 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 judgment.
• 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.