Your spouse/partner gets a skin infection and needs antibiotics: is it ethical for you to prescribe for them? Yes: it is ethical to treat short-term, minor problems.

Although physicians commonly treat their spouse, partner, or members of their own family, there is ethical concern about the appropriateness of doing so. Under certain circumstances, it is ethically permissible to treat one's family members. Clearly, emergent care, such as cardiopulmonary resuscitation, should be provided as it would customarily to anyone in society, regardless of the relationship between the physician and the injured. The matter becomes more complex, however, when the symptoms are nonemergent, yet possibly indicative of a serious disease process, or when the diagnosis is out of the scope of one's clinical skills. The Council on Ethical and Judicial Affairs of the American Medical Association has considered this matter and determined that as long as the condition is a short-term, minor problem—such as the skin infection described in the given scenario—it is ethically permissible for a physician to treat family members.1 These guidelines are also supported by investigators who have studied this common practice.2 In their analysis of the practice patterns of more than 400 medical staff physicians, researchers found that 99% of physicians had received requests from family members for medical advice or therapy. Of these, 83% reported that they had prescribed medication for a family member, and 72% reported that they had conducted a physical examination. Investigators concluded that if physicians decide to treat their family members, their judgment must be sound, they must have the appropriate medical data available to them for decision making, and they require the proper training and skills for the matter at hand. We realize that some physicians are concerned about prescribing for family members. Because of the personal relationship between the parties, the patient may not fully communicate the problem. Alternatively, the patient may try to pressure the physician into prescribing medications. Physicians, on the other hand, may feel guilty about ignoring their family members' symptoms, feeling the need to treat them to maintain a positive relationship. A more serious problem with treating a relative is that the personal relationship can interfere with a thorough assessment of the problem and objective determination of the optimal therapy. Despite these concerns, it is entirely appropriate for physicians to prescribe for family members, provided that several conditions are met. First, the ailment should be within the physician's scope of expertise. Second, the physician should not accept any limitations on having access to the patient for history taking and physical examination or to the patient's medical record. The physician should be able to get honest answers to any medical questions, such as sources of exposure to an infection. Third, having decided to treat, the physician should know enough about the appropriate therapy to feel comfortable with its use. Finally, once treatment has been initiated, follow-up is essential. If the condition is not resolving as expected, the family member should be referred to another source appropriately. If these conditions cannot be met, it is preferable that the partner-spouse be referred to his or her personal physician, or it may be appropriate for a specialist—in this case, a dermatologist—to handle the case.