Alabama Administrative Code › Title 540 - ALABAMA BOARD OF MEDICAL EXAMINERS › Chapter 540-X-9 - MISCELLANEOUS › Section 540-X-9-.08 - Sexual Misconduct In The Practice Of Medicine: A Joint Statement Of Policy And Guidelines By The State Board Of Medical Examiners And The Medical Licensure Commission

Current through Register Vol. 42, No. 9, June 28, 2024
(1) The
			 prohibition against sexual contact between a physician and a patient is well
			 established and is embodied in the oath taken by physicians, the Hippocratic
			 Oath. The prohibition is also clearly stated in the Code of Medical Ethics of
			 the American Medical Association. The reason for this proscription is the
			 awareness of the adverse effects of such conduct on patients. The report of the
			 Council on Ethical and Judicial Affairs of the American Medical Association
			 indicates that most researchers now agree that the effects of physician-patient
			 sexual contact are almost always negative or damaging to the patient. Patients
			 are often left feeling humiliated, mistreated, or exploited.
(2) Further, a patient has a right to trust
			 and believe that a physician is dedicated solely to the patient's best
			 interests. Introduction of sexual behavior into the professional relationship
			 violates this trust because the physician's own personal interests compete with
			 the interests of the patient. This violation of trust produces not only serious
			 negative psychological consequences for the individual patient but also
			 destroys the trust of the public in the profession.
(3) Sexual conduct with a patient occurs in
			 many circumstances ranging from situations where a physician is unable to
			 effectively manage the emotional aspects of the physician- patient relationship
			 to consciously exploitative situations. Underlying most situations is a
			 disparity of power and authority over a physically or emotionally vulnerable
			 patient.
(4) The prohibition
			 against sexual contact between a physician and a patient is not intended to
			 inhibit the compassionate and caring aspects of a physician's practice. Rather,
			 the prohibition is aimed at behaviors which overstep the boundaries of the
			 professional relationship. When boundaries are violated, the physician's
			 patient may become the physician's victim. The physician is the one who must
			 recognize and set the boundaries between the care and compassion appropriate to
			 medical treatment and the emotional responses which may lead to sexual
			 misconduct.
(5) The Board of
			 Medical Examiners and the Medical Licensure Commission is each charged with
			 responsibilities for protecting the public against unprofessional actions of
			 physicians and osteopaths licensed to practice medicine in Alabama. Immoral,
			 unprofessional or dishonorable conduct is a grounds for discipline the license
			 of a physician or osteopath under the provisions of
Code of Ala.
			 1975
, §
								34-24-360(2). A
			 physician's sexual contact with a patient is a violation of this statute.
(6) The Board of Medical Examiners
			 investigates allegations of sexual misconduct against physicians. The Medical
			 Licensure Commission makes decisions following a hearing concerning disposition
			 of formal complaints filed with it by the Board of Medical Examiners. It is the
			 goal of each organization to ensure that the public is protected from future
			 misconduct. In some cases, revocation of license is the only means by which the
			 public can be protected. In other cases, the Board or the Commission may
			 restrict and monitor the practice of a physician who has actively engaged in a
			 rehabilitation program. Rehabilitation of a physician is a secondary goal that
			 will be pursued if the Board and the Commission can be reasonably assured that
			 the public is not at risk for a recurrence of the misconduct.
(7) The Board and the Commission remind
			 physicians of their statutory duty to report sexual misconduct or any conduct
			 which may constitute unprofessional conduct or which may indicate that a
			 physician is unable to practice medicine with reasonable skill or safety to
			 patients. It is the individual physician's responsibility to maintain the
			 boundaries of the professional relationship by avoiding and refraining from
			 sexual contact with patients.
(8)
			 Physicians should be alert to feelings of sexual attraction to a patient and
			 may wish to discuss such feelings with a colleague. To maintain the boundaries
			 of the professional relationship, a physician should transfer the care of a
			 patient to whom the physician is attracted to another physician and should seek
			 help in understanding and resolving feelings of sexual attraction without
			 acting on them.
(9) Physicians
			 must be alert to signs indicating that a patient may be encouraging a sexual
			 relationship and must take all steps necessary to maintain the boundaries of
			 the professional relationship including transferring the patient.
(10) Physicians must respect a patient's
			 dignity at all times and should provide appropriate gowns and private
			 facilities for dressing, undressing and examination. In most situations, a
			 physician should not be present in the room when a patient is dressing or
			 undressing.
(11) A physician
			 should have a chaperone present during the examination of any sensitive parts
			 of the body for the protection of both the patient and the physician. A
			 physician should refuse to examine sensitive parts of the patient's body
			 without a chaperon present if the physician believes the patient is sexualizing
			 the examination.
(12) To minimize
			 the misunderstandings and misperceptions between a physician and patient, the
			 physician should explain the need for each of the various components of an
			 examination and for all procedures and tests.
(13) Physicians should choose their words
			 carefully so that their communications with a patient are clear, appropriate
			 and professional.
(14) Physicians
			 should seek out information and formal education in the area of sexual
			 attraction to patients and sexual misconduct and should in turn educate other
			 health care providers and students.
(15) Physicians should not discuss their
			 intimate personal problems/lives with patients.
(16) Sexual Misconduct. Sexual contact with a
			 patient is sexual misconduct and is unprofessional conduct within the meaning
			 of
Code of Ala. 1975
, §
								34-24-360(2).
(17) Sexual Contact Defined. For
			 purposes of §
								34-24-360(2),
			 sexual contact between a physician and a patient includes, but is not limited
			 to:
(a) Sexual behavior or involvement with a
			 patient including verbal or physical behavior which:
1. may reasonably be interpreted as romantic
			 involvement with a patient regardless whether such involvement occurs in the
			 professional setting or outside of it;
2. may reasonably be interpreted as intended
			 for the sexual arousal or gratification of the physician, the patient or both;
			 or
3. may reasonably be
			 interpreted by the patient as being sexual.