Alabama Administrative Code › Title 545 - MEDICAL LICENSURE COMMISSION OF ALABAMA › Chapter 545-X-4 - MISCELLANEOUS › Section 545-X-4-.07 - 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 interest 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 grounds for disciplining the license
			 of a physician 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
			 chaperone present.
(12) To minimize
			 the understandings 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) Physician 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.