Opinion ID: 2616097
Heading Depth: 1
Heading Rank: 5

Heading: claim of sexual advantage

Text: Ms. Hoopes next claims that Dr. Hammargren used the physician-patient relationship to induce her into a sexual relationship and that such conduct constitutes malpractice. While Dr. Hammargren does not dispute the existence of the sexual relationship, he asserts it cannot constitute a basis for a cause of action grounded upon professional malpractice. We disagree. A fiduciary relationship is deemed to exist when one party is bound to act for the benefit of the other party. Such a relationship imposes a duty of utmost good faith. Barbara A. v. John G., 145 Cal.App.3d 369, 193 Cal.Rptr. 422, 431 (1983). The essence of a fiduciary or confidential relationship is that the parties do not deal on equal terms, since the person in whom trust and confidence is reposed and who accepts that trust and confidence is in a superior position to exert unique influence over the dependent party. Id. 193 Cal.Rptr. at 432. This court has recognized that the physician-patient relationship is fiduciary in nature. Massey v. Litton, 99 Nev. 723, 728, 669 P.2d 248, 252 (1983)(citation omitted). The physician-patient relationship is based on trust and confidence. Society has placed physicians in an elevated position of trust, and, therefore, the physician is obligated to exercise utmost good faith. While Dr. Hammargren urges this court to limit this type of claim to physicians practicing psychiatry, we believe the fiduciary relationship and the position of trust occupied by all physicians demands that the standard apply to all physicians. See also Lochett v. Goodill, 71 Wash.2d 654, 430 P.2d 589, 591 (1967). A patient generally seeks the assistance of a physician in order to resolve a medical problem. The patient expects that the physician can achieve such resolution. Occasionally (due to illness), the patient is emotionally unstable and often vulnerable. There is the hope that the physician possesses unlimited powers. It is at this point in the professional relationship that there is the potential and opportunity for the physician to take advantage of the patient's vulnerabilities. To do so, however, would violate a trust and constitute an abuse of power. This court would condemn any such type of exploitation. Such conduct would fall below the acceptable standard for a fiduciary. Historically, the physician's primary obligation has been, above all, to do no harm. It is Ms. Hoopes' contention that Dr. Hammargren abused the physician-patient relationship by instigating a sexual relationship. First, we note that the district court deemed the judiciary an improper forum to address such issues. We disagree. While Dr. Hammargren may also be subject to professional sanctioning, Ms. Hoopes has the right to seek redress in the courts. Cotton v. Kambly, 101 Mich.App. 537, 300 N.W.2d 627, 629 (1980); Roy v. Hartogs, 81 Misc.2d 350, 366 N.Y.S.2d 297, 301 (Civ.Ct. 1975). Sexual advantage of the physician-patient relationship can constitute malpractice. Next, having concluded that Ms. Hoopes is entitled to include exploitation of the physician-patient relationship in her malpractice action, we shall examine the criterion upon which such an allegation may be based. It is incumbent upon Ms. Hoopes to prove, by a preponderance of the evidence, that Dr. Hammargren violated his fiduciary responsibilities. In order to do so, Ms. Hoopes must show that Dr. Hammargren held a superior authoritative position in the professional relationship and that, as a result of her illness, she was vulnerable. Additionally, Ms. Hoopes must show that Dr. Hammargren exploited the vulnerability. The nature and extent of the circumstances surrounding the alleged exploitation must be carefully examined. For example, we will not presume that Ms. Hoopes was incapable of giving consent. The sexual relationship which admittedly existed could have been personal and unrelated to the parameters of treatment. Additionally, a jury might determine that the physician-patient relationship had terminated prior to certain of the alleged sexual encounters. We also caution that Ms. Hoopes not only is required to prove exploitation, but also that it was the proximate cause of any claimed harm. [4] Here, in support of his motion for summary judgment, Dr. Hammargren offered no evidence (other than his deposition) to show that he did not exploit the physician-patient relationship. In fact, we note that Dr. Hammargren conceded that sexual encounters during the course of such a professional relationship is not good medical practice. Accordingly, it was error for the district court to grant summary judgment in favor of Dr. Hammargren on this claim. The order of the district court granting summary judgment in favor of Dr. Hammargren is reversed as to Ms. Hoopes' claims of mistreatment and sexual advantage of the physician-patient relationship. As to Ms. Hoopes' claim of misdiagnosis, the order of the district court is affirmed. Additionally, we find the filing of the civil action to be timely. SPRINGER, C.J., and MOWBRAY and YOUNG, [5] JJ., concur.