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The more deeply involved the individual is in the clinical encounter and in medical decision making, the more troubling sexual or romantic contact with the physician would be.

This is especially true for the individual whose decisions directly impact on the health and welfare of the patient.

Jim and Sheila talked briefly during the intake process and he was in the jail 48 hours.

Patients are often accompanied by third parties who play an integral role in the patient-physician relationship.The physician interacts and communicates with these individuals and often is in a position to offer them information, advice, and emotional support.Physicians can also volunteer their services at weekend clinics for the poor and at shelters for battered women or the homeless.In addition to meeting their obligation to care for the indigent, physicians can devote their energy, knowledge, and prestige to designing and lobbying at all levels for better programs to provide care for the poor.The following factors should be considered when considering whether a relationship is appropriate: the nature of the patient’s medical problem, the length of the professional relationship, the degree of the third party’s emotional dependence on the physician, and the importance of the clinical encounter to the third party and the patient.

Sexual contact that occurs concurrent with the patient-physician relationship constitutes sexual misconduct.Sexual or romantic interactions between physicians and patients detract from the goals of the physician-patient relationship, may exploit the vulnerability of the patient, may obscure the physician’s objective judgment concerning the patient’s health care, and ultimately may be detrimental to the patient’s well-being.If a physician has reason to believe that non-sexual contact with a patient may be perceived as or may lead to sexual contact, then he or she should avoid the non-sexual contact.Key third parties include, but are not limited to, spouses or partners, parents, guardians, and proxies.Physicians should refrain from sexual or romantic interactions with key third parties when it is based on the use or exploitation of trust, knowledge, influence, or emotions derived from a professional relationship.Caring for the poor should be a regular part of the physician’s practice schedule.