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Psychiatry registrar’s registration cancelled over relationship with vulnerable patient

Summary: It is never acceptable to have a sexual relationship with a current patient, even if the relationship is consensual. Boundary violations will be seen as particularly egregious where the patients are vulnerable and where doctors are seen to cause further harm by attempting to deny or conceal the relationship. A case involving a psychiatric registrar illustrates the potential consequences.

Tuesday, 5 September 2023

Key messages from the case

It is never acceptable to have a sexual relationship with a current patient, even if the relationship is consensual. Boundary violations will be seen as particularly egregious where the patients are vulnerable and where doctors are seen to cause further harm by attempting to deny or conceal the relationship. A case involving a psychiatric registrar illustrates the potential consequences.

Details of the decision

Boundary violation

Ms A attended several appointments with Dr C, a psychiatry registrar, at a public clinic. After one appointment, they met accidentally in the carpark and ended up talking for some time before going back to her home where they shared a meal and a bottle of wine. The next day he called her at 2.00 am and went back to her house where they had consensual sex.

Two days later, Ms A was admitted to hospital after a suspected overdose. Dr C did not disclose his contact with Ms A to the treating team or make any notes in her medical record.

Sometime later Ms A told her counsellor about the encounter.

The regulator found Dr C had committed serious professional misconduct.

Outcome

Dr C’s registration was cancelled.

The regulator was particularly concerned that Dr C continued to deny any wrongdoing and maintained that Ms A was a stalker and that her evidence could not be trusted due to her psychological ill-health. This meant Ms A was exposed to unnecessary distress during the proceedings.

Dr C was found to have abused his special position of trust with a patient whom he knew to be vulnerable. He had actively pursued the relationship despite knowing it was inappropriate.

He put Ms A at risk of harm, through the relationship and by failing to disclose potentially significant clinical information following her suspected overdose.

Key lessons

It is never acceptable to have a sexual relationship with a current patient, even if you believe the relationship is consensual.

If you do find yourself in a situation where boundaries have blurred, seek professional medico-legal advice. Never attempt to conceal a boundary violation.

References and further reading

Avant factsheet – Boundary issues

Medical Board of Australia Guidelines – Sexual boundaries in the doctor-patient relationship

For more information or immediate medico-legal advice, call us on 1800 128 268, 24/7 in emergencies.

Download case study

Psychiatry registrar’s registration cancelled over relationship with vulnerable patient (PDF)

Disclaimers

The case discussed in this publication is based on a real case. Certain information has been de-identified to preserve privacy and confidentiality. This publication is not comprehensive and does not constitute legal or medical advice. You should seek legal or other professional advice before relying on any content, and practise proper clinical decision making with regard to the individual circumstances. Persons implementing any recommendations contained in this publication must exercise their own independent skill or judgement or seek appropriate professional advice relevant to their own particular practice. Compliance with any recommendations will not in any way guarantee discharge of the duty of care owed to patients and others coming into contact with the health professional or practice. Avant is not responsible to you or anyone else for any loss suffered in connection with the use of this information. Information is only current at the date initially published. © Avant Mutual Group Limited 2023 riskiqcase266 08/23 (DT-3391)

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