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They seem to click interpersonally, and he extends his office visits with her. On 2 occasions he gives her a limited quantity of benzodiazepines for mild anxiety, which he considers a transitory stress-related condition and not an “official” DSM-IV-TR disorder. The American Psychiatric Association (APA), however, acknowledges that psychiatry has a “broader set of moral and ethical problems and dilemmas” that are unique to and magnified by the mental health setting.
M begins including personal disclosures in his conversations with her. M was taught never to date a current or former patient, but he views this situation as different. Y is seeing him only for weight loss, and he rationalizes that he is providing her with medical care, not “psychiatric” care. Psychoanalysts initially defined psychiatrist/patient boundaries as a way of structuring the unique and intimate relationship that evolves during analysis. Both the American Medical Association (AMA) and the Canadian Medical Association warn members to “scrupulously avoid using the physician/patient relationship to gratify their own emotional, financial, and sexual needs.” As are all physicians, psychiatrists are governed by the 9 biomedical ethics set forth in the AMA’s Principles of Medical Ethics.
The debate continues: unique ethics for psychiatry. Washington, DC: American Psychiatric Association; 2008.
American Psychiatric Association The principles of medical ethics with annotations especially applicable to psychiatry.
Many, if not most, will tell you “once a client, always a client.” Some might go so far as to say that treatment doesn’t actually end after you stop seeing the client, but continues perhaps indefinitely.
Ask your colleagues and co-workers, and see what they say.
Psychiatrists disciplined by a state medical board.
Further, the necessary intensity of the treatment relationship may tend to activate sexual and other needs and fantasies on the part of both patient and psychiatrist, while weakening the objectivity necessary for control. Because these guidelines can be difficult to interpret for psychiatry, the American Psychiatric Association provides further guidance with The Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry. All physicians are required to practice in accordance with the American Medical Association’s Principles of Medical Ethics. Marshall, Ph DAssociate professor, University of South Florida Polytechnic, Lakeland Karen Teston, MDPast chair, Florida Psychiatric Society Ethics Committee, staff psychiatrist, Watson Clinic LLP, Lakeland Wade C. Myers, MDProfessor and director, forensic psychiatry program, University of South Florida College of Medicine, Tampa 1.