The draft revisions around touching without informed consent initially caused some issues among doctor advocacy groups who argued that the wording needed to be changed because doctors are not able to obtain consent from unconscious patients in emergency situations.
Medical insurers also expressed concern that doctors may avoid examining patients over fears the guidelines may be used to support claims of misconduct. The MBA subsequently reworded the guidelines.
The guidelines have been revised to ensure the general public continues to trust doctors and that patients, many of whom are sick and vulnerable when seeing a doctor, can rely on that trusted relationship. That trust in professional practice extends to people supporting the patient, which includes family members. The new guidelines are titled ‘Sexual boundaries in the doctor-patient relationship’.
Sexual boundaries in the doctor-patient relationship
The content of the guidelines has not significantly changed and are largely editorial to improve readability and clarity. However the new guidelines offer more explicit advice around physical examinations, and a new section on social media. The guidelines state that patient consent must be obtained if medical students, an observer or other persons are to be present during a consultation or examination. Doctors should also determine the capacity of a child or young person, or person with impairment to give informed consent.
The social media section warns that communication between doctor and patient on such a platform can blur the boundaries between personal and professional relationships. The new guidelines also confirm that patients are unable to consent to a sexual relationship with a doctor due to the power imbalance in the relationship. Doctors are cautioned about maintaining sexual boundaries with people close to their patient, such as a carer or parents, as well as former patients.
The new document states that sexual misconduct can cause significant and lasting harm to patients, and that doctors who breach the guidelines may risk losing their registration. Furthermore, unwarranted physical examination during a consultation may constitute sexual assault and could result in mandatory notification to the police for criminal investigation.
The guidelines apply to all registered medical practitioners in Australia. The revised guidelines will come into effect next week on the 12th of December 2018. More information can be found on the website of the Medical Board of Australia.