Approved by the Board: May 22-24, 2000 Board Meeting

Service Area: Medical

Subject: Sexual Boundary Issues


Physician sexual misconduct is behavior that exploits the physician-patient relationship in a sexual way. This behavior is non-diagnostic and non-therapeutic, may be verbal or physical, and may include expressions of thoughts and feelings or gestures that are sexual or that reasonably may be construed by a patient as sexual.

There are primarily two levels of sexual misconduct: sexual violation and sexual impropriety. Behavior listed in both levels may be the basis for disciplinary action if the behavior was an exploitation of the physician-patient relationship.

Sexual violation may include physician-patient sex, whether or not initiated by the patient, and engaging in any conduct with a patient that is sexual or may be reasonably interpreted as sexual, including but not limited to:

1. sexual intercourse, genital to genital contact

2. oral to genital contact

3. oral to anal contact, genital to anal contact

4. kissing in a romantic or sexual manner

5. touching breasts, genitals, or any sexualized body part for any purpose other

than appropriate examination or treatment, or where the patient has refused

or has withdrawn consent

6. encouraging the patient to masturbate in the presence of the physician or

masturbation by the physician while the patient is present

7. offering to provide practice-related services, such as drugs, in exchange for

sexual favors.

Sexual impropriety may comprise behavior, gestures, or expressions that are seductive, sexually suggestive or sexually demeaning to a patient, including but not limited to:

1. disrobing or draping practices that reflect a lack of respect for the patient's

privacy, deliberately watching a patient dress or undress instead of providing

privacy for disrobing

2. subjecting a patient to an intimate examination in the presence of medical

students or other parties without the explicit consent of the patient or when

consent has been withdrawn

3. examination or touching of genitals without the use of gloves;

4. inappropriate comments about or to the patient, including but not limited to making sexual comments about a patient's body or underclothing, making sexualized or sexually demeaning comments to a patient, making comments about potential sexual performance during an examination or consultation except when the examination or consultation is pertinent to the issue of sexual function or dysfunction, requesting details of sexual history or sexual likes or dislikes when not clinically indicated for the type of consultation

5. using the physician-patient relationship to solicit a date

6. initiation by the physician of conversation regarding the sexual problems, preferences, or fantasies of the physician

7. examining the patient intimately without consent.

The scope of sexual misconduct behavior would also include advances towards employees or staff or patients or former patients or immediate family of patients of any origin whether office, clinic, or hospital.

Patient consent should not be viewed as a legal defense.