Advances in Psychiatric Treatment (2009) 15: 88-89. doi: 10.1192/apt.bp.108.005884
© 2009 The Royal College of Psychiatrists
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Trust and the therapeutic bond: the special case of psychiatry

INVITED COMMENTARY ON... POST-TERMINATION BOUNDARY VIOLATIONS

Julian Sheather

Julian Sheather is Ethics Manager in the Medical Ethics Department at the British medical association (BMA). His particular interests lie in mental health and mental capacity, in consent and capacity issues relating to children and young people and in public health ethics. He is the BMA’s policy lead on child protection and has particular interests in health and human rights. Dr Sheather has worked in the BMA Ethics Department for 6 years, following a period as a researcher in international health policy for the BMA’s International Department. He is a co-author of Medical Ethics Today and is a regular contributor to the Journal of Medical Ethics. He sits on the BMJ’s ethics committee and lectures widely on a range of topics in medical ethics.

Correspondence: Correspondence Dr Julian Sheather PhD, Ethics Manager, Medical Ethics Department, British Medical Association, London WC1H 9JP, UK. email: jsheather{at}bma.org.uk

This article asks whether it is ever acceptable for a psychiatrist to form an intimate relationship with a former patient. It explores the tensions that arise between the freedom of autonomous adults, the need to protect vulnerable individuals, and the public interest in maintaining trust in the doctor–patient relationship. It argues that although a complete ban on all sexual relationships between doctors and former patients would be excessively restrictive, a special case can be made for relationships with former psychiatric patients. The particular vulnerability of psychiatric patients, and the resulting need to ensure the highest standards of trust in the profession, strengthen the case for a complete ban.




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