Ethics

Why is it considered unethical for a doctor to have a relationship with a patient? I was wondering this after viewing "The Sopranos" and looking at how Dr. Melfi rebuffs Tony Soprano's attempts at courtship due to their previous doctor-patient relationship.

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I don't know what the details of the plot are at this point in the Sopranos,but I can't resist asking: If you were Dr. Melfi, would you want to bein a romantic relationship with Tony? In a more serious vein, what ismorally problematic about a romantic relationship between doctors andpatients (and therapists and clients, as well as various otherprofessional-client relationships) is that the doctor has professionalduties to the patient that may be inappropriately affected by aromantic relationship, and that the doctors may be in a position toinappropriately influence or manipulate the patient within theirpersonal relationship as a result of the knowledge or power they haveas the patient's doctor. Thus, there may be moral conflicts between theduties one has as doctor and as a lover. (Similar considerations mayapply regarding doctors and their family members or close friends.) Itmay be that in individual cases a romantic relationship won't in facthave undesirable consequences regarding one's duties. However, giventhe risks involved and the potential for harm or abuse, a generalprohibition within the medical profession is probably warranted.

However,once a doctor-patient relationship has ended, things are different. IfI performed an operation or provided therapy for a patient in the pastbut am no longer the person's doctor, the risks and duties involvedchange. So, Dr. Melfi probably doesn't have a general duty as a doctorto avoid entering into a romantic relationship with Tony once she's nolonger his doctor. Though she may still have a number of good reasonsfor not becoming Tony's lover, even if neglecting her professionalduties isn't one of them. (And, under the circumstances, telling himthat she has a professional duty that prohibits their becoming lovers maybe the best way to avoid such a relationship with him.)

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