Back to Chapter 1 Patient-Physician Relationships
Opinion 1.2.1
Treating oneself or a member of one’s own family poses several challenges for physicians, including concerns about professional objectivity, patient autonomy, and informed consent.
When the patient is an immediate family member, the physician’s personal feelings may unduly influence his or her professional medical judgment. Or the physician may fail to probe sensitive areas when taking the medical history or to perform intimate parts of the physical examination. Physicians may feel obligated to provide care for family members despite feeling uncomfortable doing so. They may also be inclined to treat problems that are beyond their expertise or training.
Similarly, patients may feel uncomfortable receiving care from a family member. A patient may be reluctant to disclose sensitive information or undergo an intimate examination when the physician is an immediate family member. This discomfort may particularly be the case when the patient is a minor child, who may not feel free to refuse care from a parent.
In general, physicians should not treat themselves or members of their own families. However, it may be acceptable to do so in limited circ*mstances:
- In emergency settings or isolated settings where there is no other qualified physician available. In such situations, physicians should not hesitate to treat themselves or family members until another physician becomes available.
- For short-term, minor problems.
When treating self or family members, physicians have a further responsibility to:
- Document treatment or care provided and convey relevant information to the patient’s primary care physician.
- Recognize that if tensions develop in the professional relationship with a family member, perhaps as a result of a negative medical outcome, such difficulties may be carried over into the family member’s personal relationship with the physician.
- Avoid providing sensitive or intimate care especially for a minor patient who is uncomfortable being treated by a family member.
- Recognize that family members may be reluctant to state their preference for another physician or decline a recommendation for fear of offending the physician.
AMA Principles of Medical Ethics: I, II, IV
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Council Reports
- PDF Treating Self or Family
Ethics Cases & Legal Briefs
- Ethics Case Fair Access to Limited Critical Care Resources
Related Opinions
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Physicians individually and collectively share the obligation to ensure that the care patients receive is safe, effective, patient centered, timely, efficient, and equitable.
Informed Consent
Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.
Confidential Health Care for Minors
Physicians have a responsibility to protect the confidentiality of minor patients, within certain limits. In some jurisdictions, the law permits unemancipated minors to request and receive confidential services relating to: contraception, pregnancy testing, prenatal care, delivery services and care to prevent, diagnose, or treat sexually transmitted disease, substance use disorders, or mental illness.
Mandatory Parental Consent to Abortion
In many jurisdictions, unemancipated minors are not permitted to request or receive abortion services without their parents’ (or guardian’s) knowledge and consent. As such, when minors seek abortion care, this may create a conflict between the value of confidentiality and the legal obligation to obtain parental consent.
Privacy in Health Care
Respecting patient privacy is a fundamental expression of respect for patient autonomy and a prerequisite for trust. Patient privacy includes personal space (physical privacy), personal data (informational privacy), personal choices, including cultural and religious affiliations (decisional privacy), and personal relationships with family members and other intimates (associational privacy). Physicians must seek to protect patient privacy in all settings to the greatest extent possible.
Confidentiality
Physicians have an ethical obligation to preserve the confidentiality of information gathered in association with the care of the patient. With rare exceptions, patients are entitled to decide whether and to whom their personal health information is disclosed.
Peers as Patients
Physicians must recognize that providing medical care for a fellow professional can pose special challenges for objectivity, open exchange of information, privacy and confidentiality, and informed consent. Physicians have the same fundamental ethical obligations when treating peers as when treating any other patient.
