Abuse of the Doctor-Patient Relationship
Edited by
Fiona Subotsky, Susan Bewley and Michael Crowe
The doctor–patient relationship is
fraught with risk. Patients may be at risk from a doctor who
misuses their position of authority, or is unclear where the
appropriate boundaries lie. Doctors risk disciplinary or criminal
proceedings when this happens. This book aims to address these
risks, to assist clinicians in their daily relationships with
patients, and to improve patient safety.
The authors examine the ethical principles and how these may be
taught; prevalence of abuse; regulation and sanctions; management
and governance; remediation; and the roles of the different
organisations that may be involved, such as the General Medical
Council and medical protection societies.
- Practical guide to help
clinicians avoid boundary violations and improve patient
safety.
- Expert contributions from a
wide range of professionals.
- Special focus on abuse by
nurses, psychotherapists, sexual therapists and
gynaecologists.
- Extensively illustrated
with case examples.
- Includes professional
guidelines.
Readership:
A multidisciplinary approach makes
this book useful for all doctors and medical trainees, especially
general practitioners and gynaecologists, as well as all mental
health professionals, nurses, social workers and their teachers and
students. Health service managers and regulators, and their legal
advisers, will also find this indispensable.
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About the editors:
Fiona Subotsky -
Consultant Child and Adolescent Psychiatrist, Kings College
Hospital, London.
Susan Bewley -
Consultant in Obstetrics and Gynaecology at St Thomas' Hospital,
London.
Michael Crowe -
Consultant Psychiatrist (private) specialising in sexual and
relationship therapy, London.
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"An important addition to our
literature on this topic. I found this book to be well written,
timely, comprehensive in scope, and of interest to anyone who wants
to learn more about this sensitive and significant topic ...useful
not only to physicians but also to a wide audience of nurses,
social workers, psychologists, other healthcare professionals, and
the lay public."
- The Journal of Nervous
and Mental Disease
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Contents
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Foreword
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Introduction: Mapping the Territory
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1
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Ethical Principles and
Professional Trust
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2
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The Patient's
Perspective
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3
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Teaching Ethics and Ethical
Behaviour to Medical Students
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4
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With the Benefit of
Hindsight: Lessons from History
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5
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The Prevalence of Boundary
Violations between Mental Health Professionals and their
Patients
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6
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Psychiatry: Responding to
the Kerr-Haslam Inquiry
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7
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The General Practitioner and
Abuse in Primary Care
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8
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Boundaries and Boundary
Violations in Psychotherapy
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9
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Sexual Therapies:
Vulnerabilities and Boundaries
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10
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Obstetrics and Gynaecology:
A Special Case?
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11
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Nurses as Abusers: A Career
Perspective
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12
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Medical Management:
Governance and Sexual Boundary Issues
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13
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Dealing with Offending
Doctors: Sanctions and Remediation
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14
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Defending Doctors: The
Protection Society's Experience
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15
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Regulation and its Capacity
to Minimise Abuse by Professionals
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16
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The Role of the General
Medical Council
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APPENDICES
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1
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Vulnerable Patients, Safe
Doctors: Good Practice in our Clinical Relationships
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2
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Maintaining Boundaries
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3
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Other Psychiatric Codes
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4
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Examples of sexualised
behaviour by healthcare professionals towards patients or their
carers
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5
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Fitness to Practise
Cases
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6
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Web Resources
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"This book clearly maps the territory
in the complex areas of boundaries between patient and professional
(all regulated healthcare professions, not just doctors). Experts
are drawn in from general practice, psychotherapy, sexual therapies
and nursing; obstetrics and gynaecology; as well as teachers,
ethicists, medical managers and healthcare regulators. ... The book
contains important guidance on the prevention of boundary
violations that vulnerable doctors can blunder into, perhaps due to
a sometimes toxic combination of overenthusiasm and naiveté."
- British Journal of
Psychiatry