New medical ethics code does not go far enough: comissioner

A new code of ethics for medical practitioners does not go far enough to lay guidelines for an appropriate doctor-patient relationship, the Health and Disabilities Commissioner says.

The new code for members of the New Zealand Medical Association (NZMA), adopted at the end of last month, has expanded on previous guidelines and includes guidelines about how far a personal relationship with a doctor should go.

"The NZMA considers that a sexual relationship with a current patient is unethical and that, in most instances, sexual relations with a former patient would be regarded as unethical, particularly where exploitation of patient vulnerability occurs," the code says.

However, if a relationship between a doctor and patient occurs after social contact, not in a professional capacity, and time has elapsed, "impropriety would not necessarily be inferred".

Health and Disabilities Commissioner Ron Paterson said the code did not go far enough to outline exactly when it would be appropriate for a doctor and patient to become intimately involved.

"I think there's something to be said for a...line, where it's made quite clear that any relationship with a former patient is not acceptable and there should be a stand down period of at least two years," he told National Radio.

"Now that's something for some people to debate, but I think that unless it's raised, there will always be some question mark for doctors and indeed patients and I wonder whether that's a good thing."

NZMA chairman John Adams told NZPA he thought it was dangerous to place time constraints on relationships.

"I feel that our code states fairly clearly the NZMA's position and it is significantly more detailed than the previous code," he said.

"I think it reflects that it is not always possible in every situation for patients to be absolutely clear (when the professional relationship ends).

"The paper presented by the Medical Council canvassed some time limit, but I think that the more prescriptive you get about that, the more dangerous it is, because there will be situations even beyond a time limit that are inappropriate."

The code concentrated more on the "depth and nature" of the doctor-patient relationship, Dr Adams said, and that if the professional relationship was brief or superficial and time had elapsed, then a personal relationship might not be considered unethical.

However, all former patient relationships would be considered unethical unless a reason was given why.

"It is a case by case basis, except the underlying thing is that in most cases it will be unethical. I feel it's a pretty strong and reasonable position," Dr Adams said.

- NZPA