Opinions

Expedited partner therapy seeks to increase the rate of treatment for partners of patients with sexually transmitted infections through patient-delivered therapy without the partner receiving a medical evaluation or professional prevention counseling. However, expedited partner therapy potentially abrogates the standard informed consent process, compromises continuity of care for patients’ partners, encroaches upon the privacy of patients and their partners, increases the possibility of harm by a medical or allergic reaction, leaves other diseases or complications undiagnosed, and may violate state practice laws.

In light of their obligation to promote the well-being of patients, physicians have an ethical obligation to take appropriate action to avert the harms caused by violence and abuse.

Health promotion should be a collaborative, patient-centered process that promotes trust and recognizes patients’ self-directed roles and responsibilities in maintaining health. Effective elements of this process may include educating and motivating patients regarding healthy lifestyle, helping patients by assessing their needs, preferences, and readiness for change, and recommending appropriate preventive care measures.

In the context of the media marketplace, understanding the role as a physician being distinct from a journalist, commentator, or media personality is imperative. Physicians involved in the media environment should be aware of their ethical obligations to patients, the public, and the medical profession; and that their conduct can affect their medical colleagues, other health care professionals, as well as institutions with which they are affiliated.

As an ethical responsibility, competence encompasses more than medical knowledge and skill. It requires physicians to understand that as a practical matter in the care of actual patients, competence is fluid and dependent on context. Physicians at all stages of their professional lives need to be able to recognize when they are and when they are not able to provide appropriate care for patients.

Short-term global health clinical encounters provide needed care to individual patients in under-resourced settings and address global health inequities. Physicians engaging in short-term global health clinical encounters have an ethical obligation to prioritize benefits for the host community and ensure quality care while maintaining awareness for cultural differences. Sponsors of short-term global health clinical encounters should ensure the provision of resources, that team members practice within the limits of their skills, and that a mechanism for meaningful data collection is in place.

Romantic or sexual interactions between physicians and patients that occur concurrently with the patient-physician relationship are unethical. A physician must terminate the patient-physician relationship before initiating a dating, romantic, or sexual relationship with a patient. Sexual or romantic relationships with former patients are unethical if the physician uses or exploits trust, knowledge, emotions, or influence derived from the previous professional relationship, or if a romantic relationship would foreseeably harm the individual.

Physicians should avoid sexual or romantic relations with any individual whose decisions directly affect the health and welfare of the patient. Physicians should refrain from sexual or romantic interactions with key third parties when the interaction would exploit trust, knowledge, influence, or emotions derived from a professional relationship with the third party or could compromise the patient’s care.

Sexual harassment can be defined as unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature. Sexual harassment exploits inequalities in status and power and abuses the rights and trust of those who are subjected to such conduct. Sexual harassment in the practice of medicine is unethical.

Having contact with patients is essential for training medical students, and both patients and the public benefit from the integrated care that is provided by health care teams that include medical students. All physicians share an obligation to ensure that patients are aware that medical students may participate in their care and have the opportunity to decline care from students.