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RETHINKING SEXUAL MISCONDUCT & DISCLOSURE AFTER LONG v. OSTROFF
There is a long-standing consensus within the medical community that romantic or sexual relationships between physicians arid patients are unethical.1 The prohibitions date back at least 2,500 years to the Hippocratic Oath and the Code of Nigerian Healing Arts; they were officially codified by the American Medical Associations Council on Ethics and Judicial Affairs in 1991.2 Among the most frequent justifications for these restrictions are "the power imbalance between the physician and the patient" that makes meaningful consent "highly questionable," the possibility that such relations will impair the objective judgment of physicians, and the fear of "transference"-a psychological phenomenon in which patients rapidly and temporarily project their feelings from past relationships onto the doctor-patient bond.3 Several studies have indicated that the potential harm from such contacts is considerable.4 Although there may well be exceptional cases in which professional interaction might lead to healthy romance, the dangers inherent in most physician-patient sexual contact probably do justify a per se proscription on such encounters.
The last decade has witnessed a rapid expansion in both the severity and scope of the taboo on physician-patient sexual relations. Twenty-four states currently provide criminal penalties for psychiatrist-patient sex-some of them quite draconian.5 Civil liability for offenders has also expanded considerably during this period.6 Individuals covered by ethical guidelines now often include ex-patients: The American Psychiatric Association prohibited all sexual contact with former patients in 1993; the American Medical Association cautioned against such relationships in 1995. Yet the most dramatic broadening of rules governing the intimate behavior of doctors has been the movement to curtail certain sexual relationships between physicians and patients' relatives. The call for such limits first arose during the case of Ghidieux v. Ohio State Medical Board m 1997. It was not until the Court of Common Pleas of Philadelphia's decision in Long v. Ostroff (2003) that the legal system was compelled to address fully the complex legal and ethical implications of such restrictions.
GLADIEUX v. OHIO STATE MEDICAL BOARD7
Supreme Court Justice Oliver Wendell Holmes warned a century ago that hard cases make bad law-and rarely has this been truer than in the legal saga of forty-three year old Toledo pediatrician Gary F. Gladieux. In 1997, the...