Sexual and nonsexual boundaries in professional relationships: principles and teaching guidelines

Abstract

Healthy professional relationships require that certain boundaries be maintained, especially if there is a power differential between the parties (e.g., physician – patient; faculty – student). Boundary violations can be generally divided into three types: sexual harassment (e.g., requests for dating, sexual innuendo, gender discrimination), sexual misconduct or exploitation (i.e., intimacy between professional and either patient or student), and nonsexual dual relationships (e.g., exchanging personal gifts, excessive disclosure, seeing students as patients while in a teaching role). Medical students may be victimized by faculty or residents who violate appropriate boundaries. They are also at risk for being potential offenders in the future. Both students and residents need to learn about risks and preventive measures in a way that is appropriate for their level of training. Both didactic teaching and discussion of relevant case vignettes can aid in this process.

Keywords:

• gender issues
• sexual trauma
• relational disorder

Acknowledgements

The author thanks Cindy Boling, Heather Rachel Davids, Karen Donahey, Peter Fagan, Christina Forbush, Adam Friedlander, David Mallott, Donna Parker, Judith Plaut, Andrea Singer and John Talbott for their helpful comments on the manuscript.