Professional Standard on Treating Self, Family Members and Friends

Preamble

For the purpose of the document the following definitions apply:

• Family member and Friend: For the purpose of this document, “Family member and Friend” means a registrant’s spouse or partner, parent, child, sibling, grandparent or grandchild; a parent, child, sibling, grandparent or grandchild of the registrants’ spouse or partner; or another individual in relation to whom the registrant has personal or emotional involvement that may render the registrant unable to exercise objective professional judgment in reaching diagnostic or therapeutic decisions.
• Treating: “treating” includes ordering and performing tests, making and communicating a diagnosis and prescribing medications. It does not include the monitoring of a condition that may be done by a non-registrant.
• Minor condition: Generally, a “minor condition” is a non-urgent, non-serious condition that requires only short-term, routine care and is not likely to be an indication of, or lead to, a more serious condition requiring medical expertise.
• Emergency: An “emergency” exists where an individual is apparently experiencing severe suffering or is at risk of sustaining serious bodily harm if medical intervention is not promptly provided.

Policy

This standard reflects ethical responsibilities of registrants set out in the Canadian Medical Association’s Code of Ethics and Professionalism (Dec, 2018), which is endorsed by the College of Physicians and Surgeons of PEI, in particular number 7 under Professional Responsibilities, which states: “Limit treatment of yourself , your immediate family, or anyone with whom you have a similarly close relationship to minor or emergency interventions and only when another physician is not readily available; there should be no fee for such treatment.”

The registrant-patient relationship is the foundation of the practice of medicine and should be maintained at a professional level. The quality of this relationship can be compromised where there is a personal, emotional or familial relationship beyond that of the registrant-patient relationship. A personal, non-professional relationship can affect many aspects of medical care. When a registrant treats someone with whom he or she has/had a personal relationship, there is a risk that the relationship will affect the registrant’s ability to provide good quality, clinically objective care.

There are several reasons for knowing and respecting boundaries, and for maintaining a professional relationship with patients. When the patient is a member of the family or a close friend, it may be difficult for a registrant to obtain a detailed history, conduct sensitive examinations, or provide comprehensive treatment options. As well, maintaining confidentiality can be difficult, records may be inadequate, and other family members may expect similar attention.

Registrants should refrain from treating themselves, family members or anyone with whom a registrant has close personal or emotional involvement.

There are limited circumstances where the risks associated with treatment in this context are either minimal or are outweighed by the benefits of providing the treatment:

1. providing infrequent treatment for minor conditions when there is no one else readily available, and
2. in emergency situations where there is no one else available or qualified to do so.

In these limited circumstances it is always advisable to make a written note documenting the treatment provided, for inclusion in the patient’s record.

It is not acceptable to conduct an independent medical exam for a friend or family member, as doing so would represent a clear conflict of interest.

Registrants must not prescribe the following medications for themselves or family members: Narcotics, controlled drugs, psychotropic drugs, or any drugs that are addicting or habituating.

Ordering bloodwork or other diagnostic tests for oneself or family members is not permitted, and can lead to issues with continuity of care and patient safety. Monitoring the results of a blood test or adjusting dosages without approval of their care provider is also not permitted.

Registrants who choose to treat family, friends or themselves might become the subject of a College complaint or might be the subject of legal action if their advice leads to harm.

Document History

Approval Date: November 4, 2019

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