Professional Codes of Ethics

Doctors, Lawyers, Therapists

American Association of Pastoral Counselors. Code of Ethics.

Principle III. Client Relationships.

It is the responsibility of members of AAPC to maintain relationships with clients on a professional basis.

We recognize the trust placed in and unique power of the therapeutic relationship. While acknowledging the complexity of some pastoral relationships, we avoid exploiting the trust and dependency of clients. We avoid those dual relationships with clients (e.g., business or close personal relationships) which could impair our professional judgement, compromise the integrity of the treatment, and/or use the relationship for our own gain.

All forms of sexual behavior or harassment with clients are unethical, even when a client invites or consents to such behavior or involvement. Sexual behavior is defined as, but not limited to, all forms of overt and covert seductive speech, gestures, and behavior as well as physical contact of a sexual nature; harassment is defined as but not limited to, repeated comments, gestures or physical contacts of a sexual nature.

We recognize that the therapist/client relationship involves a power imbalance, the residual effects of which are operative following the termination of the therapy relationship. Therefore, all sexual behavior or harassment as defined in Principle III, G with former clients is unethical.

American Bar Association. State Committees Review and Respond to Model Rules Amendments. Updated November 30, 2007. Charlotte K. Stretch and Susan M. Campbell.

Rule 1.8(j): Prohibition regarding sexual relationships with clients.

Twenty-nine states have added or proposed adding the new provision prohibiting a lawyer from having sexual relations with a client unless a consensual sexual relationship existed between them when the client-lawyer relationship commenced, or a substantially similar provision. Eleven of those states added further provisions to their rules. Minnesota, North Carolina, Oregon, Utah and Wisconsin add a definition of "sexual relations;" Minnesota, North Carolina, Oregon and Washington include provisions relating to lawyers in a firm who do not work on a client matter; Alaska, Minnesota, Nevada and Wisconsin include provisions relating to organizational clients. Minnesota adds information on how an alleged violation of the Rule will be investigated if the person making the complaint is not the client. Iowa, Oregon and Washington also refer to sexual relations with a representative of a current client if the relationship would, or would likely, damage or prejudice the client in the representation. Utah's rule prohibits sexual relationships that exploit the client-lawyer relationship and states that sexual relationships are presumed to be exploitative.

American Bar Association. Center for Professional Responsibility. Ethics 2000 Commission Report on the Model Rules of Professional Conduct.

Rule 1.8(j): Client-Lawyer Sexual Relationships Adopt new per se Rule prohibiting most client-lawyer sexual relationships.

The Commission recommends following the lead of a number of jurisdictions that have adopted Rules explicitly regulating client-lawyer sexual conduct. Although recognizing that most egregious behavior of lawyers can be addressed through other Rules, the Commission believes that such Rules may not be sufficient. Given the number of complaints of lawyer sexual misconduct that have been filed, the Commission believes that having a specific Rule has the advantage not only of alerting lawyers more effectively to the dangers of sexual relationships with clients but also of alerting clients that the lawyer may have violated ethical obligations in engaging in such conduct . . . The Commission further recommends a total, rather than a partial, ban on client-lawyer relationships.

American Dental Association. Draft Guidelines for State Dental Boards on Unprofessional Conduct Involving Sexual Boundary Violations.

Unprofessional conduct involving any sexual boundary violation by a dentist, dental hygienist or member of the dental care team results in patient harm and exploits both patient and public trust. Sexual misconduct is undeniably a violation of patient and public trust and cannot be excused by mitigating or contributory circumstances . . . The position of power in the dental care practitioner-patient relationship is inherently unequal. In order to receive dental treatment, the patient surrenders certain personal liberties and authorities to the practitioner . . . A dentist, dental hygienist, or member of the dental health care team may not engage, or attempt to engage in a relationship with a former patient within six months after the practitioner-patient relationship ends.

American Medical Association. Code of Medical Ethics.

Opinion 8.14. Sexual Misconduct in the Practice of Medicine. Sexual contact that occurs concurrent with the patient-physician relationship constitutes sexual misconduct. Sexual or romantic interactions between physicians and patients detract from the goals of the physician-patient relationship, may exploit the vulnerability of the patient, may obscure the physician's objective judgment concerning the patient's health care, and ultimately may be detrimental to the patient's well-being.

Opinion 8.145. Sexual or Romantic Relations between Physicians and Key Third Parties. Physicians should refrain from sexual or romantic interactions with key third parties when it is based on the use or exploitation of trust, knowledge, influence, or emotions derived from a professional relationship.

American Psychiatric Association. The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry. 2006.

Section 2. A physician shall uphold the standards of professionalism, be honest in all professional interactions and strive to report physicians deficient in character or competence, or engaging in fraud or deception to appropriate entities.

The requirement that the physician conduct himself/herself with propriety in his or her profession and in all the actions of his or her life is especially important in the case of the psychiatrist because the patient tends to model his or her behavior after that of his or her psychiatrist by identification. Further, the necessary intensity of the treatment relationship may tend to activate sexual and other needs and fantasies on the part of both patient and psychiatrist, while weakening the objectivity necessary for control. Additionally, the inherent inequality in the doctor-patient relationship may lead to exploitation of the patient. Sexual activity with a current or former patient is unethical.

National Association for Addiction Professionals. NAADAC Code of Ethics.

Principle 7: Dual Relationships

I understand that I must seek to nurture and support the development of a relationship of equals rather than to take unfair advantage of individuals who are vulnerable and exploitable.

I shall not engage in professional relationships or commitments that conflict with family members, friends . . . whose welfare might be jeopardized by such a dual relationship.

Because a relationship begins with a power differential, I shall not exploit relationships with current or former clients for personal gain, including social or business relationships.

I shall not under any circumstances engage in sexual behavior with current or former clients.

Code of Ethics of the National Association of Social Workers. Approved by the 1996 NASW Delegate Assembly and revised by the 1999 NASW Delegate Assembly.

1.09 Sexual Relationships

(a) Social workers should under no circumstances engage in sexual activities or sexual contact with current clients, whether such contact is consensual or forced. (b) Social workers should not engage in sexual activities or sexual contact with clients' relatives or other individuals with whom clients maintain a close personal relationship when there is a risk of exploitation or potential harm to the client. Sexual activity or sexual contact with clients' relatives or other individuals with whom clients maintain a personal relationship has the potential to be harmful to the client and may make it difficult for the social worker and client to maintain appropriate professional boundaries. Social workers--not their clients, their clients' relatives, or other individuals with whom the client maintains a personal relationship--assume the full burden for setting clear, appropriate, and culturally sensitive boundaries. (c) Social workers should not engage in sexual activities or sexual contact with former clients because of the potential for harm to the client. If social workers engage in conduct contrary to this prohibition or claim that an exception to this prohibition is warranted because of extraordinary circumstances, it is social workers--not their clients--who assume the full burden of demonstrating that the former client has not been exploited, coerced, or manipulated, intentionally or unintentionally.

Jean McAulay. "Flirting with malpractice: Protect yourself and your practice from unwanted sexual advances." Today's Chiropractic (April-May 2007).
In a September 2004 article in the Journal of Manipulative and Physiological Therapeutics [author Michael J. Stahl, D.C.] and co-author Stephen Forman, D.C., reported the incidence rate of disciplinary actions against chiropractors for sexual misconduct was 339 percent higher than for medical doctors.