Professional misconduct in therapeutic relationships. Developing critical attitudes in the medical community

Already the Hippocratic Oath defines maintaining boundaries in the physician-patient relationship as an essential part of medical care: aEuroaEuro broken vertical bar In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or men, be they free or slavesaEuro broken vertical bar aEuroe. The World Psychiatric Association's Declaration of Madrid 1996 specifically comments on boundary issues of physician-patient relationships in psychiatry. Boundary violations in any kind of therapeutic relationship - not only regarding psychotherapy - are both relevant and tabooed. There are hardly any options for patients concerned to find appropriate therapeutic and legal support. A public positioning of the medical profession seems to be very important. Apart from raising awareness, further important goals are prevention, guidelines for appropriate handling of victims and offenders, as well as integration of the issue in education and public discourse.