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The relationship between a physician and a patient is fundamental, and is not to be constrained or adversely affected by any considerations other than what is best for that patient.

The existences of other considerations, including financial or contractual concerns are and must be secondary to the fundamental relationship. Any act or failure to act by a physician that violates the trust upon which the relationship is based jeopardizes the relationship and may place the physician at risk of being found in violation of the Medical Practice Act (ORS Chapter 677). The policies expressed herein apply to all physicians in Oregon, as well as those who make decisions, which affect Oregon consumers, including health plan medical directors and other physicians employed by or contracting with such plans.

Why then does the AMA absolutely prohibit sexual relationships with consenting adult patients?

Perhaps it would be too expensive or time-consuming to scrutinize the propriety of these relationships and the effectiveness of consent on a case-by-case basis.

The columnist, Joe Gryskiewicz, MD, Edina, Minn., has been practicing for more than 25 years, and he is a former member of the ASPS Judicial Council.

A: Thank you for sharing your candid, painful story filled with harsh lessons and happenstance.

It's not uncommon for members to report their plight to the Board while neglecting to inform the Society.

Regardless of whether an act or failure to act is determined entirely by a physician, or is the result of a contractual or other relationship with a health care entity, the relationship between a physician and a patient must be based on trust, and must be considered inviolable.

Included among the elements of such a relationship of trust are: 2.