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Emergency physician care of family members, friends, colleagues and self

Published:January 26, 2019DOI:https://doi.org/10.1016/j.ajem.2019.01.046

      Abstract

      Emergency Physicians are frequently called upon to treat family members, friends, colleagues, subordinates or others with whom they have a personal relationship; or they may elect to treat themselves. This may occur in the Emergency Department (ED), outside of the ED, as an informal, or “curbside” consultation, long distance by telecommunication or even at home at any hour. In surveys, the vast majority of physicians report that they have provided some level of care to family members, friends, colleagues or themselves, sometime during their professional career. Despite being common, this practice raises ethical concerns and concern for the welfare of both the patient and the physician. This article suggests ethical and practical guidance for the emergency physician as to how to approach these situations.
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      References

        • Geiderman J.M.
        • Malik S.
        • McCarthy J.J.
        • Jagoda A.
        The care of VIPs in the emergency department: triage, treatment and ethics.
        Am J Emerg Med. 2018; https://doi.org/10.1016/j.ajem.2018.07.009
        • American Medical Association
        Treating self or family. Code of medical ethics opinion 1.2.1.
        (Available at)
      1. Code of ethics of the American Medical Association. American Medical Association, Chicago1901: 15
        • Pellegrino E.D.
        Patient and physician autonomy: conflicting rights and obligations in the physician-patient relationship.
        J Contemp Health Law Policy. 1994 Spring; 10: 47-68
        • Sade R.M.
        Ethics in cardiothoracic surgery.
        Ann Thorac Surg. 2007; 84: 723-728
        • McSheery J.
        Long distance meddling: do MDs really know what's best for their children?.
        Can Med Assoc J. 1988; 139: 420-424
      2. Medicare carriers manual [14-3-2332].
        (Available at)
        • La Puma J.
        • Stocking C.B.
        • La Voie D.
        • Darling C.A.
        When physicians treat members of their own family.
        N Engl J Med. 1991; 325: 1290-1294
        • Hanafi N.S.
        • Chirk-Jenn N.G.
        Doctors treating family members: a qualitative study among primary care practitioners in a teaching hospital in Malaysia.
        Asia Pac J Fam Med. 2006; 5
        • Eniola K.
        The ethics of caring for friends and family: when should you say no?.
        Fam Pract Manag. 2017 Jul–Aug; 24 (Available at) ([Accessed: January 2, 2019]): 44
        • Tairu T.
        • Geiderman J.M.
        Physician care of family, friends and colleagues.
        in: Jesus J. Grosman S.A. Derse A.R. Ethical problems in emergency medicine. Wiley-Blackwell, Oxford, UK2012: 1-14
        • Edgmont, Psychiatry
        Curbside consultations, 2010;7, May (5) 51–53.
        (Available at:)
        • Lin M.
        • Pappas S.C.
        • Stellin J.
        • Hashem B.E.
        Curbside consultations-the good, the bad and the ugly.
        (Available at:)
        • Cotton V.R.
        Legal risks of “curbside” consults.
        Am J Cardiol. 2010; 106: 135-138
        • American Medical Association
        Code of medical ethics opinion 1.2.1: treating self or family.
        (Available at)
        • The College of Physicians and Surgeons of Ontario
        Physician treatment of self, family members, or others close to them.
        (Available at)
        • Hojman J.
        A friends request for treatment.
        AMA J Ethics. 2015; 17: 428-431
        • Snyder L.
        ACP ethics, professionalism, and human rights committee. ACP ethics manual.
        Ann Intern Med. 2012; 156: 73-104
      3. Professional standards and guidelines: treating self, family members, and those with whom you have a non-professional relationship.
        College of Physicians and Surgeons of British Columbia
        (Available at)
        • American Academy of Pediatrics Committee on Bioethics
        Pediatrician-family-patient relationships: managing the boundaries.
        Pediatrics. 2009; 124: 1685-1688
        • Conde C.
        Treating your own.
        Tex Med. 2011; 107 (Available at) ([Accessed October 21, 2018]): 33-36
      4. Treatment of self, family, friends and employees.
        HCMS (Harris County Medical Society)
        Date accessed: December 25, 2018
        (Available at)
        • Krall E.J.
        Doctors who doctor self, family and colleagues.
        Wis Med J. 2008 Sep; 107: 279-284
        • Christie J.D.
        • Rosen I.M.
        • Bellini
        • et al.
        Prescription drug use and self-prescription among resident physicians.
        JAMA. 1998; 280: 1253-1255
        • Chaudry H.J.
        Private Communication.
        Federation of State medical Boards, August 31, 2018
        • Christman K.D.
        AMA attacks physicians caring for their families.
        J Am Physicians Surg. 2011; 16: 85-87
        • Vatcher D.
        Self-prescribing by physicians.
        JAMA. 1999; 218: 1488-1489
        • Yasgur B.S.
        Should physicians treat family and friends? Three experts weigh in.
        (Available at)