Providing Informal Medical Care to Family, Friends: Is Benevolence Worth the Risk?

the MPR take:

As many as 99% of physicians have received requests from family members for medical advice, diagnosis, or treatment and 83% report having prescribed medications to relatives. However, the ethical risks in providing medical care to family and friends are largely ignored despite the issues that can arise when the relationship shifts to that of a doctor-patient. Although not all medical organizations have issued guidelines on physicians providing care for family and friends, the American Medical Association in 1847 issued a recommendations against this practice, and the 1993 guidelines of the AMA Code of Medical Ethics advises that physicians should not treat themselves or members of their immediate family. The American College of Physicians echoes this, as does the American Academy of Pediatrics. Many physicians feel pressured to respond to medical requests from family and friends, and most have declined at least one request for advice or treatment. Aspects of the physical examination and health history may be skipped when treating these patients, along with informed consent, shared decision making, and collaboration, which can hide important factors in determining proper treatment. A friend or colleague that is an established patient in a physician’s medical practice would not be an ethical violation, but informal and undocumented care of family members and friends may come with substantial risks.

Physicians may be asked or choose to provide medical care to family members or to give informal or undocumented care to friends, neighbors, or colleagues who are not their patients.