1. Ethics Rounds: Treating Self, Family & Friends
Gary Viner MD
Jan 13, 2016

2. Real Case Middle age woman (my wife)
Awakens with me at 5:30 AM Wednesday
“I have a terrible bladder infection - phone a Rx for me!”
No fever and not otherwise unwell, rare episodes of UTI
What do you do?

3. Sept 25, 2014

6. Six Ethical Principles:
Autonomy –the right of a patient to make decisions about him/herself
Beneficence – actions beneficial to the patient
Confidentiality –all information relating to a patient
Disclosure –truthful & provide all relevant information
Equity – share finite resources fairly among patients
First do no harm –choose the least harmful action

7. What are the issues? Compromised objectivity
Preconceived notions / assumptions re: health/behaviour
Avoidance of sensitive issues
Pressure to provide care beyond expertise / habituating Rx
Need for informed consent & patient autonomy
Issues of confidentiality
Avoidance of mandatory reporting

8. Physician Treatment of Self, Family Members & Others Draft CPSO Policy
Defines family members & friends:
If affect physician’s professional judgment providing Rx Rx is prohibited
Prohibits Rx of selves / family members except minor condition & no alternative
Advises MDs to consider friends & recognizes relationships evolve
Rx of spouse/partner is sexual abuse under RHPA
MDs prohibited from prescribing certain drugs for selves/family/friends in non-pt context

9. CPSO Draft Policy – Feedback sought
Website: – Consultations
Mail:
Attn: Policy Department
80 College Street
Toronto, Ontario
M5G 2E2