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Treating family members

Important information

The new edition of Good medical practice was published on 25 March 2013 and comes into effect on 22 April 2013. This page is part of the record of the review process.

On this page you can read:

Should doctors provide medical care for their families?

Whether doctors should be free to provide medical care for members of their families, or others with whom they have a close personal relationship, has been a subject of debate over many years.

Some doctors feel strongly that there is no-one they would trust more than themselves to do their best for their loved ones, and they should be free to judge for themselves the circumstances in which providing care for a family member would not be appropriate.

They may also argue that good care relies on an understanding of the patient and a relationship of trust, and these elements exist in abundance within families. Furthermore, where doctors treat their families there is a reduction in the burden on the NHS – particularly where doctors would otherwise need to take time away from their patients to take a child to see another doctor. Where the doctor and his or her family are happy with this arrangement, they argue that there are no grounds for the GMC to restrict doctors’ and their families’ freedom of choice.

In contrast, others have argued that standards of treatment or care may be compromised where doctors provide care to members of their family. A number of reasons are suggested for this:

  1. a. Emotional involvement can lead to a lack of objectivity in clinical decision-making. 
  2. b. Assessing family members’ condition and providing treatment outside a practice setting may also mean that family members do not receive the same standard of care as other patients.
  3. c. People who receive care both from a doctor who is a family member and from a separate GP may not develop effective relationships with their own GPs or other doctors and their records are likely to be incomplete.
  4. d. Doctors’ family members are entitled to confidential medical care; family members may withhold information which is vital to a diagnosis or management of a condition. This may be a particular problem for children and young people – but could be relevant to the care of anyone with a close emotional relationship with a doctor.
  5. e. Doctors may not feel able to ask sensitive questions or conduct intimate examinations on relatives.
  6. f. Family members may feel unable to refuse treatment or seek alternative approaches to the management of a condition. Questioning a recommendation or seeking a second opinion may be seen, by either party, as demonstrating a lack of trust.

In reviewing the guidance in Good Medical Practice on this issue we will be balancing these arguments and considering:

  1. a. Legal issues: are there any restrictions in law on doctors’ freedom to provide care (for example in prescribing controlled drugs) – is this UK wide legislation, or are there different requirements across the UK?
  2. b. Human Rights issues: to what extent would restricting doctors’ freedom to provide medical treatment to their families infringe their European Convention Rights? Is providing medical treatment part of everyone’s right ‘to respect for their private and family life’?
  3. c. Other ethical issues: for example, doctor’s duty ‘to do no harm’. Is this compromised by evidence that there are inherent risks in providing care for family members?
  4. d. Practical issues: are there barriers to doctors implementing the guidance? Does it create extra work but not additional benefits?
  5. e. How do other countries approach the issue? (See notes below)

What we currently say

What Good Medical Practice says now is:

  • ‘Wherever possible, you should avoid providing medical care to anyone with whom you have a close personal relationship.’

Is it time to change – and why?

Email your views to:

What happens elsewhere

The College of Physicians and Surgeons of Ontario says:

  • 'Physicians should not treat either themselves or family members, except:
    • For a minor condition or in an emergency situation...; and
    • Only when another qualified health care professional is not readily available.'

The Medical Council of New Zealand says:

  • 'Wherever possible, avoid providing medical care to anyone with whom you have a close personal relationship. The Council recognises that in some cases providing care to those close to you is unavoidable. However, in most cases, providing care to friends, those you work with and family members is inappropriate because of the lack of objectivity and possible discontinuity of care.'

American Medical Association  "Code of Medical Ethics," Opinion 8.19 says:

  • '...physicians generally should not treat themselves or members of their immediate families.'

The Medical Council of Ireland says:

  • 'Except for minor illnesses and emergencies, it is not advisable for you to treat members of your own family or issue prescriptions, sick certificates or reports for them.'

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