Is this ethical?

She won't be too disappointed. She'll still get to see him once a year. She's pretty sure he will never say anything off the record. You're probably right, he most likely will say no, if he replies at all.

Oh well, it will just be a fantasy for her.

She hopes he will reply and at least say No.

If we can safely assume that the forum was operated in a professional manner and the psychiatrist intentionally treats members of the forums as he would potential patients, it would be no different from the director of a mental health center treating you after seeing you a few times at local events.

I think it would be ethical for the psychiatrist to treat your friend. However, if your friend already has feelings for him going in, it could make managing those feelings more difficult than it would be if she just met the person. I also think you can't take their relationship for granted. She has seen the psychiatrist interact with other members ("patients") and built a good opinion of him that could be very valuable this early in therapy. I say go for it.

It wouldn't be for therapy though. They live quite far apart so seeing him for therapy would not be feasible, and he probably doesn't do therapy at all. So it would most likely be just a meds consult.

My friend thinks the fact that he already kind of knows her a bit is great. Maybe he will have much better insight into how to help her.

She hopes he will say "yes"!

psychiatrists who do med consults are bound by the same code of ethics to not develop dual relationships, like imapatient said.

it sounds like your friend is trying to find loopholes to make this 'ok', but i would warn her very strongly against it.

Well, it is not really up to my friend whether or not this happens. It's up to the pdoc. It doesn't matter what loopholes she finds, if the pdoc doesn't think it is ethical then it is not happening.

Just curious though, why exactly is it unethical? Ethics in medicine is mostly about protecting the patient right? What about this situation is harmful? What can happen? My friend doesn't understand.

Ok Greenleaves, let's be honest here... or let's have you be honest with yourself. I think many people on this thread believe that your "friend" is you. Don't feel obligated to tell us if this is the case. But.. if your "friend" happens to be you - maybe consider why you feel the need to conceal your identity. Could it maybe be that you know this situation isn't the most ethical one in the world? There are other pdocs in your area - I'm sure I'm not alone when I say that you, uh, your "friend", should consult with them instead.

Seems to me it is... as your friend would be the one to initiate this.
It is your friend's motive(s) that are questionable, not the final outcome which is, at this point, merely an idea, a thought...

No one has answered my questions. Why exactly is it unethical? What harm can come of it?

I don't understand why no one can tell me WHY it is unethical. What harm can come out of it? Please do not respond if you cannot answer this question. Thanks.

i think it's harmful because a T cannot have a dual role. it seems you want increased social interaction with this T and you are trying to get that by "consulting" with him. it is harmful for a patient to have a social role with a T because the boundaries can get blurred. the T can lose their objectivity and hurt you. there are a number of people in this forum who have had Ts overstep what is appropriate behavior and they have been very hurt by their Ts. we don't want to see that happen to you. how about a better option of working on where you can find social interaction that would be healthy for you?

This pdoc keeps very good boundaries though, but my friend will understand if he thinks it's unethical. She just wishes she could see him ya know? She loves hims a lot. (not sexual).

How have some people here been hurt by their T's? What happened?

If your "friend" were to sub or unconsciously answer his questions in ways that he or she thinks might be viewed more favorably, then the dialog could not be clinically helpful. And as I believe this "friend" of yours might be motivated to seek a more favorable light in the doc's eyes, I think this is likely to happen.

It's not ethical. I would be shocked, knock me over with a feather, if it happened, and I think it's best left to the category of fantasy.

gg

Thanks gg, I didn't think of that before. I guess she might hide things from him to make herself look better. Though, knowing her, I don't think that would happen.

I don't mean to rain on your idea, but I do not think this pdoc will say "yes". He knows that you have a huge crush on him and I think he wouldn't want to encourage the fantasy any further. There are plenty of pdocs in your own town for a second opinion. I do not mean any harm or to sound harsh. I believe this pdoc will want to maintain his boundaries, even in this limited situation as a second opinion.

You are a special person. I do not want you to get hurt.

I am thinking this pdoc will say "No" too, or most likely he will just ignore her and hope she forgets. LOL

He seems very non confrontational and prefers to ignore/redirect people's attention to something else.

It seems that this friend is simply trying to find an excuse to spend time with this pdoc. This doesn't really have anything to do with a second opinion. This is about a fantasy. Your friend needs to get real. If she needs a second opinion, she can find a doc in her area.

Well she was thinking that since this pdoc knows her a bit already that maybe he would have some special insight into her problems.

She really does want a second opinion and it is hard to get one where she lives. There is a lack of specialists (and doctors in general) where she lives.

Lots of people go to the US to see doctors.

But yes, a big part of the reason is because she loves his pdoc and wants to be around him.

Oh well, they can always get together in their yearly get togethers.

Well just suppose he did say yes to the meds consultation, and then later after that, said he could no longer meet with you on these social get-togethers because he doesn't meet socially with his patients, how would that feel to you then? You can't have it both ways.

It seem to me your "friend" has the best part of this already and should stop trying to mess up a good thing that they already feel good about.

And you know my story about when a professional thing turns personal, I wouldn't wish anyone to go through the pain I went through because of this.

You say he keeps his professional boundaries, but you have never seen him as a patient, so you really don't know that either.

If he is part of the APA, it is against the rules to him to treat those who he has socialized with, ex: (drinking of alcohol, visiting museums, having dinner with, attending conferences with, etc.)

I think this friend of yours needs to be happy with what interactions she has with this guy, as seeking more than this could cause ALL interactions to stop because it could ruin the social type relationship you have with him and make it awkward for him to even want to do that.

Do you think my friend has ruined things with her email to him? She feels bad now. She doesn't want to make him uncomfortable.

greenleaves, a number of people have posted in this forum, since i've been here less than a year, that they have had Ts come onto them or slept with a T and it never, ever ends well for the client. since you (you've said it's you in some posts already) have a crush on this pdoc you would automatically be vulnerable with him if he was the slightest bit inappropriate in any way. he could be inappropriate in emotional or verbal ways--it doesn't have to just be sexual. we care about you and don't want to see you get hurt. that is why so many are recommending strongly that you not pursue this. there is a book that talks about women and their Ts you might find interesting and it talks all about having romantic feelings for them. it's in session: the bond between women and their therapists. it seems to be out of print but you can probably have your local library obtain a copy to borrow. here's an excerpt from the book called drawing boundaries that i think explains well the concerns we have for you. please take gentle care of yourself greenleaves.

I just have to echo all of the wonderful points made in this thread about how this sort of situation rarely ends well for the client. Even for a professional consultation. Even if it were just "one time." The complications are many.

Professionals are in a unique position within mental health and have a duty to keeping clear and delineated boundaries because of the work they do. I already have some concerns about a mental health professional who is hosting social events for people who come to him for mental health advice and support. It seems harmless enough, but it's not the same as a bunch of folks coming together to discuss baseball from a baseball forum, now is it?

There are many excellent specialists who can offer second opinions. Any additional insight this particular doc may have into your situation is readily going to be offset by the creation of a dual relationship -- interacting with him as a forum member, and then interacting with him as a client. Dual relationship is then established, which, ethically, he is obligated to avoid when possible. And in this case, it would be easily possible.

So yes, come to the U.S. for a second opinion, but choose from one of the many other fine doctors in the same area that he practices, as you're not really limited by lack of choices there.

My two cents, take it for what it's worth...

DocJohn

If this is a certain tweeter happy forum owner with deputies(or is it sheriffs?)...I don't think ethics, boundaries, and insights are his strong suite...IMO.

I wouldn't worry about making him feel uncomfortable or ruining things with him...he is a professional trained to handle sensitive psychological matters.

I truly hope your friend finds the help she needs with a doctor who practices nearby. Traveling a long distance (not to mention spending a lot of money) for a second opinion with a website owner she's in love with doesn't sound very helpful to her.

Wishing your friend much luck finding an excellent doctor, and I hope she takes good care of herself.

Or maybe think about why your friend is concerned with making him uncomfortable. I've had those feelings with my former T and when you take a closer look at them, the reasons behind them and the motivations driving them, you can discover more about yourself.