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Only in very particular circumstances could such relationships be ethically permissible.the deleterious effects of such relationships upon patients have become increasingly recognized and condemned by the medical community. One such area is whether sexual relationships with patients are ever ethically permissible and, if so, under what circumstances.Many boundaries exist in the doctor–patient relationship.These include boundaries of role, time, place and space, money, gifts and services, clothing, language and physical contact.Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy.Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.

Nor do all boundary transgressions between doctor and patient ultimately lead to sexual misconduct. A key factor in the identification of doctors at risk of violating boundaries is the enhanced vulnerability of a doctor to the transference–counter-transference dyad which occurs in varying degrees in every doctor–patient relationship.Whilst having sexual relationships with current patients is clearly unethical, the ethics of such a relationship between a doctor and former patient is more debatable.In this review of the current evidence, based on major articles listed in Medline and Bioethicsline in the past 15 years, the argument is made here that such relationships are almost always unethical due to the persistence of transference, the unequal power distribution in the original doctor–patient relationship and the ethical implications that arise from both these factors especially with respect to the patient's autonomy and ability to consent, even when a former patient.Thirdly, a discussion of the role of autonomous choice and consent is presented.On the basis of this evidence, it is argued that the circumstances in which such relationships are ethically permissible are extremely limited and that official ‘sanctioning' of these relationships should be very much the exception, not the rule.