The College of Optometrists

Maintaining boundaries

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Sub-sections

Key points

  • You are in a position of trust with your patients and their carers and you must not abuse that professional position.
  • Sexual or inappropriate emotional relationships with current or former patients are likely to cross professional boundaries.
  • You should seek advice from a colleague or professional body if you are in doubt about maintaining professional boundaries.
  • You should also alert colleagues to the risks of unprofessional behaviour and report their actions if they are putting patients at risk.

Principles of maintaining boundaries

C147
You must never abuse your professional position,238 for example by pursuing a sexual or inappropriate emotional relationship with a patient or their carer. This is because it can damage public trust in the optometric profession, and the inappropriate relationship may affect decisions you can make about a patient’s care.
C148
You are in a position of power and trust with your patients and you should maintain appropriate boundaries in how you communicate with your patients and their carers.
C149
You should not express personal beliefs, including political, religious and moral beliefs, to patients in ways that could exploit them if they are vulnerable or which might distress them.
C150
The definition of a carer in this section of guidance is a professional carer, family member, partner or friend who looks after the patient to the extent that they are part of their clinical experience, for example a parent who accompanies their child to hospital.
C151
If you are attracted to a patient you must not act on these feelings. If you are not sure whether this is affecting your professional judgement you should discuss this with a colleague or with your professional or representative body.
C152
You should be sensitive to cultural differences in personal boundaries.

Current patients

C153
If a patient or their carer pursues a sexual or inappropriate emotional relationship with you, you may need to seek advice from a colleague or professional or representative body to decide on the best course of action.
C154
If the situation cannot be resolved you should not continue to treat the patient.

Former patients

C155
You should think carefully before pursuing a personal relationship with a former patient or carer. However consensual a relationship appears to be, if a complaint is made the onus will always be on you to show you have acted professionally and sought appropriate advice.239
C156
A sexual or personal relationship with a former patient or their carer may be inappropriate because:
  1. your former professional relationship may still influence the relationship
  2. the patient was vulnerable when they were under your care and may still be vulnerable, or
  3. you may still be caring for other members of the patient’s family.

Colleagues

C157
If you are aware that a colleague or other healthcare professional has breached personal or sexual boundaries with a patient or carer you should speak to the colleague, if possible, and alert them to the dangers of this unprofessional behaviour.
C158
If you are asked for advice by a colleague who feels attracted to a patient or carer, but has not acted inappropriately you are not required to inform anyone. You should remind your colleague that they must not abuse their professional position.
C159
If you consider a colleague is putting patients at risk you should consult the relevant professional, representative or regulatory body. See section on Raising concerns.
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