Policy Statement 6.5 - Professional Boundaries

Position Summary

Dental practitioners must be aware of their responsibilities regarding professional boundaries and ensure that those boundaries are maintained.

1. Background

1.1. An appropriate dental practitioner-patient relationship is central to the practice of dentistry and is essential for the delivery of high-quality dental care.

1.2. The relationship between dental practitioners and their patients involves a unique position of trust. The quality of this relationship is influenced by the level of trust between them.

1.3. There can be a power imbalance between the dental practitioner and patient due to the dental practitioner’s position of authority and the patient’s vulnerability. This can occur as a result of many factors including an unequal knowledge base and a possible need to quickly establish a level of mutual trust.

1.4. Many dentists provide dental treatment for family, friends, colleagues and acquaintances.

1.5. The Code of Conduct of the Board describes the professional behaviour requirements for dental practitioners.

1.6. Boundary violation may include:

• using a professional position to establish or pursue a sexual, exploitative, unrelated business or otherwise inappropriate relationship with anybody under a practitioner’s care.

• the expression of personal beliefs to patients in ways that exploit their vulnerability or that are likely to cause them distress.

1.7. Boundary violations may not always occur at a single point in time but may result from an accumulation of boundary crossings over a period of time.

Definitions

1.8. The BOARD is the Dental Board of Australia.

1.9. BOUNDARY CROSSING occurs when a dental practitioner initiates a behaviour or allows a behaviour to persist in a relationship that compromises or sets a future course that compromises the dentist’s relationship with his or her patient.

1.10. BOUNDARY VIOLATION occurs when the nature of the therapeutic relationship moves from a professional relationship to a damaging personal interaction or behaviour, including sexual and nonsexual misconduct.

1.11. PROFESSIONAL BOUNDARY is the implicit or explicit demarcation separating the professional relationship with a patient or persons close to the patient from other personal or business dealings.

1.12. PROFESSIONAL RELATIONSHIP is an ongoing interaction between two people that observes a set of established boundaries or limits that are deemed appropriate under governing ethical and statutory standards.

2. Position

2.1. Dental practitioners must be aware of their responsibilities regarding professional boundaries and ensure that those boundaries are maintained.

2.2. Out of necessity, it is appropriate for dental practitioners living and working in a regional or remote community to have professional and social relationships with patients.

2.3. The consent of the patient should not be a defence of a violated boundary.