Ethical issues in sexual misconduct by clinicians.

Sexual misconduct by clinicians in the form of sexual relations with patients has long been recognized as an ethics violation and an activity suitable for assessment by the ethics committees of institutions and local and national professional organizations. The issue can be examined from the vantage point of several types of duties which bear ethical implications; these ethical duties proceed from the following four notions in this area: Sexual misconduct represents a violation of professional ethics as a fiduciary breach, abuse of a power asymmetry, exploitation of vulnerability and use of undue influence. While objections to these criteria may be raised in terms of freedom of association and consent, the violation of ethical principles by sexual misconduct remains clear.