lawyer

#Abstract

Physicians often are asked for advice about medical matters by relatives and friends. These range from requests for simple information to requests for medical opinion and judgment and more substantial involvement by the physician. I comment on the motivations and expectations of the requester and the physician, and the legal, ethical, and practical considerations related to such requests. I recommend: (1) Be clear about the expectations of the requester and yourself, including whether you are being asked for simple factual information, your medical judgment and opinion, or more substantial involvement in the situation. (2) Treat your interactions with relatives or friends with the same professional expertise and judgment as you would any patient. (3) Be aware that a physical examination and especially charging a fee strengthen the establishment of a legal relationship with the requester as your patient. (4) Respect the requester s autonomy and confidentiality and conform to HIPAA requirements where applicable. (5) Be aware of the potential conflict between your roles as a relative or friend and as a physician.

KEY WORDS: medical advice, ethics, law

Physicians often are asked for advice about medical matters by relatives and friends. This ranges from simply acting as interpreter or facilitator to offering medical advice to providing medical care. This discussion is about the more ambiguous portion of the range of requests from relatives and friends in which physicians are asked to act as informal medical consultants, a topic that has received little attention in the published literature. It is not about issues related to the medical care of family and friends, including prescribing medications, which have been covered well in the literature 1 4. Although physicians handle most such requests well, occasionally the requests provoke misunderstandings and conflicts that could be mitigated or prevented by attention to the dynamics of the transactions and adherence to some practical guidelines.

THE CONTEXT

The requests usually seem uncomplicated a simple need for factual information or a good doctor to see. Sometimes we are asked to use our judgment or offer advice. For purposes of conceptualizing and discussing this issue, the following describes a range of requests for medical advice that physicians may receive from relatives and friends. The categories progress generally from requests for simple information to requests for medical judgment and more substantial involvement by the physician. The categories are not cleanly separable, requests may fall into more than one category, and relatives and friends may ask something that is not covered by any category below.