Self and family treatment

"That the NZMA advise members that it is not good clinical practice for members to treat themselves or members of their families unless there is no other available and appropriately qualified medical practitioner. Medical practitioners should exercise great discretion in carrying out any such treatment(s)."

The Board also adopted the attached Explanatory Note to Board Policy as a guide to members.

  • The changing nature of familial relationships and concepts of dependency means that this area is highly complex and somewhat controversial. Both known and unknown biological and pharmacological factors may impede good treatment of oneself or family. The Board considers professional ethics and judgement to be key elements in arriving at a decision on this matter.
  •  The NZMA recognises there are a number of factors, some clinical and some social circumstances, that impact on the need to treat oneself and/or family. Not all of these factors are however negative. The following factors are identified to assist NZMA medical practitioner members in the exercising of their professional discretion in the treatment of oneself or family:

Factors:

  1. Principle 1 of the NZMA Code of Ethics states: "Consider the health and wellbeing of the patient to be your first priority."
  2. Principle 3 of the NZMA Code states "Respect the patient' s autonomy and freedom of choice."
  3. In an emergency, where no other medical practitioner is available, treatment of oneself or family is necessary. Treatment is likely to be urgent, timely, focused on reduction of harm and cost effective. To delay treatment while an alternative doctor is located may result in harm to the patient.
  4. A medical practitioner may be at risk of impaired judgement and lack of objectivity in the diagnosis and treatment of oneself or a family member. Isolated and rural practitioners may find themselves more frequently exposed to pressure to deliver treatment to family members;
  5. The lack of an available alternative practitioner including lack of specialist back-up may interfere with the exercise of professional judgement and the risk of practising outside ones' sphere of competence;
  6. Members should great exercise care in the prescribing of potentially addictive drugs to family members;
  7. In treating the individual, professional ethics and judgement are key elements in the treatment of oneself and family ranging from necessity (urgent life saving treatment), to a reduction in further harm, to ease and convenience.
  8. The changing nature and composition of familial relationships including changed legal definitions may mean 'family' is ill defined. Context, immediacy and dependency are important characteristics in the relationship. Issues of same sex relationships, surrogacy and donor relationships make this area more complex.

Adopted by the NZMA Board, 8 October 2002.