title: The steak dinner--a professional boundary crossing.
abstract: Maintaining professional boundaries enables clinicians to keep their patients' best interests in mind. Palliative care clinicians may be at risk for professional boundary crossings because of the intimate nature of caring for people with life-threatening illnesses. In some instances, boundary crossings can be beneficial to the patient, but must be considered thoughtfully and with trusted others. We describe the case of a primary care physician and clinic nurse who were asked by a long-time clinic patient, who was now terminally ill, to join him for a steak dinner. We discuss the approach that the physician and nurse took in deciding about whether the boundary crossing was ethically permissible. We also offer sample questions for palliative care clinicians to consider when thinking about their actions.
authors.affiliation: VA Puget Sound Health Care System, Seattle, Washington, USA; University of Washington, Seattle, Washington, USA. Electronic address: vigster@uw.edu.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Vig
authors.affiliation: University of Washington, Seattle, Washington, USA; National Center for Ethics in Health Care, Veterans Health Administration, Washington, DC, USA.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Foglia
mesh_terms: D005247:Feeding Behavior; D006801:Humans; D009723:Nurse-Patient Relations / Q000941:ethics*; D010166:Palliative Care / Q000941:ethics*; D010817:Physician-Patient Relations / Q000941:ethics*; D019452:Terminally Ill / Q000523:psychology
keywords: Professional boundaries; codes of professional ethics; palliative care; professionalism