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An ethical dinner dilemma

Back from his hols in Italy, our diarist tackles the issue of patients wanting to be friends

Back from his hols in Italy, our diarist tackles the issue of patients wanting to be friends

I've just poured a nice glass of Nero D'Avola to get me in the mood to write. I do this first because I've just spent two weeks in Sicily where this magnificent grape originates, and second because after a fortnight of Italian driving, a large glass of wine is necessary to calm my shaking hands. The unruly mob that tackles the M40 on a daily basis now seem the very apogee of civilisation.

The strain of keeping the car on the road was matched by the stress of keeping our screaming infant out of the hair of the landlady, off the cliff ledges and away from a pack of feral dogs that inhabited our cobbled courtyard. Given the amount of food that he routinely dropped as he toddled about, I think they started to view him as a benevolent blond-headed god – albeit a diminutive one.

Foot in mouth disease
All of which leads me to believe I will be going back to work for a bit of a rest. As I contemplate the week ahead I find myself thinking (surprisingly fondly) of some of my frequent flyers.

Around mid-week I'm due to see a couple who recently challenged my ethical framework: they invited me to dinner. I was pleased and flustered in equal measures. When I finally got round to declining it was neither polite nor smooth: first I said yes, then I said maybe, then I said no. The couple seemed a bit confused, and my mumbled explanation about ethics and probity seemed the excuse equivalent of 'I'm washing my hair that night'.Several of my friends seemed quite surprised by this event. My wife bristled and wanted to know if they were some sort of weird swingers (they're not).

Perfecting declining
I approached my trainer, who said that in a broader sense such things were not that uncommon. He recommended that I develop a general policy so as to prevent another foot-in-mouth episode. This prompted me to write today so that the gentle reader can develop their own response.

I contacted my defence union. There was evident relief in the chap's voice when he realised I had said 'no' to the offer. But he went on to explain that the rules are flexible and commonsensical.

For example, inviting along other friends, colleagues or family members to a public event tends to defuse the situation. It also looks better in court, as opposed to a single male doctor visiting a recently divorced and possibly deranged female patient in her own home.

I've also spoken to a random sample of GP colleagues, several of whom have patients as friends, or is that friends who are patients? It does seem to become tricky. For many of us as we leave hospital medicine this is unknown territory. I myself will proceed with caution.

Dr Geoff Tipper is a GP registrar in Maidenhead, Berkshire

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