The issues discussed in this article involve: 1) What should the ideal doctor/child/family relationship be? and 2) What models of decision-making are appropriate in pediatrics?

The American Academy of Pediatrics (AAP) policy on “Pediatrician-Patient-Family Relationships: Managing the Boundaries” (1) focuses on maintaining appropriate limits. The policy comments on five areas of concern: 1) Caring for ones' own or relatives' or friends' children is fraught with ethical issues, such as confidentiality, and should be avoided except for minor conditions or emergencies; 2) Anything more than modest gifts can adversely affect appropriate boundaries; 3) Romantic and sexual relationships with a patient represent a serious breach in a therapeutic relationship and, thus, such relations are always inappropriate, and romantic relationships with a patient's family members also should be avoided; 4) Inadvertent sexuality in the pediatrician-patient relationship can occur during demonstrations of affection or empathy through body language and verbal expression, so...

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