This interesting column by Abigail Zuger MD, addresses divergent views on patient/professional boundaries. She outlines a challenge but does not answer it: when if ever is it OK to engage in the outside lives of our patients? Perhaps a good way to frame the answer is to be able to ask one’s self as a physician whose interests are being served? If it is truly the patient’s, one may perhaps breathe a sigh of relief and proceed. But how many have the capacity of introspection and self-knowledge to know whose interests are truly being served? And how many physicians’ cloudy thinking about helping their patients by gratifying immediate wishes or needs, are actually mistreating patients by for example, prescribing narcotics inappropriately, thoughtlessly filling out forms endorsing disability or other entitlements upon request, and other actions that cheapen the profession and hurt patients.

Boundary breeches are fraught with hazards. Thus they are generally engaged in by the naive, the scoundrels, or the saints. Sadly, many a scoundrel thinks their actions are that of the saint.