2.2.3: Self-Treatment and Treatment of Family Members

Treating oneself or a family member presents unique and significant challenges, including risks to professional objectivity, concerns about patient autonomy, and difficulties ensuring informed consent.  These factors can lead to ethical and practical dilemmas that compromise the quality of care.

Pursuant to Rules 21 NCAC 32B.1001, 32S. 0212, and 32M. 0109, licensees are prohibited from prescribing controlled substances to themselves or to their immediate family members under any circumstance.

In addition, it is the position of the Board that licensees should not manage chronic conditions (including providing ongoing prescriptions for non-controlled medications) for themselves, their immediate family members, or those with significant emotional ties.  In these situations, professional objectivity is at risk, and personal feelings may unduly influence clinical judgment, thereby interfering with the delivery of optimal care.   Family members may also feel uncomfortable declining treatment or seeking care elsewhere, potentially affecting the transparency and effectiveness of care.

The Board acknowledges specific exceptions may exist in which the provision of care by a licensee to themselves or a family member may be acceptable.  These are limited to :

1. Emergency Conditions.  In an emergency, when no other qualified licensee is available, it is acceptable for licensees to treat themselves or their family members until such time as another qualified provider can assume responsibility.
2. Urgent Situations.  In limited circumstances where a licensee or immediate family member lacks access to prescribed medications or a qualified provider, it may be appropriate for the licensee to issue a short-term prescription to bridge care.
3. Acute Minor Illnesses Within Clinical Competence.  While licensees should not serve as primary or regular care providers for themselves or their family members, there are certain situations in which care may be acceptable.  Examples would be treatment of antibiotic-induced fungal infections or prescribing ear drops for a family member with external otitis.  It is the expectation of the Board that licensees will not treat recurrent acute problems.
4. Over-the-Counter Medication.  This Position Statement is not intended to prevent licensees from suggesting over-the-counter medications or other non-prescriptive modalities for themselves or family members, as a lay person might.

Licensees who provide care to themselves or individuals with whom they have a personal relationship are expected to adhere to the same standards of care that govern all clinical encounters. Licensees must not diagnose or treat conditions that fall outside the bounds of their professional training or clinical competence.

The Board expects licensees to maintain appropriate medical record documentation for any care that is rendered.  It is also prudent for the licensee to provide a copy of the medical record to the patient’s provider.

Licensees who inappropriately treat themselves, their family members, or others with whom they have a significant emotional relationship should be aware that they may be subject to investigation and disciplinary action by the Board.