When breaking bad news to a patient or their family, or helping them through a particularly upsetting time, it might seem like second nature to offer a hug for reassurance, or return the hug if they initiate one. But it does raise the question of whether the professional relationship between doctor and patient means this type of interaction is not always appropriate.

The MDU published advice on this topic in the lead-up to Valentine's Day, and we found that opinions differed. Some doctors said they would hug a patient if it felt right at the time, while others would refuse in any situation.

In terms of medico-legal advice, although the GMC makes it clear in its guidance that doctors mustn't use their 'professional position to pursue a sexual or improper relationship with a patient or someone close to them', it doesn't mention anything specific on hugging. 

Although offering or accepting a hug from a patient doesn't necessarily mean you've crossed a professional boundary, it does blur the line between simply showing empathy and being thought of as over-familiar.

MDU advice: keep it in context

It's important to be able to show compassion for patients and comfort them when they need it. But bear in mind that if you initiate a hug, there is a chance it may be misconstrued – particularly if the patient reads into something else you say or do and considers it inappropriate. Another scenario to avoid is if a patient initiates a hug because they have amorous feelings towards you.

It often comes down to the context for the hug and the patient's individual preferences. There are plenty of people who can be visibly upset but prefer to avoid being physically comforted, even by close friends or family, so it's important to make a judgement based on the situation and your knowledge of the patient. You can also consider whether their age or gender means they're more or less likely to accept or offer a hug.

If a patient initiates a hug which you are not comfortable with, you can always extend a handshake and a smile while explaining that you feel that hugging oversteps a professional boundary. This way you are making it clear that it's nothing personal, while also offering an alternative which can help avoid any feelings of embarrassment. On the other hand, if you're happy to be hugged by a distressed or grateful patient, then you don't need to feel that you should reject their advance.

Make a note

It's always a good idea to make a full note of your consultation with the patient, including physical interaction, as it may help with the patient's ongoing care and in case it ever comes up in the future. You could include mention of the circumstances surrounding the hug, who initiated it, and any verbal consent given by the patient.

While giving or receiving a hug may be a genuine human reaction to seeing another person in distress, erring on the side of caution can help prevent inadvertent misunderstandings and the medico-legal issues that could follow.