A systematic review documenting reasons whether physicians should provide treatment to their family and friends.

Background: Physicians are likely to be asked to provide medical care to relatives or friends. Evidence suggests that most physicians treat loved ones during their active years. However, in the academic literature, critical approaches to the matter are dominating. Ethical guidelines often discourage physicians from treating family members and friends outside of exceptional circumstances.

Objective: This systematic review aims to identify reasons for and against treating family and friends as portrayed in the literature published.

Methods: A search string designed for the database "PubMed," snowball sampling, and hand searching was used to identify possibly eligible publications. Seventy-six publications were screened for all reasons presented in favour of and against physicians treating loved ones. Qualitative content analysis was used for data extraction. Combining a deductive and inductive approach, a coding system was developed.

Results: Many publications analysed represent articles portraying personal experiences; fewer show original research. Reasons against and in favour of treating family and friends were identified. Several publications specify conditions under which the treatment of loved ones may be legitimate. The reasons identified can be assigned to a micro or macro level of human interaction.

Conclusions: This systematic review shows that the discourse of physicians treating loved ones is held predominantly in the context of personal experiences. The majority of authors seem to have a rather pragmatic interest in the topic, and systematic or analytic approaches are rare. While most authors mention various codes of ethics, several publications criticize these or consider them insufficient.