In response to societal changes, a more flexible disciplinary response to sexual relationships between health practitioners and patients has developed over the last 15 years in New Zealand. The new approach involves a close focus on the circumstances of the particular case, balancing relevant aggravating and mitigating factors, to determine whether a disciplinary finding is called for and the appropriate penalty. Relationships between parties in relatively equal power positions, without strong evidence of patient exploitation or vulnerability, where prompt steps are taken to disengage the professional relationship, or involVe minor health services only, may not result in a disciplinary finding at all. Even where patient vulnerability is present, there has been movement away from automatic de-registration to suspension for periods often less than the maximum, provided there are sufficient mitigating factors. There is early indication of a stricter approach in the relatively new category of case of downloading and accessing objectionable material than in cases of sexual relationships, although there are too few cases yet to enable an appropriate disciplinary benchmark to have emerged. The rhetoric of the need for severity and public protection in one such case was not, however, matched by the imposition of the most serious of penalties.