Can the American Psychiatric Association ( APA ) govern itself within its ethical guidelines or does it hold struggles of involvement where Torahs are required to protect its patients? Although the Hippocratic Oath taken by head-shrinkers includes “ making no injury ” and keeping a professional and ethical relationship with their patients and the community, some chose to put their personal desires above the ethical codification they swore to continue. Within the Frontline episode, “ My Doctor, My Lover, ” the ethical behaviour of a head-shrinker and the APA were challenged. The narrative is told from opposing point of views and leaves the spectator inquiring about the ethical and legal protection of patients and their advocators.
Analysis of Opposing Point of views
On November 12, 1991, “ Frontline ” aired a 90-minute episode entitled “ My Doctor, My Lover. ” This telecasting show recounted a 1989 sexual maltreatment instance filed by Melissa Roberts-Henry against head-shrinker Dr. Jason Richter ( Zaritsky, 1991 ) . Richter admitted to prosecuting in a sexual relationship with Roberts-Henry, nevertheless the re-telling of the events of the relationship differ greatly. Both point of views will be presented in the analysis.
Psychiatrist
Jason Richter graduated from Columbia Medical School as a head-shrinker where he took the Hippocratic Oath, which included making no injury to his patients. He had been practising psychopathology for 10 old ages and was married with one kid when he met his patient Melissa Roberts-Henry. He treated her for 11 months and diagnosed her as holding a crude superego and that she looked to people outside of her for proof. Harmonizing to Richter, Roberts-Henry questioned him persistently about how he felt about her and that she pursued a sexual relationship with him. Although Richter had written in her instance notes that a sexual relationship would be damaging to Roberts-Henry, he called her to stop their physician – patient relationship so he could prosecute a relationship with her. Richter recalled having a missive from Roberts-Henry bespeaking the professional relationship be dissolved. He felt that he was non working her because he wanted to assist her by acquiring into a relationship. He besides felt that they had gotten near plenty over their eighteen-month sexual matter to see disassociating his married woman. He stated on many occasions that he loved her and the stoping of their relationship left him aching.
Patient
Melissa Roberts-Henry, a married geologist, went to seek therapy because of the depression and guilt she felt after holding an adulterous matter she had late ended. She stated that her hubby was off a batch and was fearful of her matrimony falling apart. In contrast to Richter, Roberts-Henry remembers Richter inquiring her what she thought of him on multiple occasions. This led her to believe that he was believing about her and although she stated that she did non hold feelings for him, she began to believe about him. Harmonizing to Roberts-Henry and her hubby, they felt that Richter was insulating her from her household and friends. He kept stating her he would handle her better than everyone else would. Her matrimony became a rollercoaster and began falling apart. Her symptoms became worse and she became more dependent on her head-shrinker. Richter told her to halt taking her medicine and she became self-destructive. She began believing that since he truly helped her and cared about her that a physical relationship would be good. She stated that he could be “ my physician and my lover. ” At this point, she asked Richter if there could be something between them. She confirmed that she had sent him a missive to stop their professional relationship so they could prosecute an confidant relationship.
Melissa ‘s remembrance of the sexual relationship is really different from Richter ‘s version. She stated that the first sexual contact occurred two months after the professional relationship ended. She went to his office where he pulled her bloomerss off and had intercourse without her consent forcing a tampon up interior of her. She remembers shouting and hearing him say, “ Is n’t this what you wanted? ” Thereafter, the bulk of their sexual brushs occurred in Richter ‘s office and would be timed as if she was an assignment. He set assignments for their sexual brushs at one time per month. Melissa remembers non being able to do much sense out of what was go oning to her and felt she needed extra therapy. Richter saw her range for aid as a menace to his calling and later threatened her. The Richter – Roberts-Henry relationship had reached its breakage point and Melissa told her hubby about what had occurred. Melissa ‘s hubby confronted Richter sing his unethical and illegal behaviour and promised to stand by her. Melissa Roberts-Henry filed a case against Dr. Jason Richter that went to test in February of 1989.
Legal Proceedings
Dr. Richter was provided a top attorney through his APA insurance. The defence scheme was to examine into Melissa ‘s sexual yesteryear to demo that she was promiscuous. Mrs. Roberts-Henry was questioned repeatedly and for long periods. Her household and friends were tracked down and asked inquiries about her sexual yesteryear. Her male parent, cognizing nil of Melissa ‘s past sexual history, was brought in and questioned for 24 hours. Richter brought in sexual phantasy letters that he had received from Roberts-Henry and brought Forth confidant inside informations from his psychiatric Sessionss with her to heighten his defence.
Melissa Roberts-Henry claimed that because of the episode with Dr. Richter, she suffered from posttraumatic emphasis upset ( PTSD ) . Dr. Richter ‘s lawyer, a adult female, countered that it was merely “ secondary addition syndrome, which means, symptoms seem to increase when you want money for the symptoms. ” However, Roberts-Henry ‘s go toing head-shrinker, Dr. Gay, testified that she suffered from PTSD and was supported in the diagnosing by three other head-shrinkers every bit good as the defence head-shrinker. Even with the support provided, Dr. Gay was placed under examination and accused of doing Roberts-Henry ‘s symptoms. Dr. Gay was non able to supply any session notes because Roberts-Henry did non give permission for her private Sessionss to go portion of the tribunal proceedings. Dr. Gay ‘s personal life began to be questioned and brought into tribunal.
The three work forces and three adult females jury found Dr. Richter guilty of one misdemeanour of substandard attention. The jury attributed 82 % of the duty to Richter and 18 % to Roberts-Henry, demoing that Richter ‘s defence worked. Melissa Roberts-Henry was awarded $ 180,000, a much smaller sum than was sought and that hardly covered her psychotherapeutics disbursals.
Impact
Richter retained his medical licence, divorced his married woman, remarried and continued a booming pattern. Dr. Gay, on the other manus, was forced to vacate her place as vice-president of the ethical society because of the allegations and her referrals dropped 75 % . She closed her pattern in 1990 and was unable to acquire anyone to take over Melissa ‘s attention. Dr. Gay requested that the APA review their schemes in future instances.
Melissa Roberts-Henry became an advocator for patient rights and was able to force through statute law that made it a offense for head-shrinkers to hold sex with their patients in Colorado. This 1991 statute law besides placed a bound on the probe of a patient ‘s sexual history. She continues to talk out and hosts a group for adult females who have been sexually assaulted by their physicians, many of whom ne’er report it.
Dr. Cynthia Rose, former APA president of Colorado, spoke out against Dr. Richter and stated that she would ne’er mention a patient to him. Dr. Fleming besides believed that Richter was non safe to be about and that the Torahs were unequal in protecting patients.
Synthesis
This picture study non merely exposes the misdemeanor of the regulation that a head-shrinker should non hold sex with a patient, but adds in the manner in which such instances are dealt with by the jurisprudence and the American Psychiatric Association. It points out that although the APA is supposed to regulate its members and maintain them up to the ethical grade that it really has a fiscal interest in guaranting malpractice instances are won. The struggle of involvement in the APA becomes really apparent within the picture. The defence tactics used in this instance leave the feeling that the APA invested insurance company will put undue force per unit area on anyone delivery charges to deter future malpractice suits. The patient is no longer considered or protected by the really administration that was put in topographic point to protect them.
Roberts-Henry was compelled to reply many inquiries about her sexual yesteryear, but Richter was non required to unwrap any information sing his sexual history. Richter besides used confidential information gathered during his Sessionss to supply his defence squad with information, go againsting doctor-patient confidentiality. The defence used this information to put uncertainty in the jurymans ‘ heads when assigning duty.
Roberts-Henry go toing head-shrinker, Dr. Martha Gay, came under onslaught by the APA defence squad merely because she had taken Roberts-Henry as a patient. They charged that Dr. Gay aggravated her status alternatively of assisting. Dr. Gay requested aid from her insurance company, the same APA backed insurance company that represented Dr. Richter, and she was told that the insurance company had approved the onslaughts on her. Dr. Gay was left contending for her repute without the backup of her insurance bearer. Richter ‘s defence hoped to decrease the amendss against him by seting uncertainties about Dr. Gay ‘s competency in the jurymans ‘ heads. Dr. Nanette Gartrell resigned from the Psychiatric Association ‘s Committee on Women in protest of the issues environing this instance. She said, “ In this instance, I think the psychiatric association put its resources behind the defence in order to do an illustration of Dr. Gay and intimidate and harass other adult females head-shrinkers who might see back uping their patients who have been victimized by head-shrinkers ( Zaritsky, 1991 ) . ”
Evaluation
Double relationships with patients have been a subject of treatment even prior to the events that took topographic point within the Richter instance. Although it was non a offense to hold sex with a patient, Richter ignored the ethical principal of nonmaleficence ( American Psychiatric Association, 2009 ) . Professionals have a duty to move in a mode that will non do injury to their patients. Richter ‘s notes included a statement that he felt that a sexual relationship would do injury to Roberts-Henry, yet he pursued it anyways.
Sexual activity with a patient reveals the head-shrinkers disregard for the curative relationship in favour of the sexual 1 ( Moleski & A ; Kiselica, 2005 ) . “ It is clear from study research, and from instance survey studies, that therapist sexual contact has about universally negative effects for the client ” ( Stake & A ; Oliver, 1991, Introduction subdivision, A¶ 1, as cited by Moleski & A ; Kiselica, 2005 ) . Once the sexual relationship becomes primary, the head-shrinker fails in his duty to advance liberty and nonmaleficence. Richter took advantage of Melissa ‘s demand for aid, her willingness to portion her deepest ideas, and her eventual trust on him. This made her particularly susceptible to his influence and authorization. Because of this power instability, Melissa may hold felt that she did non hold the freedom to take to come in or non to come in into the sexual relationship with Richter, nor the freedom to go forth it ( Moleski & A ; Kiselica, 2005 ) . Moleski and Kiselica wrote of the calamity of sexual relationships:
The tragic cost for the patient of such a relationship may include cognitive disfunction, sexual confusion, ambivalency, suppressed fury, guilt, depression, psychosomatic upsets, and hazard of self-destruction ( Kagle & A ; Giebelhausen, 1994 ; Smith & A ; Fitzpatrick, 1995 ; Stake & A ; Oliver, 1991 ) . Furthermore, Stake and Oliver cited the devastation of the unity of the curative relationship, the client ‘s lessened trust in future health professionals, and the aggravation of the really symptoms for which the client had sought aid as farther negative consequences of sexual contact.
Melissa appeared to endure many of the issues cited in this journal article from the sexual relationship with Richter. Interestingly, during the test and while under the attention of Dr. Gay, Melissa besides had an aggravation of the symptoms she sought aid with from Dr. Richter.
The unethical behavior of Richter towards Melissa led her to register a ailment. This ailment opened Melissa ‘s private life to the populace. Richter abused confidentiality and her right to favor by his revelation of therapy information to his defence lawyers ( American Psychiatric Association, 2009 ) . The curative relationship was subverted and used for Richter ‘s personal demands.
The unethical behavior of the APA was besides really evident within the picture. Based on the information provided in the picture, Dr. Gay was non provided the protection she paid for because her insurance bearer decided to back up Dr. Richter ‘s instance. She was left unprotected and her calling suffered irreparable harm. The payout for the insurance claim became the top precedence of the APA backed insurance company. No sense of justness entered into the determinations made by the APA. The patient and her back uping physician were left without protection from the very organisation that was put in topographic point to protect them. How can the APA govern its members if its lone focal point is on its fiscal protection? It can non. The APA ethical rules were wholly ignored in this instance.
Because of the continuity of Melissa Roberts-Henry, jurisprudence was put into topographic point to step in where the APA failed. The picture leaves all who watch it doubting the ethical rules of the APA and whether they will adhere to them. This uncertainty has already spilt over into Torahs that now provide condemnable countenances against psychological professionals who enter into sexual relationships with patients in many provinces besides Colorado.
American Psychiatric Association. ( 2009 ) . Principles with notes. In The rules of medical moralss: With notes particularly applicable to psychiatry ( 2009 Edition Revised ed. , pp. 3-10 ) . ( Original work published 1973 ) Retrieved from hypertext transfer protocol: //www.psych.org/mainmenu/psychiatricpractice/ethics/resourcesstandards/principlesofmedicalethics.aspx
Moleski, S. M. , & A ; Kiselica, M. S. ( 2005, Winter ) . Double relationships: A continuum runing from the destructive to the curative. Journal of Counseling & A ; Development, 83, 3-11.
Zaritsky, J. ( Director ) . ( 1991 ) . My physician, my lover [ Television series episode ] . In D. Fanning & A ; V. Storring ( Producer ) , Frontline. New York, New York: Public Broadcasting Service.
