Strasburger L H, Jorgenson L, Randles R
Department of Psychiatry, McLean Hospital, Belmont, MA.
Am J Psychiatry. 1991 Jul;148(7):859-63. doi: 10.1176/ajp.148.7.859.
Legislative enactment of criminal penalties for psychotherapists' sexual contact with their patients is pending in several states. The arguments in favor of criminalization are that it serves as a deterrent, offers retribution, provides redress when other avenues are blocked, deals with unlicensed psychotherapists, makes victims' assistance funds available, and provides due process protection against false accusations. In opposition to criminalization are the arguments that civil and administrative measures already exist to deal with the problem, it may have a chilling effect on the reporting of misconduct, it may void malpractice insurance, it makes guilty psychotherapists place themselves in jeopardy if they acknowledge their wrongdoing in attempting to make amends, it removes control of the legal process from the victim, it fails to offer rehabilitation, and it singles out psychotherapists from other fiduciaries for more stringent treatment. APA district branches inevitably will be called on to take positions with regard to legislation criminalizing sexual exploitation of patients. The current public outrage over patient victimization, however appropriate it may be, appears to make it difficult to publicly justify anything other than support for criminalization.
几个州正在等待通过立法对心理治疗师与患者发生性接触的行为实施刑事处罚。支持将其定为犯罪的理由包括:它具有威慑作用、可实现报应、在其他途径受阻时提供补救、应对无执照的心理治疗师、提供受害者援助资金,以及提供针对诬告的正当程序保护。反对将其定为犯罪的理由则是:现已有民事和行政措施来处理该问题;它可能对不当行为的举报产生寒蝉效应;它可能使医疗事故保险无效;如果有罪的心理治疗师在试图弥补过错时承认自己的不当行为,可能会使自己陷入危险境地;它将法律程序的控制权从受害者手中夺走;它没有提供康复措施;并且它将心理治疗师与其他受信托人区别对待,给予更严厉的惩处。美国心理学会的地区分会不可避免地会被要求就将对患者的性剥削定为犯罪的立法表明立场。然而,当前公众对患者受害情况的愤怒,无论多么合理,似乎使得除了支持定罪之外,很难公开为其他任何事情辩护。