Boekelheide P D
J Fam Pract. 1978 Jan;6(1):87-90.
This paper is a review of incest from epidemiologic, familial, and individual points of view. The incest taboo has characterized almost every culture and society throughout the ages. Respect for the incest barrier is a cultural demand made by society and is not a physiological or biological imperative. Overt incest occurs in a dysfunctional family through tension-reducing "acting out." The family physician is in a unique position to observe and understand the family dynamics which both help maintain defenses against the incestuous wishes as well as, in some families, contribute to the practice of incest. For 2,000 years physicians have taken the Hippocratic oath, with its explicit love relationship clause, as a reminder of their ethical responsibilities towards their patients. Examples of para-incestuous relationships between vulnerable individuals and authoritative helping figures are cited. A psychodynamic rationale is offered as to why sexual relationships between patients and their family physicians are not therapeutically beneficial. Clues for assessment and ten preventive measures are presented to enable physicians to monitor themselves and the families in their practice.
本文从流行病学、家庭及个体角度对乱伦进行了综述。乱伦禁忌几乎贯穿了各个时代的每一种文化和社会。对乱伦界限的尊重是社会提出的一种文化要求，而非生理或生物学上的必需。显性乱伦发生在功能失调的家庭中，通过减轻紧张的“付诸行动”表现出来。家庭医生处于一个独特的位置，能够观察并理解家庭动态，这些动态既有助于维持对乱伦欲望的防御，在某些家庭中也会促成乱伦行为。两千年来，医生们一直遵守希波克拉底誓言，其中明确的恋爱关系条款提醒着他们对患者的道德责任。文中列举了弱势个体与权威帮助者之间准乱伦关系的例子。对于患者与其家庭医生之间的性关系为何不利于治疗，给出了一个心理动力学原理。文中还给出了评估线索及十条预防措施，以使医生能够在其诊疗工作中对自己及患者家庭进行监督。
