Gutheil T G
Department of Psychiatry, Harvard Medical School, Boston, MA 02115.
Jpn J Psychiatry Neurol. 1994;48 Suppl:39-44. doi: 10.1111/j.1440-1819.1994.tb03037.x.
Sexual misconduct by clinicians in the form of sexual relations with patients has long been recognized as an ethics violation and an activity suitable for assessment by the ethics committees of institutions and local and national professional organizations. The issue can be examined from the vantage point of several types of duties which bear ethical implications; these ethical duties proceed from the following four notions in this area: Sexual misconduct represents a violation of professional ethics as a fiduciary breach, abuse of a power asymmetry, exploitation of vulnerability and use of undue influence. While objections to these criteria may be raised in terms of freedom of association and consent, the violation of ethical principles by sexual misconduct remains clear.
临床医生与患者发生性关系形式的性行为不端，长期以来一直被视为违反伦理道德的行为，是适合由机构以及地方和国家专业组织的伦理委员会进行评估的活动。这个问题可以从几种具有伦理意义的职责角度来审视；这些伦理职责源于该领域的以下四个观念：性行为不端作为一种信托违约行为，是对职业道德的违反，是对权力不对称的滥用，是对脆弱性的利用以及不当影响的使用。虽然可能会从结社自由和同意的角度对这些标准提出异议，但性行为不端对伦理原则的违反仍然是显而易见的。
