Appelbaum P S, Zoltek-Jick R
Department of Psychiatry, University of Massachusetts Medical Center, Worcester, 01655, USA.
Am J Psychiatry. 1996 Apr;153(4):457-65. doi: 10.1176/ajp.153.4.457.
This paper explores the implications for psychotherapy of a series of court cases involving suspected childhood sexual abuse that have raised the question of when psychiatrists and other psychotherapists can be sued by third parties for their behavior in therapy.
The authors begin by considering traditional legal approaches that until now, with few exceptions, granted only patients the right to sue caregivers for negligence. Then they turn to Ramona v. Ramona, the most publicized of a new line of cases, in which the California courts allowed a father accused of abusing his daughter to sue his daughter's therapists.
The rationale for the abandonment of the previous restrictions on liability in Ramona was that since the father was a "direct victim" of the therapists' negligence, traditional limitations on the therapists' duties toward him should not apply. Related cases have used similar logic. Inherently difficult for the courts to apply, the direct victim standard would leave therapists unclear as to how to avoid duties to third parties, other than by refusing to treat patients with family members who may be potential litigants. Moreover, aggrieved third parties essentially would have the power to bring effective treatment to a halt by filing suit or threatening to do so.
Although concern about therapeutic practices related to memories of childhood abuse may be warranted, abandonment of traditional rules against suits by nonpatients would be ill-advised. In the meantime, therapists can take steps to lessen the probability of their becoming involved in such litigation.
本文探讨了一系列涉及疑似儿童性虐待的法庭案件对心理治疗的影响，这些案件引发了精神病医生和其他心理治疗师何时会因治疗行为被第三方起诉的问题。
作者首先考虑传统的法律方法，到目前为止，除了少数例外，只有患者有权起诉护理人员的过失行为。然后他们转向“雷蒙娜诉雷蒙娜案”，这是一系列新案件中最受关注的一起，加利福尼亚州法院允许一名被指控虐待女儿的父亲起诉其女儿的治疗师。
在“雷蒙娜案”中放弃先前对责任的限制的理由是，由于父亲是治疗师疏忽行为的“直接受害者”，对治疗师对他的责任的传统限制不应适用。相关案件采用了类似的逻辑。法院很难适用直接受害者标准，这会让治疗师不清楚如何避免对第三方的责任，除非拒绝治疗可能有潜在诉讼当事人家庭成员的患者。此外，受害的第三方基本上有权通过提起诉讼或威胁提起诉讼来有效终止治疗。
虽然对与童年虐待记忆相关的治疗实践表示担忧可能是有道理的，但放弃禁止非患者起诉的传统规则是不明智的。与此同时，治疗师可以采取措施降低卷入此类诉讼的可能性。
