0
Get Alert
Please Wait... Processing your request... Please Wait.
You must sign in to sign-up for alerts.

Please confirm that your email address is correct, so you can successfully receive this alert.

1
Letter to the Editor   |    
Posttermination Boundary Issues
THOMAS G. GUTHEIL, M.D.
Am J Psychiatry 2002;159:878-878. doi:10.1176/appi.ajp.159.5.878

To the Editor: The excellent article by Drs. Malmquist and Notman provided a needed critical examination of the legal system’s use and misuse of the clinical concept of transference. As an expert witness in more than 250 cases of boundary violations/sexual misconduct, I have also been impressed with the curious tendency of both courts and boards of registration to treat transference as tantamount to a finding of incompetence, although I profess that an undue-influence model is plausible and often accurate (1). The latter model is at least more respectful of patient autonomy.

The article seemed to omit a central issue, however—economics. To have sex with a past or present patient is an intentional act, hence, an intentional tort, which precludes coverage by malpractice insurance. Plaintiffs’ attorneys have had two choices in making such cases triable: 1) stressing the other negligences commonly found in such cases (2) or 2) "creating" a negligent (insurable) tort by claiming mismanagement of the transference, a form of (insurable) negligence. Legal precedent has then enshrined the centrality of a transference analysis, even when it does not fit, as Drs. Malmquist and Notman so effectively pointed out.

Gutheil TG: Patient-therapist sexual relations. Harv Health Lett  1989; 6:4-6
 
Jorgenson L, Bisbing SB, Sutherland PK: Therapist-patient sexual exploitation and insurance liability. Tort and Insurance Law J  1992; 27:595-614
 
+

References

Gutheil TG: Patient-therapist sexual relations. Harv Health Lett  1989; 6:4-6
 
Jorgenson L, Bisbing SB, Sutherland PK: Therapist-patient sexual exploitation and insurance liability. Tort and Insurance Law J  1992; 27:595-614
 
+
+

CME Activity

There is currently no quiz available for this resource. Please click here to go to the CME page to find another.
Submit a Comments
Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
Comments are moderated and will appear on the site at the discertion of APA editorial staff.

* = Required Field
(if multiple authors, separate names by comma)
Example: John Doe



Related Content
Books
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 52.  >
Gabbard's Treatments of Psychiatric Disorders, 4th Edition > Chapter 55.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 49.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 49.  >
The American Psychiatric Publishing Textbook of Substance Abuse Treatment, 4th Edition > Chapter 49.  >
Topic Collections
Psychiatric News