Characteristics of Faculty Accused of Academic Sexual Misconduct in the Biomedical and Health Sciences

Espinoza M, Hsiehchen D.
JAMA. 2020;323(15):1503–1505.
doi:10.1001/jama.2020.1810

Abstract

Despite protections mandated in educational environments, unwanted sexual behaviors have been reported in medical training. Policies to combat such behaviors need to be based on better understanding of the perpetrators. We characterized faculty accused of sexual misconduct resulting in institutional or legal actions that proved or supported guilt at US higher education institutions in the biomedical and health sciences.

Discussion

Of biomedical and health sciences faculty accused of sexual misconduct resulting in institutional or legal action, a majority were full professors, chairs or directors, or deans. Sexual misconduct was rarely an isolated event. Accused faculty frequently resigned or remained in academics, and few were sanctioned by governing boards.

Limitations include that only data on accused faculty who received media attention or were involved in legal proceedings were captured. In addition, the duration of behaviors, the exact number of targets, and the outcome data could not be identified for all accused faculty. Thus, this study cannot determine the prevalence of faculty who commit sexual misconduct, and the characteristics may not be generalizable across institutions.

The lack of transparency in investigations suggests that misconduct behaviors may not have been wholly captured by the public documents. Efforts to eliminate nondisclosure agreements are needed to enhance transparency. Further work is needed on mechanisms to prevent sexual misconduct at teaching institutions.

The info is here.

Goldwater Rule: Red Line or Guideline?

Scott O. Lilienfeld, , Joshua D. Miller, Donald R. Lynam
Perspectives on Psychological Science 
Vol 13, Issue 1, pp. 33 - 35
First Published October 13, 2017

The decades following Miller’s (1969) call for psychological scientists to “give psychology away” have witnessed a growing recognition that we need to do more to communicate our knowledge to the general public (Kaslow, 2015; Lilienfeld, 2012). But should there be limits on the nature of this communication? The Goldwater Rule, which expressly forbids psychiatrists from commenting on the mental health of public figures whom they have not directly examined, answers this query in the affirmative; as we observed in our article (Lilienfeld, Miller, & Lynam, 2017), this rule has been de facto adopted by psychology.

We appreciate the opportunity to respond to two commentators who raise thoughtful qualifications and objections to our thesis, which holds that the Goldwater Rule is antiquated and premised on dubious scientific assumptions.  We are pleased that both scholars concur with us that the direct interview assumption—the principal empirical linchpin of the Goldwater Rule—is contradicted by large bodies of psychological research.

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Psychologists should typically refrain from proffering diagnostic judgments regarding public figures. Such judgments boost the risk of inaccurate ‘arm chair' diagnoses and of damaging the reputation of public figures and the profession at large.  At the same time, there is scant justification for a categorical ban on this practice, especially because psychologists can at times offer diagnostic information that bears to some degree on the question of individuals’ suitability for high public office.  We therefore recommend reformulating the 'Goldwater Rule” as the 'Goldwater Guideline.’  Such a change would underscore the wisdom of discretion with respect to statements concerning the diagnostic status of public figures but remind psychologists that such statements can be useful and even advisable within limits.

The article is here.

Three professors under criminal investigation for sexual misconduct

The Dartmouth Senior Staff
The Dartmouth
Originally posted October 31, 2017

Three professors are alleged to have engaged in sexual misconduct and are being investigated by law enforcement, College President Phil Hanlon wrote in a campus-wide email Tuesday morning. The New Hampshire Attorney General’s office, the Grafton County Attorney’s office, the New Hampshire State Police, the Grafton County Sheriff’s office and the Hanover Police Department have all launched criminal investigations of the professors.

Psychology and brain sciences professors Todd Heatherton, Bill Kelley and Paul Whalen are on paid leave and their access to campus has been restricted, College spokesperson Diana Lawrence confirmed on Oct. 25. Lawrence said the professors were being investigated by the College for “allegations of serious misconduct.”

“It is important to remember that investigations are ongoing, with no official findings yet produced,” Hanlon wrote. “However, we take these allegations very seriously and are pursuing our own independent investigations in coordination with law enforcement officials.”

The College is cooperating with law enforcement officials, Hanlon wrote.

“I want to say in the most emphatic way possible that sexual misconduct and harassment are unacceptable and have no place at Dartmouth,” Hanlon wrote in his email. “Such acts harm us as individuals and as members of the community.”

The article is here.

Genitals photographed, shared by UPMC hospital employees: a common violation in health care industry

David Wenner
The Patriot News/PennLive.com
Updated September 16, 2017

You might assume anyone in healthcare would know better. Smart phones aren't new. Health care providers have long wrestled with the patient privacy- and medical ethics-related ramifications. Yet once again, smart phones have contributed to a very public black eye for a health care provider.

UPMC Bedford in Everett, Pa. has been cited by the Pennsylvania Department of Health after employees snapped and shared photos and video of an unconscious patient who needed surgery to remove an object from a genital. Numerous employees, including two doctors, were disciplined for being present.

It's not the first time unauthorized photos were taken of a hospital patient and shared or posted on social media.

• Last year, a nurse in New York lost her license after taking a smart phone photo of an unconscious patient's penis and sending it to some of her co-workers. She also pleaded guilty to misdemeanor criminal charges.
• The Los Angeles Times in 2013 wrote about an anesthesiologist in California who put a sticker of a mustache on the face of an unconscious female patient, with a nurse's aid then taking a picture. That article also reported allegations of a medical device salesman taking photos of a naked woman without her knowledge.
• In 2010, employees at a hospital in Florida were disciplined after taking and posting online photos of a shark attack victim who didn't survive. No one was fired, with the hospital concluding the incident was the "result of poor judgement rather than malicious intent," according to an article in Radiology Today. 
• Many such incidents have involved nursing homes. An article published by the American Association of Nurse Assessment Coordination in 2016 stated, "In the shadow of the social media revolution, a disturbing trend has begun to emerge of [nursing home] employees posting and sharing degrading images of their residents on social media." An investigation published by ProPublica in 2015 detailed 47 cases since 2012 of workers at nursing homes and assisted living facilities sharing photos or videos of residents on Facebook. 

The article is here.

Sexual abuse by doctors sometimes goes unpunished

Associated Press
Originally published July 6, 2016

Sexual abuse by doctors against patients is surprisingly widespread, yet the fragmented medical oversight system shrouds offenders' actions in secrecy and allows many to continue to treat patients, an investigation by The Atlanta Journal-Constitution has found.

The AJC obtained and analyzed more than 100,000 disciplinary orders against doctors since 1999. Among those, the newspaper identified more than 3,100 doctors sanctioned after being accused of sexual misconduct. More than 2,400 of the doctors had violations involving patients. Of those, half still have active medical licenses today, the newspaper found.

These cases represent only a fraction of incidences in which doctors have been accused of sexually abusing patients. Many remain obscured, the newspaper said, because state regulators and hospitals sometimes handle sexual misconduct cases in secret. Also, some public records are so vaguely worded that patients would not be aware that a sexual offense occurred.

The article is here.

Not All Multiple Relationships are Created Equal

By Ofer Zur
Independent Practitioner, 34/1, 15-22. 2014.

Introduction

Most mental health professionals have attended risk management and ethics workshops where one of the central messages was the dire warning that multiple relationships are generally unethical, inherently harmful, mostly prohibited, and should be avoided.  While the term "unethical" is thrown about liberally when it comes to multiple relationships, the fact is that none of the major professional organizations' codes of ethics prohibit all forms of dual or multiple relationships.

The entire article is here.

State reprimands psychologist David T. Bice over "touch"

Psychiatric Crimes Database
Originally posted January 3, 2012

On October 8, 2012, the Oregon Board of Psychologist Examiners reprimanded David T. Bice, Ph.D. for unprofessional conduct; failure to avoid harm; failure to obtain informed consent and exceeding the boundaries of competence with regard to a teenage female patient.

According to the Board’s document, Bice engaged in “comforting touch” with the patient, which made her uncomfortable to the extent that “she will never see a male counselor again.” Bice additionally failed to make entries in the patient’s chart when he touched her, the rationale for touching, how the patient reacted, etc.; failed to get the patient’s full informed consent, relative to the use of touch in that the did not address the use of touch with the patient nor did he address it in his informed consent documents or the patient’s chart notes; exceeding the boundaries of competence by engaging in touch with the patient “without first establishing a strong therapeutic alliance and [failing] to monitor [the patient’s] reactions…and to make a corresponding chart note.”

In addition to the reprimand, Bice must successfully complete coursework in the areas of informed consent, patient charting and the use of touch during therapy and is also required to practice for a minimum of one year under the supervision of a licensed psychologist, among other things.

When Is It Okay to Date a Patient?

By Shelly Reese
Medscape Ethics Report 2012
Originally published November 15, 2012


Introduction

To the besotted poet, love is intoxicating, exasperating, invigorating. To the doctor -- if the would-be paramour is a patient -- it's also unethical.

But physician responses to Medscape's 2012 ethics survey clearly indicate that many physicians aren't willing to condemn every romance. When asked, "Is it ever acceptable to become involved a romantic or sexual relationship with a patient?" more than two thirds (68%) of the 24,000 doctors who responded resoundingly say "no."

In contrast, nearly one third are more nuanced in their view. Only a tiny minority (1%) give romance with current patients a green light, but a sizable share (22%) say that a romantic relationship with a former patient may be acceptable, as long as at least 6 months have passed since the professional relationship was terminated. Another 9% say the ethics depend on the situation.

Whereas the American Medical Association (AMA) clearly states that sexual contact that is concurrent with the doctor/patient relationship constitutes sexual misconduct, it takes a fuzzier position on relationships that might develop later. The AMA notes that the prior doctor/patient relationship may unduly influence the patient and that such a relationship is unethical if the doctor "uses or exploits trust, knowledge, emotions or influence derived from the previous professional relationship."

Ethicists, such as Dr. Richard Martinez, director of forensic psychiatry services at Denver Health Medical Center and the author of several articles on ethical decision-making and the patient/physician relationship, says the AMA was wise to leave a little wiggle room in its opinion.

"Relationships are complicated," he says. "Every ethical dilemma has to be evaluated and considered on a case-by-case basis."

The entire story is here.

Thanks to Gary Schoener for this information.

Psychologist Kristina Nana Killam Duangpatra banned for six months for inappropriate relationship with prisoner

By Tony Keim
The Courier-Mail
Originally published November 5, 2012


A FEMALE psychologist who had a "personal and intimate relationship" with a Brisbane prisoner - including offering to have his child - has been banned for six months.

The Queensland Civil and Administrative Tribunal was told psychologist Kristina Nana Killam Duangpatra had an improper relationship with a prisoner over a two-year period.

QCAT acting Deputy President Kerrie O'Callaghan, in a just published eight-page decision, said Duagnpatra first met the prisoner, identified only as Mr Cougan, at Wacol's Wolston Correctional Centre when she began treating him on August 3, 2009.

The tribunal became involved after a disciplinary referral from the Psychology Board of Australia indicated Duangpatra was having an improper relationship with a former patient.

The entire story is here.

NH psychologist's sex charges reinstated

Hollenbeck’s sex charges reinstated

By Danielle Rivard
Sentinel Source.com
Originally published September 6, 2012

The case of a psychologist with a practice in Keene who was accused of having sex with a former patient is headed back to court.

Burton G. Hollenbeck Jr., 58, of Richmond faced 30 counts of aggravated felonious sexual assault before a Cheshire County Superior Court judge dismissed the charges.

Prosecutors appealed to the N.H. Supreme Court, which reversed the decision in a ruling released Wednesday.

Hollenbeck was accused of engaging in sexual conduct with the woman less than a year after her therapy with him ended, which violates state law, according to court documents.

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In its 3-1 decision Wednesday, the N.H. Supreme Court said the state has a legitimate interest in protecting people whose ability to consent to sexual contact may be compromised by the inherent nature of the treatment relationship, and in maintaining the integrity of mental health professionals.

The entire story is here.

When I Kissed the Teacher

Student-Doctor Relationships Can Be Problematic When It Comes to a Teaching Environment

By Guy Rughani
From Student BMJ
Medscape Today News
Originally posted on July 17, 2012

Here is one excerpt:

From the beginning of medical school we are told that doctors should never date their patients. Accusations of preying on the vulnerable, abusing a position of trust, and eroding professional integrity are all persuasive reasons against such relationships. Indeed, in the United Kingdom, the General Medical Council has extensive guidance on the topic, requiring doctors to “maintain a professional boundary between themselves and their patients.” Although some guidance exists for staff about relationships in the workplace (see box), why do we never hear warnings against student-doctor/teacher relationships?

Jonathan Coe is the director of the Clinic for Boundaries Studies, an organisation which supports the victims of professional boundary violations and educates professionals in improving their approaches to prevention. “When we [patients] go to a doctor, we bring with us a level of vulnerability to the relationship,” says Mr Coe. “Implicitly, we are seeking assistance with issues whose solution is outside our knowledge and ability to respond effectively. There is a clear power differential and it is this that means that senior practitioners need to be careful before entering into any kind of personal involvement.”

Mr Coe argues that the guiding ethical principles that underpin the doctor-patient relationship are also relevant in the context of doctor-student matches. “There is a general ethical responsibility to avoid harm [non-maleficence/beneficence] and to respect autonomy,” he says, “both of which are at risk if an intimate relationship [among doctors and students] is started.”

The entire story is here.

California places psychologist David Van Zak's license on probation

Psychiatric Crimes Database
Originally published July 5, 2012

On January 26, 2012, the California Board of Psychology placed DAVID VAN ZAK, Ph.D.’s license on probation for five years. According to the Board’s Accusation, Van Zak committed, among other things, repeated acts of negligence by accepting financial gifts from a patient, as well as the patient’s invitation to join her and her husband on a Mexican cruise.

The entire story is here.

Psychologist D. Laurence More surrenders license on charges of sex with two patients

Psychiatric Crimes Database
Originally published on June 11, 2012

On November 16, 2011, D. Laurence More, M.Ed. permanently surrendered his psychologist’s license to the Pennsylvania State Board of Psychology.

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More admitted that, approximately one month following termination, he commenced a personal relationship with the wife and further admitted that approximately two to three months later, he commenced a sexual relationship with her.

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More engaged in a sexual relationship with a different patient without first waiting two years after terminating professional services, as required by Board regulations.

The entire story is here.

Va. Beach court psychologist suspended

By Andy Fox
wavy.com
Originally published on June 4, 2012

A clinical psychologist was suspended indefinitely and charged with inappropriate behavior with a client after a woman claimed he kissed her.

Local courts relied on Dr. Brian Wald to give advice on parental custody in divorce cases. In documents obtained by WAVY.com the Board of Psychology says Wald is a danger to public health and safety.
His website states he has conducted over 300 parenting capacity evaluations and now he's suspended indefinitely and the likely target of a civil lawsuit.

The entire story is here.

Charlottesville psychologist's license suspended after alleged intimate activity with former client

By Daily Progress Staff Reporters
The Daily Progress
May 25, 2012

The Virginia Board of Psychology has suspended indefinitely a Charlottesville practitioner’s license after her continued intimate and sexual involvement with a former client, according to an order issued by the board.

The document claims Carrie E. Schaffer, a local clinical psychologist, was not truthful in a self-report to the board in 2009 in which she said she ended a relationship with the former client.

The entire story is here.

Thanks to Ken Pope for this information.

Paulucci psychologist suspended, fined $50K by state board

A Minnesota psychologist who charged thousands of dollars to organize a client’s closets, attend a funeral and visit a gravesite — and accepted dozens of expensive gifts from the client, Gina Paulucci of Wayzata — was suspended indefinitely and fined $50,000 for her actions, according to a Minnesota Board of Psychology order made public this week.

by Jane Friedman
Minneapolis Star Tribune

Originally published May 25, 2012

A Roseville psychologist who charged thousands of dollars to organize a client’s closets, attend a funeral and visit a gravesite — and accepted dozens of expensive gifts from the client, Gina Paulucci of Wayzata — was suspended indefinitely and fined $50,000 for her actions, according to a Minnesota Board of Psychology order made public this week.

Kathryne Sanders, 63, acknowledged in an interview that her professional relationship with the client went over the line, but said her career as a psychologist is likely over, so she won’t have to pay the record fine due upon reinstatement.

State law requires psychologists to observe strict boundaries between professional and personal relationships, and Sanders said “there were definitely issues there. But I also think this is something that is extremely common. I just don’t think it’s deserving of the penalty that I received.”

The entire story is here.

Los Angeles-Area Psychologist Surrenders License

Psychiatric Crime Database
A Public Service of the Citizens Commission on Human Rights
Originally Published May 10, 2012

On March 6, 2012, psychologist Ross U. Porter surrendered his license to the California Board of Psychology in lieu of facing a hearing on twelve counts of negligence.

According to the Board’s document which laid out the accusations against him, Porter engaged in multiple relationships with the daughter of a family to whom he provided individual and family therapy. The family, described in the state’s documents as “The ‘A’ Family,” consisted of a mother, father and six children.

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Porter encouraged Angela to interact socially with his family and to do volunteer work in conjunction with a fundraiser for Porter’s non-profit organization he ran called Stillpoint. Porter also hired and paid her to baby sit and house sit for him. When a health care practitioner engages a patient in his or her business or social activities, it is considered potentially harmful to the patient and is a violation of the American Psychological Association’s ethical principles, as well as a violation of sections of the California Business and Professions Code.

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In late 2008, during a therapy session with Angela and her parents, Porter recommended that Angela be allowed to move into his home for an indefinite period of time. It was agreed and she moved in.

The whole story is here.

Ohio Teacher Convicted of Sex with Students

Stacy Schuler

LEBANON, Ohio — A high school teacher was convicted Thursday of having sex with five students, some of them football players, after a judge rejected an insanity defense that argued the teens took advantage of her.

Stacy Schuler was sentenced to a total of four years in prison for the encounters with the Mason High School students at her home in Springboro in southwest Ohio in 2010. She can ask a judge to free her from prison after six months.

The 33-year-old Schuler, who could have faced decades in prison, cried as she was handcuffed and led out of the courtroom.

The five teens testified that Schuler, a health and gym teacher, had been drinking alcohol at the time of the encounters and was a willing participant who initiated much of the contact. The teens were about 17 at the time. The age of consent in Ohio is 16, but it's illegal for a teacher to have sex with a student.

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Testimony from a defense psychologist had suggested that Schuler's medical and physical ailments, combined with her vegan diet and use of alcohol and an antidepressant, helped impair her ability to tell right from wrong.

A psychologist for the prosecution rebutted that testimony, saying that the use of alcohol does not meet the state standard for an insanity defense and that willingly getting drunk is not a legal defense for a crime.

The entire story can be found here.

Suspended Nova Scotia doctor may get licence back

CBC News.
Former patient blames doctor for suicide

A Nova Scotia doctor who used a patient to get a narcotic drug for her personal use will be allowed to return to the practice of medicine if she fulfils several conditions imposed by the College of Physicians and Surgeons of Nova Scotia.

Dr. Violet Hawes of Middle Musquodoboit had her licence suspended in November 2009 after the allegations surfaced.

The following month, one of her former patients committed suicide and left a note blaming her.
Doug Carpenter, 49, took his life in the parking lot of the Musquodoboit Valley Memorial Hospital in December 2009.

He left a note for his family saying "Dr. Hawes did this to me."

According to Carpenter's medical records, Hawes prescribed him Hydromorph Contin — a narcotic — for the first time in January 2008.

Carpenter's mother, Phyllis, said her son had described an arrangement with his doctor when she prescribed the drug.

"She would have a prescription ready for him when he went in there for his drug. He would fill it and give it to her," Carpenter told CBC News last December.

The entire CBCNews-Canada story can be here.

There was a similar case in central Pennsylvania in which a physician used numerous patients to obtain narcotics for himself.  In the Pennsylvania case, the physician's patient did not commit suicide, but he apparently told patients the drugs were for a dying parent.  Physicians using patient to obtain narcotics occurs.

Some of that information can be found here.

Petitioner was charged with five misdemeanor counts of unlawful procurement of prescription drugs in violation of 63 P.S. � 390-8(13) - however, the misdemeanor conviction is not at issue in this proceeding. Both the felony and misdemeanor charges involved Hydrocodone (Lortab) a Schedule III controlled substance. I.G. Ex. 8, at 1.

Psychologist withdraws SJC appeal on license

BY: Colman M Herman and Bruce Mohl
CommonWealth

August 24, 2011

A female psychologist who had sex with a former patient is withdrawing her court appeal seeking the return of her license.

Brookline psychologist Mary O’Neill acknowledged having a sexual relationship with her patient, Eric MacLeish, just weeks after his therapy sessions ended. The standard punishment in such cases is permanent license revocation, but O’Neill filed an appeal with the state Supreme Judicial Court arguing that her license should be only temporarily suspended because her lapse in judgment was caused by the collapse of her own marriage.

The case was scheduled to be heard next month, but SJC Clerk Susan Mellen said O’Neill’s attorney told her he is withdrawing the appeal. Mellen said some paperwork must be completed before the withdrawal is official, but she says she has already told the SJC justices not to bother studying the case files. The Associated Press reported that O’Neill’s attorney  confirmed he was withdrawing the appeal, but gave no reason for the decision. The attorney could not be reached by CommonWealth.

The case was the focus of a lengthy article on CommonWealth’s website that dealt with the legal issues involved as well as O’Neill’s high-profile patient, MacLeish. MacLeish is an attorney who represented many of the clients who sued the Catholic Archdiocese of Boston alleging priests had sexually abused them. The case brought MacLeish national attention, but court records indicate it also scarred him emotionally and made him realize that he had been sexually abused as a child at the hands of a teacher at a boarding school in England and by a scoutmaster associated with the school.

In 2004, MacLeish turned to O’Neill for help. She diagnosed him with post-traumatic stress disorder and treated him for 10 sessions between August and September 2004. Shortly after those sessions ended, the two were sleeping together.

Linda Jorgenson, a Massachusetts attorney who has represented hundreds of people who have claimed their therapists abused them sexually, said she couldn’t understand why O'Neill would withdraw her appeal. "Her briefs have been filed. All that is left is for the oral argument to take place in September,” she said. “I don't see anything that she had to lose by waiting for the court to issue its ruling."

Thanks to Gary Schoener for the information.

The reader can find the earlier blog post here.