Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Sexual Boundaries. Show all posts
Showing posts with label Sexual Boundaries. Show all posts

Wednesday, June 29, 2022

Abuse case reveals therapist’s dark past, raises ethical concerns

Associated Press
Originally posted 11 JUN 22

Here is an excerpt:

Dushame held a valid driver’s license despite five previous drunken driving convictions, and it was his third fatal crash — though the others didn’t involve alcohol. The Boston Globe called him “the most notorious drunk driver in New England history.”

But over time, he dedicated himself to helping people recovering from addiction, earning a master’s degree in counseling psychology and leading treatment programs from behind bars.

Two years later, he legally changed his name to Peter Stone. He was released from prison in 2002 and eventually set up shop as a licensed drug and alcohol counselor.

Last July, he was charged with five counts of aggravated felonious sexual assault under a law that criminalizes any sexual contact between patients and their therapists or health care providers. Such behavior also is prohibited by the American Psychological Association’s ethical code of conduct.

In a recent interview, the 61-year-old woman said she developed romantic feelings for Stone about six months after he began treating her for anxiety, depression and alcohol abuse in June 2013. Though he told her a relationship would be unethical, he initiated sexual contact in February 2016, she said.

“‘That crossed the line,’” the woman remembers him saying after he pulled up his pants. “‘When am I seeing you again?’”

While about half the states have no restrictions on name changes after felony convictions, 15 have bans or temporary waiting periods for those convicted of certain crimes, according to the ACLU in Illinois, which has one of the most restrictive laws.

Stone appropriately disclosed his criminal record on licensing applications and other documents, according to a review of records obtained by the AP. Disclosure to clients isn’t mandatory, said Gary Goodnough, who teaches counseling ethics at Plymouth State University. But he believes clients have a right to know about some convictions, including vehicular homicide.

Tuesday, April 20, 2021

State Medical Board Recommendations for Stronger Approaches to Sexual Misconduct by Physicians

King PA, Chaudhry HJ, Staz ML. 
JAMA. 
Published online March 29, 2021. 
doi:10.1001/jama.2020.25775

The Federation of State Medical Boards (FSMB) recently engaged with its member boards and investigators, trauma experts, physicians, resident physicians, medical students, survivors of physician abuse, and the public to critically review practices related to the handling of reports of sexual misconduct (including harassment and abuse) toward patients by physicians. The review was undertaken as part of a core responsibility of boards to protect the public and motivated by concerning reports of unacceptable behavior by physicians. Specific recommendations from the review were adopted by the FSMB’s House of Delegates on May 2, 2020, and are highlighted in this Viewpoint.

Sexual misconduct by physicians exists along a spectrum of severity that may begin with “grooming” behaviors and end with sexual assault. Behaviors at any point on this spectrum should be of concern because unreported minor violations (including sexually suggestive comments or inappropriate physical contact) may lead to greater misconduct. In 2018, the National Academies of Science, Engineering, and Medicine identified sexual harassment as an important problem in scientific communities and medicine, finding that greater than 50% of women faculty and staff and 20% to 50% of women students reportedly have encountered or experienced sexually harassing conduct in academia. Data from state medical boards indicate that 251 disciplinary actions were taken against physicians in 2019 for “sexual misconduct” violations (Table). The actual number may be higher because boards often use a variety of terms, including unprofessional conduct, physician-patient boundary issues, or moral unfitness, to describe such actions. The FSMB has begun a project to encourage boards to align their categorization of all disciplinary actions to better understand the scope of misconduct.

Tuesday, April 7, 2020

Tavis Smiley Ordered To Pay PBS $1.5 Million For Violating Network's 'Morality' Clause

Vanessa Romo
npr.org
Originally published 4 March 20

Here is an excerpt:

Throughout the three-week civil trial, jurors heard from six women who testified that Smiley subjected subordinates to unwanted sexual advances. "One woman who accused Smiley of sexual harassment left the show and received a $325,000 settlement," Variety reported.

The win for PBS may prove to be significant for other companies facing workplace suits stemming from sexual-misconduct allegations, who are seeking to break ties with accused individuals.

"In the midst of the #MeToo movement, he violated our morals clause... You can't have a consensual relationship between a manager and a subordinate because of the power dynamic. It's never consensual because that manager has power over all aspects of that person's employment," the network's lead attorney, Grace Speights, said in court.

Smiley's dismissal was one of many in the wake of the #MeToo movement which first gained global attention in 2017, after dozens of women accused movie producer Harvey Weinstein of sexual misconduct. Years later, a jury has convicted Weinstein of rape, Bill Cosby is behind bars for sexual assault, and popular hosts including Matt Lauer and Charlie Rose — who was fired by PBS in 2017 — have been removed from the airwaves amid accusations of misconduct.

The info is here.

Thursday, December 12, 2019

State Supreme Court upholds decision in Beckley psychiatrist case

Jessica Farrish
The Register-Herald
Originally posted 8 Nov 19

West Virginia Supreme Court of Appeals on Friday upheld a decision by the West Virginia Board of Medicine that imposed disciplinary actions on Dr. Omar Hasan, a Beckley psychiatrist.

The original case was decided in Kanawha County Circuit Court in July 2018 after Hasan appealed a decision by the West Virginia Board of Medicine to discipline him for an improper relationship with a patient. Hasan alleged the board had erred by failing to adopt recommended finding of facts by its own hearing examiner, had improperly considered content of text messages and had misstated various facts in its final order.

Court documents state that Hasan began providing psychiatric medication in 2011 to a female patient. In September 2014, the patient reported to WVBOM that she and Hasan had had an improper relationship that included texts, phone calls, gifts and “sexual encounters on numerous occasions at various locations.”

She said that when Hasan ended the relationship, she tried to kill herself.

WVBOM investigated the patient’s claim and found probable cause to issue disciplinary actions against Hasan for entering a relationship with a patient for sexual satisfaction and for failing to cut off the patient-provider relationship once the texts had become sexual in nature, according to court filings.

Both are in violation of state law.

The info is here.

Tuesday, October 15, 2019

Why not common morality?

Rhodes R 
Journal of Medical Ethics 
Published Online First: 11 September 2019. 
doi: 10.1136/medethics-2019-105621

Abstract

This paper challenges the leading common morality accounts of medical ethics which hold that medical ethics is nothing but the ethics of everyday life applied to today’s high-tech medicine. Using illustrative examples, the paper shows that neither the Beauchamp and Childress four-principle account of medical ethics nor the Gert et al 10-rule version is an adequate and appropriate guide for physicians’ actions. By demonstrating that medical ethics is distinctly different from the ethics of everyday life and cannot be derived from it, the paper argues that medical professionals need a touchstone other than common morality for guiding their professional decisions. That conclusion implies that a new theory of medical ethics is needed to replace common morality as the standard for understanding how medical professionals should behave and what medical professionalism entails. En route to making this argument, the paper addresses fundamental issues that require clarification: what is a profession? how is a profession different from a role? how is medical ethics related to medical professionalism? The paper concludes with a preliminary sketch for a theory of medical ethics.

Tuesday, September 3, 2019

Psychologist Found Guilty of Sexual Assault During Psychotherapy

Richard Bammer
www.mercurynews.com
Originally published July 27, 2019

A Solano County Superior Court judge on Friday sentenced to more than 11 years behind bars a former Travis Air Force Base psychologist found guilty last fall of a series of felony sexual assaults on female patients and three misdemeanor counts.

After hearing victim impact testimony and statements from attorneys — but before pronouncing the prison term — Judge E. Bradley Nelson looked directly at Heath Jacob Sommer, 43, saying he took a version of exposure therapy “to a new level” and used his “position of trust” between 2014 and 2016 to repeatedly take advantage of “very vulnerable people,” female patients who sought his help to cope with previous sexual trauma while on active duty.

And following a statement from Sommer — “I apologize … I never intended to be offensive to people,” he said — Nelson enumerated the counts, noting the second one, rape, would account for the greatest number of years, eight, in state prison, with two other felonies, oral copulation by fraudulent representation and sexual battery by fraudulent means, filling out the balance.

Nelson added 18 months in Solano County Jail for three misdemeanor charges of sexual battery for the purpose of sexual arousal. He then credited Sommer, shackled at the waist in a striped jail jumpsuit and displaying no visible reaction to the sentence, with 904 days in custody. Additionally, Sommer will be required to serve 20 years probation upon release, register as a sex offender for life, and pay nearly $10,000 in restitution to the victims and other court costs.

The info is here.

Sunday, July 7, 2019

Time to End Physician Sexual Abuse of Patients: Calling the U.S. Medical Community to Action

AbuDagga, A., Carome, M. & Wolfe, S.M.
J GEN INTERN MED (2019).
https://doi.org/10.1007/s11606-019-05014-6

Abstract

Despite the strict prohibition against all forms of sexual relations between physicians and their patients, some physicians cross this bright line and abuse their patients sexually. The true extent of sexual abuse of patients by physicians in the U.S. health care system is unknown. An analysis of National Practitioner Data Bank reports of adverse disciplinary actions taken by state medical boards, peer-review sanctions by institutions, and malpractice payments shows that a very small number of physicians have faced “reportable” consequences for this unethical behavior. However, physician self-reported data suggest that the problem occurs at a higher rate. We discuss the factors that can explain why such sexual abuse of patients is a persistent problem in the U.S. health care system. We implore the medical community to begin a candid discussion of this problem and call for an explicit zero-tolerance standard against sexual abuse of patients by physicians. This standard must be coupled with regulatory, institutional, and cultural changes to realize its promise. We propose initial recommendations toward that end.

Friday, June 14, 2019

From the talking cure to a disease of silence: Effects of ethical violations in a psychoanalytic institute

Jane Burka, Angela Sowa, Barbara A. Baer, & others
The International Journal of Psychoanalysis (2019) 100:2, 247-271,

Abstract

This article presents an in-depth study of one institute’s efforts to recover from effects of ethical violations by two senior members. Qualitative data analysis from voluntary member interviews details the damage that spread throughout the institute, demonstrating that a violation of one is a violation of many. Members at all levels reported feeling disturbed in ways that affected their emotional equilibrium, their thinking processes, and their social and professional relationships. The aggregated interview data were reported to the institute community in large and small group meetings designed to reverse the “disease of silence” and to allow members to talk with each other. Outside consultation helped with this emotionally arduous process. The authors offer hypotheses concerning the nature of group anxieties during ethics crises. We assert that both sexual and non-sexual boundary violations break the incest taboo, as they breach the generational protection required of professional interactions. Ethical violations attack the group’s foundational ethos of care, unleashing primitive anxieties and defences that interfere with capacities for thinking, containment, collaboration, and integration. Since the full reality of what happened is unknowable, hybrid truths emerge, causing conflict and disturbances that inhibit thoughtful group discourse.

The article can be downloaded here.

Monday, May 20, 2019

Ethics board fines former Pa. judge for texts, sex with defendant's girlfriend

Mark Scolforo
The Associated Press
Originally published April 26, 2019

Pennsylvania's judicial ethics board fined a since-retired district judge $5,000 this week for having sex with the girlfriend of a defendant, sending her salacious texts and letting his own lawyer practice before him without telling the other parties.

The Court of Judicial Discipline fined former Bradford County District Judge Michael G. Shaw and issued a severe reprimand, saying he had appeared to be genuinely contrite.

Shaw spent 24 years as district judge in Sayre, but did not run for re-election in 2017, as he was being investigated.

The court says Shaw, who was not charged criminally, appeared to be genuinely remorseful for his conduct. His lawyer in the proceedings, William Hebe, did not return a phone message Friday.

Shaw is a former police officer and is not a lawyer. Pennsylvania magisterial district judges, who are elected, do not have to be licensed lawyers. District judges set bail and conduct preliminary hearings for serious crimes, and handle minor offenses and lower-level civil matters.

Court findings say Shaw was supervising treatment court in 2014 when a repeat DUI defendant he knew enrolled in the court program. Shaw had worked for the man's father years before.

The man's girlfriend subsequently told Shaw on Facebook that she was breaking up with the man, leading to a series of messages that became sexual in nature.

The info is here.

Thursday, April 11, 2019

6 women sexually abused by counselor at women's rehab center Timberline Knolls, prosecutors say

David Jackson
The Chicago Tribune
Originally posted March 7, 2019

Here is an excerpt:

Cook County prosecutors allege that a Timberline Knolls counselor, Mike Jacksa, sexually assaulted or abused six patients last year at the leafy 43-acre rehab center in suburban Lemont. Former patients told police that Jacksa subjected them to rape, forced oral sex, digital penetration and fondling beneath their clothes. He faces 62 felony charges.

The abuse allegations began to surface last summer, but Timberline officials waited at least three weeks to contact law enforcement, police reports show. In the meantime, Timberline staff conducted internal investigations, twice suspending and reinstating Jacksa, police records show.

In early July, when Timberline staff discovered journal entries by a patient that described her sexual encounters with Jacksa, they confronted the woman in his presence, police reports show. Afterward, the woman “went back to her lodge and broke a mirror, intending to hurt herself or commit suicide over the embarrassment and emotional distress the whole situation with Jacksa had caused,” a Lemont police report said. “She was transported to a hospital.”

Widely accepted treatment standards say people who report sex crimes should not be forced to give their accounts in front of their alleged attackers.

Timberline Knolls suspended Jacksa a third time in early August, after the police got involved, then fired him Aug. 10. His alleged sexual attacks on patients were “an isolated incident,” said Timberline spokesman Gary Mack. “Facility administrators were greatly saddened by this whole situation and believed they acted swiftly and certainly to take Jacksa off the street.”

The info is here.

Monday, April 1, 2019

Psychiatrist suspended for ‘inappropriate relationship.’ He got a $196K state job.

Steve Contorno & Lawrence Mower
www.miamiherald.com
Originally posted February 28, 2019

Less than a year ago, Domingo Cerra Fernandez was suspended from practicing medicine in the state of Florida.

The Ocala psychiatrist allegedly committed one of the cardinal sins of his discipline: He propositioned a patient to have a sexual and romantic relationship with him. He then continued to treat her.

But just months after his Florida suspension ended, Cerra Fernandez has a new job. He’s a senior physician at the North Florida Evaluation and Treatment Center, a maximum-security state-run treatment facility for mentally disabled adult male patients.

How did a recently suspended psychiatrist find himself working with some of Florida’s most vulnerable and dangerous residents, with a $196,000 annual salary?

The Department of Children and Families, which runs the facility, knew about his case before hiring him to a job that had been vacant for more than a year. DaMonica Smith, a department spokeswoman, told the Herald/Times that Cerra Fernandez was up front about his discipline.

The info is here.

Tuesday, March 12, 2019

Atlanta child psychologist admits to molesting girl, posting it online

Ben Brasch and Kristal Dixon
The Atlanta Journal-Constitution
Originally posted February 15, 2019

A metro Atlanta psychologist who spent years counseling children will spend two decades in prison after violating the trust of those around him and molesting a pre-teen girl.

In a muffled voice, Jonathan Gersh, 38, admitted in a Cobb County court Friday that he took lewd pictures of the girl, which he put online and were viewed around the world.

Prosecutors said he also took cell phone pictures of children in bathing suits in public and offered to trade photos online. “These pictures are not baseball cards to be traded,” said Judge Steven Schuster.

Gersh’s charges included child molestation and child pornography, but Schuster said “I have a duty to the victim, the victim’s family and society to stop any form of what I perceive to be sex trafficking.”

Defense attorney Richard Grossman had asked the judge for five years in prison. Prosecutors asked for 18 years. Grossman said described his client’s actions as compulsive “voyeurism” and said Gersh “led an exemplary life” as a loving father who offered pro bono counseling to the community.

The info is here.

Thursday, March 7, 2019

Prominent psychiatrist accused of sexually exploiting patients

Michael Rezendes
The Boston Globe
Originally posted February 21, 2019

A prominent North Shore psychiatrist is facing lawsuits from three female patients who say he lured them into degrading sexual relationships, including beatings, conversations about bondage, and, in one case, getting a tattoo of the doctor’s initials to show his “ownership” of her, according to court documents.

The women allege that Dr. Keith Ablow, an author who was a contributor to Fox News network until 2017, abused his position while treating them for acute depression, leaving them unable to trust authority figures and plagued with feelings of shame and self-recrimination.

“He began to hit me when we engaged in sexual activities,” wrote one plaintiff, a New York woman, in a sworn affidavit filed with her lawsuit. “He would have me on my knees and begin to beat me with his hands on my breasts,” she wrote, “occasionally saying, ‘I own you,’ or ‘You are my slave.’”

The malpractice lawsuits, two of them filed on Thursday in Essex Superior Court and a third filed last year, paint a picture of a therapist who encouraged women to trust and rely on him, then coaxed them into humiliating sexual activities, often during treatment sessions for which they were charged.

When the New York woman had trouble paying her therapy bills, she said, Ablow advised her to work as an escort or stripper because the work was lucrative.

Although the women used their real names in their lawsuits, the Globe is withholding their identities at their request.  The Globe does not identify alleged victims of sexual abuse without their consent.

The info is here.

Wednesday, March 6, 2019

A Pedophile Doctor Drew Suspicions for 21 Years. No One Stopped Him.

Christopher Weaver, Dan Frosch and Gabe Johnson
The Wall Street Journal
Originally posted February 8, 2019

Here is an excerpt:

An investigation by The Wall Street Journal and the PBS series Frontline found the IHS repeatedly missed or ignored warning signs, tried to silence whistleblowers and allowed Mr. Weber to continue treating children despite the suspicions of colleagues up and down the chain of command.

The investigation also found that the agency tolerated a number of problem doctors because it was desperate for medical staff, and that managers there believed they might face retaliation if they followed up on suspicions of abuse. The federal agency has long been criticized for providing inadequate care to Native Americans.

After a tribal prosecutor outside of the IHS finally investigated his crimes, Mr. Weber was indicted in 2017 and 2018 for sexually assaulting six patients in Montana and South Dakota. Court documents and interviews with former patients show that Mr. Weber plied teen boys with money, alcohol and sometimes opioids, and coerced them into oral and anal sex with him in hospital exam rooms and at his government housing unit.

“IHS, the local here, they want to just forget it happened,” said Pauletta Red Willow, a social-services worker on the Pine Ridge reservation. “You can’t ever forget how someone did our children wrong and affected us for generations to come.”

The info is here.

Thursday, February 14, 2019

Sex talks

Rebecca Kukla
aeon.co
Originally posted February 4, 2019

Communication is essential to ethical sex. Typically, our public discussions focus on only one narrow kind of communication: requests for sex followed by consent or refusal. But notice that we use language and communication in a wide variety of ways in negotiating sex. We flirt and rebuff, express curiosity and repulsion, and articulate fantasies. Ideally, we talk about what kind of sex we want to have, involving which activities, and what we like and don’t like. We settle whether or not we are going to have sex at all, and when we want to stop. We check in with one another and talk dirty to one another during sex. 

In this essay I explore the language of sexual negotiation. My specific interest is in what philosophers call the ‘pragmatics’ of speech. That is, I am less interested in what words mean than I am in how speaking can be understood as a kind of action that has a pragmatic effect on the world. Philosophers who specialise in what is known as ‘speech act theory’ focus on what an act of speaking accomplishes, as opposed to what its words mean. J L Austin developed this way of thinking about the different things that speech can do in his classic book, How To Do Things With Words (1962), and many philosophers of language have developed the idea since.

The info is here.

Happy Valentine's Day

Wednesday, February 13, 2019

Former San Diego psychiatrist won't see jail time after admitting to sexual contact with patients

Mark Saunders
www.10news.com
Originally posted January 18, 2019

A former San Diego County psychiatrist who admitted to having sexual contact with seven female patients during office visits and sexual battery will not see any jail time.

Leon Fajerman, 75, was not sentenced to any jail time during his sentencing hearing Friday. Instead, the judge ordered Fajerman to serve house arrest for a year, pay an undetermined amount of restitution, and he must register as a sex offender.

He is eligible to have an ankle bracelet removed after six months of house arrest, pending good behavior.

Friday, victim impact statement's were read in court by the victims' attorney, who called the sentencing of no jail time absurd. Jessica Pride, an attorney representing two victims said they suffered from, “post-traumatic stress disorder, they are also suffering from anxiety, night terrors, insomnia, suicidal ideations.”

The info is here.

Monday, January 14, 2019

Air Force Psychologist Found Guilty of Sexual Assault Under Guise of Exposure Therapy

Caitlin Foster
Business Insider
Originally published Dec. 10, 2018

A psychologist at Travis Air Force Base in California was found guilty on Friday of sexually assaulting military-officer patients who were seeking treatment for post-traumatic stress disorder, The Daily Republic reported.

Heath Sommer may face up to 11 years and eight months in prison after receiving a guilty verdict on six felony counts of sexual assault, according to the Republic.

Sommer used a treatment known as "exposure therapy" to lure his patients, who were military officers with previous sexual-assault experiences, into performing sexual activity, the Republic reported.

According to charges brought by Brian Roberts, the deputy district attorney who prosecuted the case, Sommer assaulted his patients through "fraudulent representation that the sexual penetration served a professional purpose when it served no professional purpose," the Republic reported.

Monday, July 23, 2018

St. Cloud psychologist gets 3-plus years for sex with client

Nora G. Hertel
Saint Cloud Times 
Originally published June 14, 2018

Psychologist Eric Felsch will spend more than three years in prison for having sex with a patient in 2011.

Stearns County Judge Andrew Pearson sentenced Felsch Thursday to 41 months in prison for third-degree criminal sexual conduct, a felony. He pleaded guilty to the charge in April.

Felsch, 46, has a St. Cloud address.

It is against Minnesota law for a psychotherapist to have sex with a patient during or outside of a therapy session. A defendant facing that charge cannot defend himself by saying the victim consented to the sexual activity.

Sex with clients is also against ethical codes taught to psychologists.

The information is here.

A psychologist in Pennsylvania can face criminal charges for engaging in sexual relationships with a current patient.

Friday, April 6, 2018

Complaint: Allina ignored intern’s sexual harassment allegations

Barbara L. Jones
Minnesota Lawyer
Originally published March 7, 2018

Here is an excerpt:

Abel’s complaint stems from the practicum at Abbott, partially under Gottlieb’s supervision.  She began her practicum in September 2015. According to the complaint, she immediately encountered sexualized conversation with Gottlieb and he attempted to control any conversations she and other students had with anybody other than him.

On her first day at the clinic, Gottlieb took students outside and instructed Abel to lie down in the street, ostensibly to measure a parking space. She refused and Gottlieb told her that “obeying” him would be an area for growth. When speaking with other people, he frequently referred to Abel, of Asian-Indian descent, as “the graduate student of color” or “the brown one.”  He also refused to provide her with access to the IT chart system, forcing her to ask him for “favors,” the complaint alleges. Gottlieb repeatedly threatened to fire Abel and other students from the practicum, the complaint said.

Gottlieb spent time in individual supervision sessions with Abel and also group sessions that involved role play. He told students to mimic having sex with him in his role as therapist and tell him he was good in bed, the complaint states. At these times he sometimes had a visible erection, the complaint also says. Abel raised these and other concerns but was brushed off by Abbott personnel, her complaint alleges.  Abel asked Dr. Michael Schmitz, the clinical director of hospital-based psychology services, for help but was told that she had to be “emotionally tough” and put up with Gottlieb, the complaint continues. She sought some assistance from Finch, whose job was to assist Gottlieb in the clinical psychology training program and supervise interns.  Gottlieb was displeased and threatening about her discussions with Schmitz and Finch, the complaint says.

The article is here.

Monday, March 19, 2018

#MeToo in Medicine: Waiting for the Reckoning

Elizabeth Chuck
NBC News
Originally posted February 21, 2018

Here is an excerpt:

Health care organizations make clear that they do not condone inappropriate behavior. The American Medical Association calls workplace sexual harassment unethical and specifically states in its Code of Medical Ethics that “Sexual relationships between medical supervisors and trainees are not acceptable, even if consensual.”

Westchester Medical Center Health Network, where Jenkins says she was sexually harassed as a resident, maintains that it has never tolerated workplace harassment. In a statement to NBC News, it said that the surgeon in question "has not worked at Westchester Medical Center for years and we have no record of a report."

"Our policies on harassment are strict, clear and presented to all employees consistently," it said.

"Mechanisms have been and continue to be in place to enable confidential reporting and allegations involving staff are investigated swiftly and thoroughly. Disciplinary actions are taken, as appropriate, after internal review," the statement said, adding that Westchester Medical Center's policies were "continuously examined and enhanced" and that reporting sexual harassment was encouraged through its confidential 24-hour hotline.

More than a hotline is needed, said many females in medicine, who want to see an overhaul of their entire profession — with men made aware of what's unacceptable and women looking out for one another and supporting each other.

The article is here.