Lomax vs Miss A - Case on Ethical Misconduct - Thesis Example

? Lomax vs Miss A: A Case on Ethical Misconduct Your School Department, This paper is a partial fulfillment for the subject ________, under Professor ________. Roy vs. Hartogs: A Case on Ethical Misconduct I. Lomax vs. Miss A There is a case in UK making a lot of press waves lately. It is about a psychiatrist, Dr. Steve Lomax, having sex with his patient while undergoing therapy. This went on for thirteen years and now that the patient and the doctor have parted ways, the patient is suing the doctor for malpractice. Consequently, the General Medical Council Panel found the doctor guilty of using his role as a “treating psychiatrist to pursue and establish an improper sexual and emotional relationship with Miss A”. Their relationship allegedly started in 1988 when Miss A when Dr. Lomax started referring to their sexual tensions. The psychiatrist also took the patient home in his car and kissed her after the first few appointments. Then one day, when they are keeping their appointment, they started having sex. After that, Dr. Lomax broke up with his wife. Miss A never believed that there were notes and medical records pertaining to their “professional” relationship. The doctor seemed to be “matey” and chatty and was like “talking to a friend”. He did astrological readings as well, and proceeded to give out mix tapes that made Miss A “feel really special”. Then they proceeded to have sex in the doctor’s daughter’s bedroom. Then they had sex in his office when they kept their “appointment”. Then after a few months, in June 1988, they decided to move in and started living together for fifteen years. When the doctor and his patient broke up, the woman sued the doctor for malpractice. Another case of this type surfaced on April 2011 in Seattle, WA. Another public person in their neighborhood, Dr. Richard Adamson, has been sued because he had sex with his patient. The patient, Patient A, has been his patient for four years and they have been repeatedly having sex in his office. When the relationship ended, the patient sued because Adamson gave her severe psychological and emotional injury. The end of the relationship was because the doctor was obsessed with a younger girl. The girl in question here is a depressive and with a history of being sexually abused by her father when she was a child. He has another relationship with another girl, this time a divorcee. The affair started when the woman started with the divorce, and because of the stress related to the divorce, she became vulnerable to him, and they proceeded to have a sexual relationship. After that relationship, he proceeded to have more relationships with women. The doctor is also accused of giving intimate details pertaining to his personal life and his wife’s suicide. These cases are similar to Roy vs. Hartogs case. The Roy vs. Hartogs case is quite important in the history of US Judiciary. It is a landmark case against ethical misconduct between psychotherapists and their patients. In this case, the psychiatrist Hartogs used sex to “treat” his patient Julie Roy. It was evidently a malpractice case since the defendant sexually exploited the respondent. There weren’t any laws about the psychiatrist having sex with the patient before this case. In fact, there were a lot of psychiatrists doing that, according to a 1972 article in New York Magazine (Chesler, 1972), they were increasing. It should be noted though, that this was in 1972, when there were no laws preventing psychiatrists from having “therapeutic” sex with their client. At the time the TIME article was published a survey was performed by University of California School of Medicine (Kardener, 1973), indicating that 5-13% of the American physicians have had erotic contact with their patients; 19% of them even say that it is beneficial. The article even had a profile on the possible psychiatrist seducer. These psychiatrists are usually over 40, 10 to 25 years older than their patients and always a man; married and usually suffer from premature ejaculation with their patients (Chesler, 1972). The article even quoted an article in Contemporary Psychoanalysis that says this type of men are usually  "withdrawn and introspective, studious, passive, shy . . . (more) intellectually (than) physically adventurous . . . This adds up to being unpopular with the opposite sex. None of this stops a person from having fantasies of sexual conquest. It may even encourage sexual fantasies."  Clearly, Lomax, Adamson and Hartogs was this type of psychiatrist. In 1969, Julie Roy, on the other hand, was a secretary for Esquire Magazine at the time when she went to Hartogs for a twice-weekly talk sessions, for her depression treatment (TIME, 1975). After a few weeks of only-talk treatment, Hartogs suggested that they should have sex together to help her erase any guilt feelings she has over a previous sexual relationship with a woman. Finally, she succumbed to her doctor’s “orders” and he told her that this is a step of “progress”. After their sexual episode, he then hired her as his secretary and paid her $3 per letter. He then waived the $10 fee per session. The sex therapy continued through another year, sometimes in the doctor’s apartment, sometimes as frequently as three times a day. The one day, in 1970, she “broke up” with Hartogs but after three days, she begged him to take her back. He did not take her back; he refused to refer her to another psychiatrist. That year, she was confined to psychiatric wards of Metropolitan Hospital twice (TIME, 1975). Hartogs, meanwhile, testified that Roy was an incurable schizophrenic and “does not know the difference between reality and fantasy”; he also claims that he never had sex with the woman, and that she sues him as a revenge for cutting off her treatment. II. Ethics: Utilitarianism Utilitarianism is an ethical theory that measures the correctness of the deed in relation to the number of people it serves. If it serves a lot of people, it is a successful deed. It is also called the greatest happiness principle, as it only serves for the people of the population that was made happy by a certain action. There are two types of utilitarianism: act and rule. Act utilitarianism states that we should choose what action can deliver more pleasure to the general public. Rule utilitarianism states that one should follow rules that would benefit the most of the population. III. Application of Utilitarianism In the Lomax case, one can apply utilitarianism because the solution of this case is largely a matter of consequence, and utilitarianism is a consequential theory. The doctor has the power over the patient and he knows that the patient would do anything he commanded, because he is a doctor. According to the survey by the University Of California School Of Medicine, 19% of the psychiatrists think that having sex with the patient is actually beneficial. Under the theory of utilitarianism, one should ask the question, beneficial to whom? In the Lomax case, theoretically, both of them should benefit the advantages of having sex (with each other): release of anxieties, a general good feeling about the self, etc. However, the hypothesis about the “sex being beneficial to the patient” proved to be false because the patient got more traumatized as the sex continued. She developed emotional damage. This occurs to about 90% of the patients who were subjected to sex treatment, according to Dr. Gatrell (1990). Therefore act utilitarianism failed in this scenario, as it did not make the two of them happy, only one of them. The act also failed because the consequence of the action of the doctor did not result to anything better than the original scenario and utilitarianism is all about human-well being lessening human suffering. The act that should have also provided benefits for the patient as a result of the doctor’s decision did not happen. Instead, the decision of the doctor to have sex with the patient led to more problems for him, like this case. However, if one considers the society as a whole, this whole drama is actually a necessary evil (well, evil for the ones involved anyway) because this gives awareness to people, especially women and patients of an unprofessional doctor. Because of this case, many patients are now protected against malicious doctors who try to control them sexually. III. Deontology Deontology is another theory in ethics that espouses obedience to rules; however, this is all about morality and duty towards another person, unlike in rule utilitarianism where it is only concerned about the people being benefited of the said situation. Therefore, deontologists look at their guidebooks and rulebooks to determine if they had been moral or not. It emphasizes autonomy. It is universal, as morals are universal. This is also called duty-based ethics. Deontology also is also quite absolutist. In contrast to utilitarianism, deontology does not care for the outcome if it is beneficial to the greater population; in deontology, what matters is that they follow the moral code even if it endangers most of the population. IV. Application of Deontology In this case, the doctor is clearly not doing his duty. Although he believed, along with the 19% of their physician population that having sex with the patient is right, he should not have done that as a doctor. He violated the sacred patient-doctor relationship. He also broke the Hippocratic Oath “I will follow that method of treatment which according to my ability and judgment, I consider for the benefit of my patient and abstain from whatever is harmful or mischievous.” He failed to honor his duty as a doctor, as dictated in the first part of the Hippocratic Oath. Morally as well, since the moral code of the society dictates that a doctor should always maintain professional conduct with their patients. It is also immoral for a person to “take advantage” of a sick person since she couldn’t defend herself. Especially in this case where the patient is mentally unstable; he, the psychiatrist, can automatically dismiss her claims against him because of his title as a doctor, and she as a patient. It should be noted that she was uncomfortable with the idea of having sex with the doctor at first but continued to have sex with him as she “loved” her. She also said that she fell in love with him, which is understandable, given the fact that the rules and boundaries of their relationship were unclear. IV. Conclusion There are a lot of cases in the world that involve sex between the doctors and their patients. Not only it is illegal, it is also unethical. The doctors should always be the one protecting the patient at all times, not exploit them, even if they know that they are at their most vulnerable. The psychiatrists, with their training, put them in a spot where they can easily prey on the weak people. This kind of relationship is wrong in all levels. One, it breaks the doctor-patient relationship. The second, the professional status of the doctor is not maintained. There is an unspoken contract between the doctor and the patient that he would do everything to cure the patient but that’s that. No more extra, intimate relationships. Another thing is that this relationships are done not out of love; they are made because the psychiatrist has his own needs, at the expense of his patients. This paper is about a male doctor who applied sex therapy to treat his patients. Although it is not a popular course of treatment, surveys tell that there are some doctors, about 19%, believe that sex between the doctor and the patient is therapeutic. There are two ethical theories mentioned in this paper: utilitarianism and deontology. Utilitarianism is populist in nature. It states that any decision, one should consider the benefits and the population. If a certain decision would be beneficial to most people, then that’s the right decision. It does not care for morals or law, as in act utilitarianism. Deontology on the other hand, is more about morals. It adheres to the rules of society even if it is contrary to popular ideas. It is absolutist in nature as opposed to utilitarianism’s populist nature. Even if the decision is unpopular, under the deontology, it should be right because the moral code dictated it so. In this case, utilitarianism sort of worked because the case brought the issue to the greater society. Although Miss A’s life is ruined, the landmark case proved to be beneficial to patients under malicious doctors, especially those doctors who constantly make sexual advances to them. If taken on the level of the patient-doctor relationship, the idea of utilitarianism is a failure because it did not give benefits to both parties. In fact, it brought dismay. At the first part, sure, the doctor was being benefited with sexual favors and pleasures but the case got him. The patient on the other hand, did not get any benefits from the doctor’s decision. However, she suffered deep emotional trauma. She was permanently damaged as a person, and this is because of a single man’s decision. Deontology certainly did not work on this case. The mere fact that the doctor had sex with the patient is a violation of the society’s moral code. The fact that the woman was psychologically forced to have sex with the doctor added to the fact that it was morally wrong. The doctor broke the patient-doctor relationship as well as failing to follow the Hippocratic Oath. This case is an example of ethical misconduct. This is an example of making wrong decisions with the wrong people at the wrong time. Technically, having consensual sex with another person is not a crime. But since one is a doctor and the other one is a patient, one keeps a role in a relationship. Take note that the doctor-patient relationship is not a relationship of equal stature. The doctor is always on top of the relationship as he is healthier, more so in a psychiatric relationship. In that relationship, we can see that the sex is indeed quite exploitative and that is immoral and hurtful to another person. References: Ho, V. (2011). Woman sues Seattle psychiatrist accused of sex with patients. Seattlepi.com. Retrieved from: http://www.seattlepi.com/local/article/Woman-sues-Seattle-psychiatrist-accused-of-sex-1327888.php#ixzz1bG5cjxhD N.A. (2011). Guernsy Dr Steven Lomax struck off for sex with patient. BBC. Retrieved from: http://www.bbc.co.uk/news/world-europe-guernsey-14629288 N.A. (1975). The Sexes: Love Thy Analyst. TIME. Retrieved from: http://www.time.com/time/magazine/article/0,9171,946537-1,00.html The Hippocratic Oath. History of Medicine Division, National Library of Medicine, National Institutes of Health. Retrieved from: http://www.nlm.nih.gov/hmd/greek/greek_oath.html Chesller, P. (1972). The Sensous Psychiatrists. New York Magazine. Retrieved from: http://nymag.com/news/features/48888/ Simon, R.I. (1985). Sexual Misconduct of Therapists: A Cause for Civil and Criminal Action. Trial, 21 (5), 46-51. Waller, Bruce N. 2005. Consider Ethics: Theory, Readings, and Contemporary Issues. New York: Pearson Longman. Read More