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Sexual abuse of patients by psychiatrists

Published online by Cambridge University Press:  02 January 2018

Kate Lovett*
Affiliation:
South Hams Community Mental Health Team, Ivybridge, Devon PL21 9AB, email: kate.lovett@pcs-tr.swest.nhs.uk
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Abstract

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Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 2006. The Royal College of Psychiatrists

I was pleased to read Dr Kennedy’s review of the Kerr/Haslam Inquiry (Psychiatric Bulletin, June 2006, 30, 204–206) and Dr Subotsky’s response on behalf of the College (Psychiatric Bulletin, June 2006, 30, 207–209). Dr Subotsky referred to sexualised behaviour between doctors and patients having been made criminal.

The Sexual Offences Act 2003 introduced significant changes to the law by introducing a new offence of sexual activity with a person with mental disorder impeding choice. This offence requires proof of sexual touching and that the individual was unable to refuse because of or for a reason related to a mental disorder. In addition, it must be proven that the perpetrator knew or could reasonably have been expected to know that the victim had a mental disorder (Reference Stevenson, Davies and GunnStevenson et al, 2004). The key factor in determining whether it is possible to bring a safe conviction will hinge around capacity to refuse unwanted sexual activity. This is not defined in the Act (British Medical Association, 2004). For people with mental illness, where capacity is likely to fluctuate, it may be difficult to prove what their mental state was at the time of the alleged offence. Although well intentioned, in practice the law may be difficult to implement.

Clinicians should be aware that they or their colleagues may be arrested on a charge of rape should they decide to have sexual intercourse with their patients. Doctors will always be in the position of having more choice in these situations than their patients. For this reason, it is right that the College continues to deem that relationships of sexual intimacy between doctor and patient are totally unacceptable (Royal College of Psychiatrists, 2002).

References

British Medical Association (2004) Assessment of Mental Capacity – Guidance for Doctors and Lawyers. London: BMJ Books.Google Scholar
Royal College of Psychiatrists (2002) Vulnerable Patients, Vulnerable Doctors: Good Practice in Our Clinical Relationships (Council Report CR101). London: Royal College of Psychiatrists.Google Scholar
Stevenson, K., Davies, A. & Gunn, M. (2004) Blackstone's Guide to The Sexual Offences Act 2003. New York: Oxford University Press.Google Scholar
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