Two Consenting Adults?...or Just Plain Unethical Behaviour?

Please read the following case and let me know what your thoughts are...of course I have my own!

Case

Patient: 32-year-old Caucasian female

Problem/Chief Complaint: Depression/Alleged Sexual Abuse by her physician

History of present illness: This patient, who is the primary complainant in this case, presents the following testimony. She has suffered from depression for many years, beginning as a teenager. She has seen many providers for care over the years, including psychologists and psychiatrists. Three years ago, her family (husband and three children) moved to Utah so her husband could accept a promotion with his company. At the time of the move, the patient was under a psychiatrist's care and was taking anti-depressant medication. She is originally from Utah and was glad to be returning "home." She and her husband had also discussed filing for divorce, but agreed to wait until the family was resettled in Utah. They hoped that proximity to her family and friends would help her condition. She was told to establish care with a new psychiatrist after the move. She selected a new psychiatrist from the list provided by her husband's insurance company. That doctor is the defendant in this case.

The patient states that she and her new psychiatrist seemed to get along well. She states that she was very fond of him and appreciated his concern and assistance. After six months of therapy, she stated the psychiatrist expressed his own attraction to her. She states that her psychiatrist would often tell her about his own personal problems, including marital problems. After one difficult session, she stated that the psychiatrist gave her a big hug and then began kissing her. She stated that she offered a little resistance, but because of her attraction to him and his expressions of affection for her, that she allowed his advances. Over the next few months, their relationship progressed to include sexual intimacy and "secret" dinners at distant restaurants. The patient began pushing the psychiatrist to advise her about getting a divorce, whether he was going to get a divorce, and whether they could be married. Abruptly, after their last session (over a year ago), the psychiatrist told her that he couldn't see her any more and that he was going to stay with his wife. That night she attempted suicide and was admitted to a psychiatric institution for care. She told no one about this relationship until six months ago, when she admitted it to her new psychiatrist - who recommended that she report it to the Physician's Licensing Board. Coincidentally, the Board was already investigating two similar complaints about this physician.

The attorney for the State presents evidence from the new psychiatrist noting the suicide attempt and serious worsening of the patient's chronic depression, secondary to the termination of her affair with the prior physician. He also notes that the patient's husband is now seeking a divorce and child custody on grounds of marital infidelity. He adds that this was the fourth complaint filed against this doctor. The first two, from several years ago, were dropped because the complainant refused to testify. The other two investigations are proceeding, but have been delayed by the privacy concerns of those patients.

The psychiatrist, through questioning by his attorney, explains that he was truly attracted to this patient. He stated that he was having marital difficulty and was considering a divorce; therefore, he saw no problem in pursuing a relationship with someone to whom he was attracted. He also felt sure that her feelings were mutual and that their relationship was fully consensual. He admitted that he kept the relationship from his wife ("who wouldn't"), but when she found out and threatened divorce, he broke it off. He stated that he never imagined that it would be detrimental to this patient. At this hearing he admits that his judgment might have been somewhat impaired and that, for the most part, doctors shouldn't have intimate relationships with their patients. He hopes that the Board will understand and forgive this limited lapse of his judgment. His attorney adds that the Board cannot consider any other "unproven allegations" against his client when making their decision.

PLAN:
Disposition: This case of alleged unprofessional conduct is turned over to the Board for their decision. Options include dismissal or acquittal, which would end the civil case, or finding of fault. If fault is concluded, then the Board must recommend disciplinary action ranging from a verbal censure, to probation (with or without conditions), or to revocation of his license to practice medicine.