Dating patient ethics
Analyzing this issue requires examining post-termination sexual involvements from at least two perspectives: that of our values and that of our knowledge and data about the dynamics and effects of such involvements--in short, the ethical and clinical/research perspectives.From the ethical perspective, a conflict arises between General Principle A, Beneficence and Nonmaleficence, and General Principle E, Respect for People's Rights and Dignity.Sexual involvements with former clients and patients, however, are more complicated from an ethical perspective.Time may attenuate the intensity and even the likelihood that an involvement will result in harm.The possibility of post-termination sexual involvements raises a number of empirical questions directly relevant to our ethical analysis, as the following six examples show: Note three things about Ethical Standard 10.08.First, by creating an absolute prohibition against sexual involvements for two years post-termination and then placing the burden on the psychologist to demonstrate that the involvement is not exploitative, the standard gives priority to nonmaleficence while leaving room for the exercise of client autonomy.Psychologists who engage in such activity after the two years following cessation or termination of therapy and of having no sexual contact with the former client/patient bear the burden of demonstrating that there has been no exploitation, in light of all relevant factors, including (1) the amount of time that has passed since therapy terminated; (2) the nature, duration, and intensity of the therapy; (3) the circumstances of termination; (4) the client's/ patient's personal history; (5) the client's/patient's current mental status; (6) the likelihood of adverse impact on the client/patient; and (7) any statements or actions made by the therapist during the course of therapy suggesting or inviting the possibility of a post-termination sexual or romantic relationship with the client/patient.
Ethical Standard 10.08 is an excellent illustration of how the code accomplishes this essential function.
As a profession, we have learned all too well the harms that occur when psychologists become sexually involved with their clients.
The harms are so clear that our code, like the codes of all major mental health organizations, absolutely prohibits such involvements.
In post-termination relationships, however, given the passage of time, the harm becomes less certain and the likelihood that a client's autonomy will be compromised less clear.
Here we see the important relationship between the ethical and the empirical: To clarify and deepen the ethical analysis, we must examine these relationships in light of data.
The conflict arises because Principle A exhorts psychologists to do good and not do harm, while Principle E exhorts psychologists to respect individuals' right to self-determination.