It's time to criminalize psychotherapist sexual exploitation in Massachusetts

November 16, 2011

When a suburban homemaker shows up at the emergency room at Newton-Wellesley Hospital feeling suicidal, she sees a psychiatrist, Dr. Joseph A. Jackson, who gives her a kind of treatment she never expected. Over the course of four sessions, what starts out as a professional relationship quickly turns social, then manipulative, and finally sexual and exploitative. As a result, Jackson’s license to practice medicine was revoked a year ago for sexual misconduct with a patient.

Jackson is one of the 70 or so physicians of all types who have been disciplined by the Massachusetts Board of Registration in Medicine since 2004 for sexual misconduct and related boundary violations. At first blush, that may not sound like a lot, but the number of women who are sexually preyed upon by their doctors and other clinicians is under-reported according to many experts, including Linda Jorgenson, a local attorney who has represented hundreds of victims against doctors for crossing what she calls the “very bright line.”

“Sexual abuse of patients by doctors is pervasive, but it is vastly under-reported,” says Jorgenson. She points to a number of reasons why victims are reluctant to blow the whistle on the doctors who have sexually abused them.

“Many women, for instance, are embarrassed and think that no one will believe them,” she says. “Others feel alienated and mistrustful and so are afraid to do anything.”

Researchers estimate that only 1 percent to 4 percent of victims ever step forward.

Bottom line: More needs to be done to convince victims to take action. To that end, the Federation of State Medical Boards (FSMB) says that state medical boards should do public outreach. But the Board of Registration in Medicine, the state agency that licenses and disciplines physicians in Massachusetts, does no such thing — not even a brochure on the topic is to be had.

FSMB also recommends that medical boards should use investigators who are the same gender as the complainants who file sexual abuse cases. But the medical board here does not do this as a matter of course.

“Such cases are not always assigned to same-gender investigators, but one would specifically be if a complainant requests it, or that staff felt that a complainant would be more comfortable,” says Russell Aims, chief of staff to the board. “Staff I spoke to about it indicated that it’s rarely an issue.”

Maybe it is an issue, but complainants are afraid to ask for fear of offending someone. Same-gender investigators of sexual abuse cases should be the rule.

There is another related thing that needs to be done here in Massachusetts — sexual exploitation of patients needs to criminalized.

Beginning with Wisconsin’s criminalization of sex between a clinician and a patient in 1984, a number of states began to consider how they could do more than rely on organizational codes of ethics and disciplinary proceedings to address the problem. Although the laws vary widely, at least 23 states now make sexual abuse of patients by clinicians a criminal act — Massachusetts is not one of them.

Back in the early 1990s, there was an effort to criminalize sexual misconduct by clinicians with patients in the commonwealth, but the legislation died on Beacon Hill, and the Legislature has not looked back since then, even though the problem goes unabated.

Jorgenson strongly argues that sexual misconduct should be criminalized in the state.

“One of the primary benefits as I see it would be that it would articulate to everyone the wrongfulness of the behavior and thus serve as a deterrent,” she says. “The law could also provide for financial retribution to pay back the perpetrators for their outrageous conduct.”

Source: Colman M. Herman, "State board lets docs off easy; Abuse of patient must be a crime," Boston Herald, November 14, 2011.