Sexual activity in therapy: legal and ethical issues

The new modalities of therapy based on sensitivity training and behavioral modifications techniques, including sexual therapy, have changed the relationship between therapist and patient, making the therapist vulnerable to malpractice suits. The whole legality of the court cases involving sexual intimacy between patient and doctor in the mental health field relies essentially on the interpretation of transference, a questionable psychological concept, but its court value is even more disputable since the damages are ill-defined from the psychological point of view. The ethical aspect of this issue, however, rests primarily on the Hippocratic oath which rightly attempts to separate therapeutic from nontherapeutic practicing of care. Yet, if the sexual interaction as a part of behavior modification is included under care, this changes even the existing concept of the ethical code. We need a better regulation of the doctor-patient relationship in order to avoid the intrusion of a questionable legality which for the most part rests on untested psychological dynamics.