Setting the Boundaries
Home Office Report, UK
July 2000
Home Office
of the UK is the internal affairs department of the
government in the UK. They have brought out a report in July of
this year 2000, which set out to modernise the sex-laws in the UK.
In this report are many proposals for new laws. Chapter Four of
the report deals with the treatment of vulnerable people,
including clients who receive counselling. Recommendation 32
states: "There should be offences of a breach of a
relationship of care to prohibit: Sexual relationships
between doctors and their patients, and therapists and their
clients." (Point 3).
An excerpt of that chapter is provided below. Free copies of
this document can be obtained from the Home-Office in the UK by
telephoning Haydee Scarsbrook on 020-7273 3443
Crown copyright material is
reproduced with the
permission of the Controller of Her Majesty's Stationery Office.
Restrictions apply.
4.8.9 Although a patient may seem to have free choice and be able
to escape, he or she is not in charge of their own feelings and is
not in a situation where free choice can be exercised. Some research
indicates this lack of control:
"The woman patient under these circumstances is seldom in
control of any of these issues. What is more typical is that the
woman patient is caught up in the throes of her own past, of her
childlike feelings, of experiencing emotions that are powerful and
frightening and that often lead the woman in such a posture to
feel that she is at the moment not in charge of any aspect of her
life... the woman patient at such moments is in a state of
psychological regression- a retreat into a childhood state not
only emotionally, but also intellectually. At that moment she
becomes the helpless child again, reliving the experiences of the
past, unable to cope with what is happening to her, feeling robbed
of the ability to make choices, perceiving herself as small and
weak and therefore unable to defend herself."
(Extract from Chapter 5 Seduction of the Female Patient (Sydney
Smith PhD) Sexual Exploitation in Professional relationships,
Gabbard G.O., 1989, American Psychiatric Press, Washington.
The victim of such abuse could just as easily be a man.
4.8.10 We therefore identified several potential categories of
vulnerability where the vulnerable people should be protected:
- Those who are mentally disordered and receiving inpatient or
outpatient care;
- Those in residential homes who are in receipt of care services
(hospitals, hospices, nursing homes and homes for mentally
disabled people);
- Those in the community who are assessed as being in need of
care, and in receipt of intimate care services such as bathing
or dressing;
- Those who put themselves in the care of medical practitioners,
therapists or others who provide therapeutic or caring services:
- Those who are confined in institutions such as secure units,
detention centres or prisons.
4.8.12 We were not convinced that the present regime of good
practice and professional codes was adequate to provide protection.
Whilst some professionals have defined codes and disciplinary
procedures, others do not. Some therapies are not regulated at all.
Other countries have increasingly sought to define in law certain
relationships, which include such an imbalance of power and
authority that where there is a sexual relationship it is so wrong
as to be criminal. There is a strong case for the law to prohibit
sexual relationships between vulnerable people (possibly those who
cannot choose or can be unduly influenced into entering a sexual
relationship) and those who provide medical, therapeutic or intimate
care services to them, whether those services are provided in an
institution or in the community. The law would reflect the serious
abuse of relationship of trust that is implicit in the relationship….
4.8.13 There is a two-fold advantage to this approach: it
underpins and extends existing codes, which say that such
relationships are inappropriate, unprofessional and wrong. Where
carers or therapists are not subject to any professional code or
control, it would provide a sanction and give confidence to the
wider public. It would have to be very clearly defined so that those
who were care providers knew their responsibility under the law.
This has the potential to be very effective in increasing the
protection of the law to very vulnerable people. Consent would be
irrelevant: it would be necessary to prove both that sexual
penetration took place, and the fact of the relationship of trust
falling within the law….
"Setting the Boundaries" Volume 2 has two bullet points
on page one:
- Those who coerce, force or deceive anyone into sexual activity
are criminally culpable; any coercion, force or deception
towards a child or vulnerable person is particularly serious;
- Those who induce or encourage children or other vulnerable
people to participate in, or be exposed to, sexual behaviour are
criminally culpable;
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