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Mental Health Malpractice: When Doctors Take Advantage of Patients


When people normally think of malpractice, they think of botched surgeries, failure to diagnose illness, medication errors and other failures of doctors that relate to the way treatment itself is delivered.

A recent case, however, highlights another area of malpractice, which can occur when instead of treating the patient’s body, his or her mind needs treatment. The case of Dupree v. Giugliano is currently on appeal to New York’s highest court, with oral arguments heard by the court in October.

When Kristen Dupree needed help with panic attacks, depression and marital troubles, she went first to her family physician, James Giugliano. As most family physicians would do in such a case, Dr. Giugliano referred Ms. Dupree to a therapist. However, he did not simply make a referral: he prescribed anti-depressants, provided talk therapy and had a sexual affair with her for nine months.

The New York appellate court heard the case, ruling in a 3-1 decision that Dr. Guilgiano was guilty of malpractice for having an affair with Ms. Dupree. It noted that Dr. Giugliano was acting as a mental health practitioner, treating Ms. Dupree’s mind, not just her body, as soon as he prescribed psychiatric medications and provided talk therapy to her. And since their professional relationship was one relating to Ms. Dupree’s emotional state, Dr. Giugliano’s taking advantage of her and harming her through the affair constituted medical malpractice.

The Court noted that the affair caused harm to Ms. Dupree. When the affair ended, Ms. Dupree confessed the marital indiscretion to her husband, who then divorced her. The affair also negatively affected her course of treatment with her therapist: though she told her therapist that she was having an affair, she did not disclose to the therapist Dr. Giugliano’s identity as her lover, an important detail for her therapist to know. The trust between patient and therapist that is necessary for psychological healing was stressed at the outset.

Psychological harm is real. This sad case shows demonstrates the wide-ranging effects of a doctor’s behavior when it falls below the standard of care.

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