Court Opinion

ID: 9573990
Source: CourtListenerOpinion
Date Created: 2023-08-21 21:01:12.104082+00
Date Added: 2024-06-11T12:43:53.501674
License: Public Domain

MOORE, Justice,
dissenting.
Sexual conduct between a psychotherapist and his patient is one of the most notorious forms of psychotherapist malpractice.1 By engaging in sex with his patient, a therapist intentionally disregards well established standards of professional conduct. However, the court holds that this intentional misconduct may fall within the scope of a therapist’s employment so that it is appropriate to apply the doctrine of “respondeat superior” to impose strict liability on his employer. I believe that it is both unfair and unwise to impose the cost of this intentional breach of ethical standards on the psychotherapeutic community at large through the application of respondeat superior. Therefore, I respectfully dissent.
The doctrine of respondeat superior imposes vicarious liability on an employer for the torts of an employee if they are committed within the scope of his employment. Fruit v. Schreiner, 502 P.2d 133, 140 (Alaska 1972). As we discussed in Fruit, one of the purposes of respondeat superior, is “to include in the costs of operation inevitable losses to third persons incident to carrying on an enterprise, and thus distribute the burden among those benefit-ted by the enterprise.” 502 P.2d at 141 (emphasis added). It is fair to place these losses on the employer because he sought to profit from an enterprise in which his employees will inevitably commit torts and because he is better able to distribute the loss through increased prices or liability insurance. W.P. Keeton, Prosser and Kee-ton on the Law of Torts § 69, at 500-01 (5th ed.1984). Thus, we have not interpreted the phrase “scope of employment” so as to impose liability on employers for all torts of their employees. “The acts of the employee need be so connected to his employment as to justify requiring that the employer bear that loss.... Employees’ acts sufficiently connected with the enterprise are in effect considered as deeds of the enterprise itself.” Fruit, 502 P.2d at 141. In determining the sufficiency of this connection, we have looked to the Restatement (Second) of Agency §§ 228-229 (1957) [hereinafter Second Restatement] as a set of guidelines indicating whether conduct is within the scope of employment. Luth v. Rogers and Babler Constr. Co., 507 P.2d 761, 764 n. 14 (Alaska 1973).
The court focuses primarily on Second Restatement § 228(l)(c) which requires that the conduct “is actuated, at least in part, by a purpose to serve the master.” This “motivation to serve” factor preserves the fairness aspect of the basis of vicarious liability that an employer profits from the enterprise in which his employee’s acts inevitably will include torts. There is no reasonable interpretation under which Gar-vin’s sexual misconduct2 possibly could benefit Samaritan. In a factually similar case, a New Jersey court found that the therapist “had betrayed his trust as a therapist and that his conduct was too little actuated by a purpose to serve his employer.” Cosgrove v. Lawrence, 214 N.J.Super. 670, 520 A.2d 844, 848 (1986), aff'd, 215 N.J.Super. 561, 522 A.2d 483 (1987).
The court, however, reinterprets the “motivation to serve” factor as requiring only that the tortious conduct “arises out of and is reasonably incidental to the employee’s legitimate work activities.... ” Supra at 348 (emphasis added). Even under this weakened standard, respondeat superior should not apply because therapist-patient sex is not “reasonably incidental” *351to psychotherapy. To understand this, it is essential to consider the nature of therapist-patient sex and its relationship to the objectives of psychological counseling. The parties agree that the sexual conduct at issue stemmed from the therapist’s exploitation of a psychotherapeutic phenomenon known as the transference. Dr. Robert Nelson, a founder of Samaritan and a consulting pastoral counselor, explained the concept of transference as follows:
Transference is a phenomenon that occurs that is similar to a state of dependency in which the client begins to project the roles and relationships and the images and experiences that they have had with other people previous in their life, especially significant other people such as mother, father, brothers, sisters, early teachers and adult models, upon the therapist.
Dr. Nelson continued that since the transference relationship is very “delicate” and “fragile,” “the counselor has [a] professional and ethical responsibility to manage that relationship ... so the client is not damaged in any way.” This duty is manifest in the accompanying phenomenon of the “countertransference” where “the counselor ... begins then to project out of his or her own experience and previous relationships in life upon the client.” Dr. Nelson testified that “countertransference is a very dangerous thing.” He concluded that “any kind of sexual acting out is an extreme form of the misuse of counter-transference .... ”
Dr. Nelson’s testimony is consistent with the psychotherapeutic community’s unanimous view that a therapist’s exploitation of the transference in order to engage in sexual conduct with his patient is unethical. See Davidson, supra note 1 at 43; Stone, The Legal Implications of Sexual Activity Between Psychiatrist and Patient, 133 Am.J. Psychiatry 1138, 1139 (1976) (“[t]he experts would ... agree ... that ‘there are absolutely no circumstances which permit a psychiatrist to engage in sex with his patient.’ All such instances constitute misuse of the transference.”) Therapist-patient sex is not a result of a therapist’s negligence. Garvin’s mishandling of the transference was not accidental. He did not make a mistake. Rather, he intentionally acted on his own feelings for his patient.3
Given this factual background, the court’s conclusion that the sexual conduct in this case was “ ‘incidental’ to the therapy,” supra at 348, is confused. Therapist-patient sex arises not out of the transference, which is essential to the therapy, but the intentional abuse of the transference. Although Doe styles her complaint to sound in negligence, she alleges that Gar-vin’s sexual conduct stemmed from his intentional abuse of the transference in order to derive personal sexual gratification. Doe states in her brief that “this sexual activity was an exploitation of Garvin’s therapist-patient relationship with Doe.” (Emphasis added). This allegation is supported by Doe’s affidavit testimony: “As I continued to meet with him, Reverend Gar-vin became more aggressive sexually. I confronted him about his conduct and he agreed he was wrong. However, the sexual contact continued until mid-July, when sexual intercourse occurred.” (Emphasis added). Regardless whether Doe’s complaint sounds in professional malpractice or intentional tort, it is undisputed that Gar-vin intentionally disregarded well established standards of professional conduct by engaging in sexual relations with Doe.
The court’s error can be traced to its reliance on the reasoning of the Ninth Circuit in Simmons v. United States, 805 F.2d 1363 (9th Cir.1986). The Simmons court found that a therapist’s sexual conduct with a client “occurred in conjunction with his legitimate counseling activities” because it arose out of the transference. 805 F.2d at 1369. The court reasoned that “the centrality of transference to therapy renders it impossible to separate an abuse of transference from the treatment itself.” *352805 F.2d at 1369-70. This is just wrong. That transference is an essential component of psychotherapy does not imply that an intentional abuse of transference in order to derive personal sexual gratification is also essential. As the Cosgrove court held:
[I]t cannot be said that the sexual intercourse was so fairly and reasonably incidental to the therapy that it may be regarded as a method of carrying out the objectives of the employment. Not only was such conduct prohibited by the employer, but it violated the guidelines set forth in the code of ethics of the National Association of Social Workers.
520 A.2d at 847. Garvin’s intentional disregard of professional standards of conduct is diametrically opposed to his legitimate work activities.
Consider the case of an associate lawyer who discloses the confidences of his client for personal gain in violation of the rules of professional conduct. The client sues the lawyer’s firm for damages under a respon-deat superior theory. Under the court’s reasoning, since the confidential relationship between a lawyer and a client is an essential component of legal representation, a lawyer’s abuse of that relationship is reasonably incidental to legal representation and therefore falls within his scope of employment. However, the court surely would not consider a lawyer who breached his duty of confidentiality for personal gain to be “motivated to serve” his law firm. Conduct constituting an intentional violation of professional ethical standards for personal benefit cannot be considered reasonably incidental to the profession.
The court next considers whether Gar-vin’s conduct fits the requirement of Second Restatement § 228(2) that an employee’s conduct may not be “different in kind from that authorized.” Since employees are seldom employed in order to commit torts, the majority interprets this provision to mean that “only the act which leads to, and is incidental to the tortious behavior cannot be different in kind from acts the employee is authorized to perform in furtherance of the employer’s enterprise.” Supra at 348 n. 7. The majority concludes without argument “that a jury might reasonably find that Garvin’s tortious conduct arose out of, and was reasonably incidental to counseling activities authorized by and of potential benefit to Samaritan.” Id.
To what authorized counseling activities does the court refer? If the court means psychotherapy, it is just false that Garvin’s sexual misconduct arose out of psychotherapy. Therapist-patient sex stems not from the transference, but from its intentional abuse. On the other hand, if the court means Garvin’s intentional abuse of the transference, such conduct was not authorized. There simply is no reasonable interpretation under which Garvin’s sexual misconduct was reasonably incidental to his authorized duties as a psychotherapist.
Finally, the court considers whether the tortious conduct occurred “substantially within the authorized time and space limits.” Second Restatement § 228(l)(b). Relying on the fact that sexual fondling occurred during counseling, the court concludes that “a trier of fact could reasonably conclude that Garvin’s tortious conduct occurred within authorized time and space limits_” Supra at 349. The court misapplies the criterion. The question is not whether any tortious conduct occurred within authorized time and space limits. Garvin clearly satisfies that criterion on the undisputed facts. The question is rather whether the conduct occurred “substantially” within those limits. It is undisputed that except for two instances of fondling, all the tortious conduct including sexual intercourse occurred not only outside of the office, but also after termination of therapy. No reasonable trier of fact could conclude that the tortious conduct occurred substantially during therapy. Faced with similar facts, the Cosgrove court correctly reasoned:
[Pjlaintiff and defendant Lawrence engaged in sexual intercourse not only in Lawrence’s office at the county operated mental health center, but in parks, and Lawrence’s home. Such conduct off the mental health center’s premises cannot be said to be within the authorized time *353and space limits as required by sec. 228 of [the Second Restatement],
520 A.2d at 848.
In sum, the court misapplies the Second Restatement criteria in determining that therapist-patient sex is “reasonably incidental” to psychotherapy and therefore reasonably may be considered within the scope of employment for purposes of respondeat superior liability. There is no reasonable interpretation of those criteria that would justify imposing liability on mental health employers for the sexual misconduct of their therapists.
The court’s erroneous application of the Restatement criteria is obvious when viewed in light of the purposes of responde-at superior liability. In an important case last year, the California Supreme Court held as a matter of law that a school district could not be held vicariously liable for a teacher’s sexual abuse of a fourteen year old junior high school student. John R. v. Oakland Unified School District, 48 Cal.3d 438, 256 Cal.Rptr. 766, 771-75, 769 P.2d 948, 953-57 (1989). Although John R. did not involve psychotherapy, the dependency existing in the teacher-student relationship is analogous to the dependency existing in the therapist-patient relationship on account of the transference phenomenon.4 The California court cited several cases involving therapist-patient sex, including Simmons, as relevant to its resolution of the issue in John R. 769 P.2d at 953 n. 8. Unlike many courts that woodenly apply the Second Restatement criteria to the facts of the case, the California court analyzed the question in terms of the policies to be served by imposing liability. The court considered three reasons for imposing liability on an enterprise for the risks incident to the enterprise:
(1) [I]t tends to provide a spur toward accident prevention; (2) it tends to provide greater assurance of compensation for accident victims[,] and (3) at the same time it tends to provide reasonable assurance that, like other costs, accident losses will be broadly and equitably distributed among the beneficiaries of the enterprises that entail them.
769 P.2d at 955.
With respect to accident deterrence, the court found that it “plays little role in the allocation of responsibility for the sexual misconduct of employees generally....” 769 P.2d at 956. Since a therapist’s sexual misconduct stems from his intentional disregard of well established standards of professional conduct, there is little that an employer can do to reduce its occurrence. Although Samaritan may be able to reduce the incidence of sexual misconduct through careful selection of its therapists and close monitoring of their conduct, it is already subject to a duty to exercise due care in that regard. In this very case, Doe claims that Samaritan was negligent in its hiring and supervision of Garvin. To render mental health employers strictly liable for the sexual misconduct of their employees at best would be ineffectual. At worst, it could threaten the therapeutic process itself by encouraging employers to invade the privacy of the therapist-patient relationship.
The John R. court also found the second reason — assurance of compensation — inapplicable to the case of sexual misconduct.
The acts here differ from the normal range of risks for which costs can be spread and insurance sought. The imposition of vicarious liability on school districts for the sexual torts of their employees would tend to make insurance, already a scarce resource, even harder to obtain, and could lead to the diversion of needed funds from the classroom to cover claims.
769 P.2d at 956 (citation omitted). The same considerations apply with even more force in the case of mental health employers. Imposing vicarious liability would tend to make medical malpractice insurance, already a scarce and expensive resource, even harder to obtain. It is also unclear whether medical malpractice insur-*354anee would even cover sexual misconduct. Whether or not mental health employers could insure against this risk, they would have to raise the cost of their services dramatically. Mental health services would be denied to those who are least able to pay. While victims of therapist sexual misconduct may enjoy a greater chance of being compensated, the cost of creating that benefit in reduced access to mental health services is'unacceptable.
Finally, the court concluded that it would be unfair to spread the risk of the abuse of the dependency relationship between teacher and student among the beneficiaries of public schools:
[T]he connection between the authority conferred on teachers to carry out their instructional duties and the abuse of that authority to indulge in personal, sexual misconduct is simply too attenuated to deem a sexual assault as falling within the range of risks allocable to a teacher’s employer.
John R., 769 P.2d at 956. Similarly, in this case, it would be unfair to impose the risk of a therapist’s abuse of the dependency created by the transference on his employer. Sexual misconduct is not an improper method of carrying out the authority granted to a therapist; rather, it constitutes an intentional abuse of that authority for personal gratification.
The motivation for the court’s holding is not difficult to find. Therapist-patient sex is a serious problem in the psychotherapeutic community. However, imposing vicarious liability on mental health employers for the sexual misconduct of their employees is not an appropriate response to the problem. First, imposing vicarious liability would create incentives to invade the privacy of the therapist-patient relationship that is essential to the psychotherapeutic enterprise. Second, it would restrict access to mental health services to those who are least able to afford them. Third, and perhaps most important, spreading the cost of therapist-patient sex to the consumers of mental health services is unfair. Therapist-patient sex, although not uncommon, is not an inevitable cost of mental health care. It is a cost imposed by therapists who intentionally disregard the standards of conduct of mental health professionals for personal sexual gratification. For these reasons, I would affirm the superior court’s decision granting Samaritan summary judgment on Doe’s respondeat superi- or claim.

. See Davidson, Psychiatry's Problem with No Name: Therapist-Patient Sex, 37 Am.J. Psychoanalysis 43, 48-49 (1977) ("[I]t is generally agreed that therapist-patient sex is psychologically deleterious for the involved woman patient and is unethical practice for the male practition-er_”).

. Both parties agree that the tortious conduct in question was Garvin's engaging in sexual relations with Doe. Doe alleges that "Garvin breached his duty as counselor by engaging in sexual activity with Doe." (Emphasis added).

. One commentator, finding the idea "absurd" that any well-qualified therapist could not help himself from acting out his sexual feelings, states that such an impulse-ridden person would scarcely be safe on a dance floor. E. Mintz, Touch and Psychoanalytic Tradition, 56 Psychoanalytic Rev. 365 (1969).

. Dr. Nelson testified that "the counselor/coun-selee relationship could be described psychologically as similar to a parent authority figure and child dependent relationship.” In fact, one of the roles that the patient projects on the therapist is that of an "early teacher[ ].”