Abstract:
In the fall of 2019, a much-publicized court case brought to national attention the issues of patient-doctor confidentiality when it comes to reporting the deaths of newborns in the United States. It is unclear whether the recent overturning of Roe v. Wade will lead to more cases like this. This article discusses issues of countertransference, as well as the ethical and legal implications were it to be a psychiatrist, in active treatment of such a patient, who would be required to make such a report. More specifically, as in the publicized court case, the patient could be a minor at the time, receiving treatment from a child psychiatrist. The implications of such a case include how countertransference affects the perception of fatal child neglect compared to intentional neonaticide; the ethical dilemma of generating a mandated report with the goal of child safety when such a report could lead to real legal consequences for a minor child; and considerations regarding continued treatment of a patient after such a report is made. It is likely that countertransference, shaped by attitudes toward mothers and idealized views on mothering, may play a large role in all these circumstances.
摘要:
在2019年秋天,一个广为人知的法院案件引起了全国关注,涉及报告美国新生儿死亡的患者-医生保密问题。目前还不清楚最近罗伊诉韦德案的推翻是否会导致更多这样的案件。本文讨论了反移情问题,以及作为一名精神病医生的道德和法律含义,在积极治疗这样的病人时,谁将被要求做出这样的报告。更具体地说,就像公开的法庭案件一样,病人当时可能是未成年人,接受儿童精神病医生的治疗。这种情况的含义包括与故意杀新生儿相比,反移情如何影响对致命儿童忽视的认识;当这种报告可能导致对未成年儿童的真正法律后果时,生成以儿童安全为目标的强制性报告的道德困境;以及在做出此类报告后对患者继续治疗的考虑。很可能是反移情,由对母亲的态度和对母亲的理想化观点塑造,可能会在所有这些情况下发挥重要作用。