President Edward Joseph announced to the Executive Council at the recent Denver meeting that the American Psychoanalytic Association has been named a defendant in a lawsuit claiming that we have violated federal antitrust laws. The plaintiffs are four psychologists who claim to act on behalf of a class of all doctors of clinical psychology with similar credentials and training.
Although the plaintiffs are acting as individuals comprising a private action group, it appears that they have sought and obtained moral and financial support from the American Psychological Association and its Division 39.
Also named as defendants in the suit are the New York Psychoanalytic Institute, the Columbia University Center for Psychoanalytic Training and Research, and the International Psycho-Analytical Association. All of the other member institutes of the American are named as co-conspirators, but are nondefendants.
The complaint was filed in the United States District Court for the Southern District of New York on March 5, 1985. It charges that we have engaged in actions that constitute a conspiracy to restrain trade and that because of this, the plaintiffs and the class they purport to represent have suffered professional and economic hardships. They seek to force the American to change these alleged practices and also seek to collect monetary damages.
The legal document itself is long and technical. The complaint alleges that we engage in three practices which, plaintiffs claim, are in restraint of trade: first, that we restrict full clinical training in our institutes to physicians; second, that we do not allow our members to teach in those nonaffiliated institutes where nonphysicians are able to obtain training and prevent nonphysicians from obtaining training at IPA-affiliated institutes; third, that we do not refer patients to nonmedical psychoanalysts.
On May 3, 1985, our lawyers submitted an answer to the complaint, denying most of the multitude of specific allegations and seeking dismissal of the suit. Of course, we do not deny that we are an organization of medical psychoanalysts and that this is stated in our bylaws. Many pages of the complaint against us seek to establish that a medical degree is not a necessary prerequisite to becoming a psychoanalyst, and quotes, often taken out of context, from our own many deliberations on this matter, are said to document this particular point of view.
An important legal question of probable significance is whether educational institutions such as our institutes have the right to establish academic prerequisites or other admissions requirements.
The plaintiffs have requested through the court that we submit an enormous number of documents. The criteria for all the pieces of paper which, the plaintiffs claim, might bear on the case are very broad and very general. Many of our deliberations and statements regarding standards for training are matters of public record: minutes of meetings, admissions requirements, position statements, articles in the Journal and Newsletter, and so forth.
But much of what is called for is in violation of confidentiality: private communications and even such things as the actual applications for waivers and the confidential files attached to them. The officers of the Association, the Central Office staff, and our lawyers have begun to categorize these materials and to draw lines. We will fight very hard to safeguard from scrutiny any documents containing material of a sensitive and personal nature.
Many Councilor's wondered what we might anticipate as events unfold. Dr. Joseph stated that this is unclear at this point; it is unclear how strong a case the plaintiffs sincerely believe they have and how far they are willing to go.
We believe that legally we have done no wrong by requiring a medical degree as a prerequisite for training, that nonphysicians have always been free without objection from us to obtain training freely available to them elsewhere, and that the other charges regarding a conspiracy to restrain their freedom to obtain training and practice their profession are untrue.
We have, of course, debated for many years the complicated questions attached to the issue of whether we should train lay analysts. Our concerns have mainly focused on maintaining our high standards. Our deliberations have taken into account the many sensitive and complex perspectives that must be considered to safeguard the integrity and quality of our own organization before undertaking major change. The membership has often been divided in their opinions for a variety of reasons. All of the arguments over the years have been amply documented in the Newsletter and elsewhere.
The spirit of the discussion in Council supported Dr. Joseph's view that, as always, our deliberations concerning nonmedical training should continue to be dominated by the substantive issues involved, and guided by our wish to continue
to maintain our standards and safeguard the reputation and prestige that this policy has gained for us over the years.
Many, of course, expressed concern over the possibility of legal proceedings which could stretch on for years and be a financial drain on our organization, although this is equally true for those who have brought the suit against us.
Additionally, others thought that underlying the legal action was an important set of human factors which could be directly addressed and responded to. Many of those who are suing us are hurt, some say, by what they perceive to be second class citizenship in our eyes and are painfully aware that our institutes represent a quality of education to which they sincerely aspire.
Some councilors expressed the belief that if we met with this group and established a real and reasonable dialogue, the adversary tone and legalistic issues— false issues many of us believe — might evaporate. According to this “reasonable” view, we all want what is best for psychoanalysis and can possibly work out differences in good faith.
Many others cautioned against such common sense well-intentioned humanism. Some of these thought that our good intentions can be used against us when many-sided issues involving judgments of quality and ethical standards are subjected to the advocacy process of a legal proceeding. Legal logic and legal questions require strong legal advice and defense, they say. In a litigious climate, we must expect sometimes to deal with such things, and be prepared to use legal means to defend ourselves and safeguard our own best interests.
Most importantly, many argued, there should be no temptation to concede principles on the basis of expediency or legal or economic threat. This would play into the spirit of the complaint against us, which accuses us of having pursued policies for the narrow purpose of political and economic gain. In fact, most of us are poignantly aware that choosing to be psychoanalysts has tended to place us in positions that do not in the ordinary course of events lead to front runner status among those for whom political power and financial gain are leading motives.
Our power has always lain in the prestige which derives from our adherence to high standards and the academic and professional quality of our members, member institutes and societies, and our organization. If we must clarify this to win our case in court, the feeling of the majority appeared to be that we should do so. There was strong feeling that our principles must not be compromised—that there is no harm in negotiation, but if it becomes necessary to take a stand, then we must.