CONTENTS
1 INTRODUCTION
4
2 GENERAL PRINCIPLES
6 6 6 6 7 7 7 8 8 9
2.1 Psychoanalytic & non-psychoanalytic approaches to confidentiality
2.2 The analyst’s responsibility for the frame/setting
2.3 The patient’s trust that the analyst will protect confidentiality 2.4 The possibility of unresolvable conflict between competing needs or views 2.5 Confidentiality as an ethical & technical foundation of psychoanalysis
2.6 Confidentiality & privacy
2.7 Institutional & individual responsibilities 2.8 Ethical versus legal considerations 2.9 Psychoanalysis and the wider community
3 PROTECTION OF PATIENTS IN THE USE OF CLINICAL MATERIAL FOR TEACHING, ORAL PRESENTATIONS, PUBLICATIONS, & RESEARCH
10 10
3.1 Preliminary remarks and the problem of ‘informed consent’
3.2 Reducing potential and experienced harm to patients induced by the profession's scientific, technical, and ethical needs to share clinical experience 12 3.3 At the institutional level: teaching 13 3.4 Presentations of clinical material in congresses & other scientific events 14 3.5 Publications in psychoanalytic journals and e-journals 15 3.6 Psychoanalytic research 16
4 CONFIDENTIALITY WHEN USING TELECOMMUNICATIONS, INCLUDING FOR REMOTE ANALYSIS & SUPERVISION
17 17 17 18 19 20 20 23 24 25
4.1 Introduction
4.2 Privacy in the classical setting
4.3 Loss of privacy in telecommunicative settings 4.4 Loss of privacy in the classical setting
4.5 Long-term consequences
4.6 Implications for the IPA and its members
4.7 Measures which only appear to address the problem 4.8 Ethical implications & some possible partial protections
4.9 Conclusion
5 THIRD-PARTY REQUESTS FOR A BREACH OF CONFIDENTIALITY
26
6 COLLEAGUES AGAINST WHOM A COMPLAINT HAS BEEN MADE
29
7 PATIENTS’ ACCESS TO FILES, INCLUDING PROCESS NOTES
30
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