1 INTRODUCTION The Confidentiality Committee has been mandated by the IPA Board to review “the ways in which confidentiality pertains to and impacts on the work of IPA psychoanalysts”, to draft documents on best practices for the IPA Board to review and approve, and to advise the Board on related issues for the 2019 Congress (see Appendix A). The members of the Committee are: Dr. Andrew Brook (IPA Treasurer, Chair), Psic. Nahir Bonifacino (Uruguayan Psychoanalytical Association), Mr. John Churcher (British Psychoanalytical Society), Dr. Allannah Furlong (Canadian Psychoanalytic Society), Dr. Altamirando Matos de Andrade (Chair of the IPA Ethics Committee, Ex-Officio), Dr. Sergio Eduardo Nick (IPA Vice-President, Ex-Officio), Mr. Paul Crake (IPA Executive Director, Ex-Officio). Administrative and technical support was provided by Mr. Steven Thierman. Although from its beginnings the IPA has had a major interest in confidentiality, an immediate impetus for establishing the Committee was a situation that arose in which confidential information about a patient was revealed during discussion of a clinical presentation at an IPA congress. Because the information was revealed in the response to a question by a member of the audience following the presentation, it could not have been prevented in advance by any review process. Subsequently the patient learned of what had been said and was outraged. The patient sued and the IPA ended up paying a substantial sum in settlement. The primary issue was not the money, or who was responsible for what, but how to prevent such ethical violations in the future. The Committee met on 20 occasions prior to producing a draft report in April 2018. The draft report was presented to the IPA Board at its meeting in June 2018, in London, following which it was sent to Presidents of component Societies and made available to all IPA members and candidates via the July IPA Newsletter, with an invitation to comment by 28th September. A further 3 meetings were held to discuss the feedback before producing the final report. In approaching our task we have kept in mind a number of general principles which are detailed below. We then discuss separately five areas of focal concern: protection of the patient in the use of clinical material for teaching, oral presentations, publications, and research; confidentiality when using telecommunications, including for remote analysis and supervision; third-party requests for a breach of confidentiality; colleagues against whom a complaint has been made to the Ethics Committee, while an investigation is ongoing; and patients’ access to files, including process notes. The first two of these are discussed in some detail as areas of current preoccupation for the IPA. We have had the benefit of reading unpublished legal advice about confidentiality and informed consent prepared for the IPA by an English barrister (Proops, 2017). We have also had sight of draft versions of recent documents prepared by a working party on confidentiality of the British Psychoanalytical Society, and by a working group of the German
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