Report of the IPA Confidentiality Committee (English)


1 INTRODUCTION 4
2

2 GENERAL PRINCIPLES 6
2

2.1 Psychoanalytic & non-psychoanalytic approaches to confidentiality 6
2

2.2 The analyst’s responsibility for the frame/setting 6
2

2.3 The patient’s trust that the analyst will protect confidentiality 6
2

2.4 The possibility of unresolvable conflict between competing needs or views 7
2

2.5 Confidentiality as an ethical & technical foundation of psychoanalysis 7
2

2.6 Confidentiality & privacy 7
2

2.7 Institutional & individual responsibilities 8
2

2.8 Ethical versus legal considerations 8
2

2.9 Psychoanalysis and the wider community 9
2

3 PROTECTION OF PATIENTS IN THE USE OF CLINICAL MATERIAL FOR TEACHING, ORAL PRESENTATIONS, PUBLICATIONS, & RESEARCH 10
2

3.1 Preliminary remarks and the problem of ‘informed consent’ 10
2

3.2 Reducing potential and experienced harm to patients induced by the profession's scientific, technical, and ethical needs to share clinical experience 12
2

3.3 At the institutional level: teaching 13
2

3.4 Presentations of clinical material in congresses & other scientific events 14
2

3.5 Publications in psychoanalytic journals and e-journals 15
2

3.6 Psychoanalytic research 16
2

4 CONFIDENTIALITY WHEN USING TELECOMMUNICATIONS, INCLUDING FOR REMOTE ANALYSIS & SUPERVISION 17
2

4.1 Introduction 17
2

4.2 Privacy in the classical setting 17
2

4.3 Loss of privacy in telecommunicative settings 18
2

4.4 Loss of privacy in the classical setting 19
2

4.5 Long-term consequences 20
2

4.6 Implications for the IPA and its members 20
2

4.7 Measures which only appear to address the problem 23
2

4.8 Ethical implications & some possible partial protections 24
2

4.9 Conclusion 25
2

5 THIRD-PARTY REQUESTS FOR A BREACH OF CONFIDENTIALITY 26
2

6 COLLEAGUES AGAINST WHOM A COMPLAINT HAS BEEN MADE 29
2

7 PATIENTS’ ACCESS TO FILES, INCLUDING PROCESS NOTES 30
2

8 GENERAL CONCLUSIONS 32
3

9 RECOMMENDATIONS 34
3

9.1 Protection of patients in the use of clinical material 34
3

9.2 Telecommunications and remote analysis 36
3

9.3 Third party requests for a breach of confidentiality 37
3

9.4 Colleagues against whom a complaint has been made 37
3

9.5 Patients’ access to process notes 37
3

9.6 Psychoanalysis and the wider community 38
3

10 COMMENTS RECEIVED BY THE COMMITTEE CONCERNING THE DRAFT VERSION OF THIS REPORT 39
3

10.1 Introduction 39
3

10.2 Comments on the report as a whole 40
3

10.3 Intrinsic limitations of psychoanalytic confidentiality 41
3

10.4 The community-of-concern approach 42
3

10.5 Informed consent and sharing of clinical material 42
3

10.6 Telecommunications 43
3

10.7 Third party requests 45
3

10.8 Child & adolescent analyses 45
3

10.9 Analyses of candidates & colleagues 46
3

10.10 Archives 46
3

10.11 Comments received after the report was finished 46
3

11 REFERENCES 47
3

12 FURTHER READING 51
3

13 APPENDICES 61
3

1 INTRODUCTION
4

2 GENERAL PRINCIPLES
6

2.1 Psychoanalytic & non-psychoanalytic approaches to confidentiality
6

2.2 The analyst’s responsibility for the frame/setting
6

2.3 The patient’s trust that the analyst will protect confidentiality
6

2.4 The possibility of unresolvable conflict between competing needs or views
7

2.5 Confidentiality as an ethical & technical foundation of psychoanalysis
7

2.6 Confidentiality & privacy
7

2.7 Institutional & individual responsibilities
8

2.8 Ethical versus legal considerations
8

2.9 Psychoanalysis and the wider community
9

3 PROTECTION OF PATIENTS IN THE USE OF CLINICAL MATERIAL FOR TEACHING, ORAL PRESENTATIONS, PUBLICATIONS, & RESEARCH4F
10

3.1 Preliminary remarks and the problem of ‘informed consent’
10

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

4.1 Introduction
17

4.2 Privacy in the classical setting
17

4.3 Loss of privacy in telecommunicative settings
18

4.4 Loss of privacy in the classical setting
19

4.5 Long-term consequences
20

4.6 Implications for the IPA and its members
20

4.7 Measures which only appear to address the problem
23

4.8 Ethical implications & some possible partial protections
24

4.9 Conclusion
25

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

8 GENERAL CONCLUSIONS
32

9 RECOMMENDATIONS24F
34

9.1 Protection of patients in the use of clinical material
34

At the institutional level
34

Presentation of clinical material in congresses and other scientific events25F
34

Psychoanalytic journals and e-journals
35

Psychoanalytic research
36

9.2 Telecommunications and remote analysis
36

9.3 Third party requests for a breach of confidentiality
37

9.4 Colleagues against whom a complaint has been made
37

9.5 Patients’ access to process notes
37

9.6 Psychoanalysis and the wider community
38

10 COMMENTS RECEIVED BY THE COMMITTEE CONCERNING THE DRAFT VERSION OF THIS REPORT
39

10.1 Introduction
39

10.2 Comments on the report as a whole
40

10.3 Intrinsic limitations of psychoanalytic confidentiality
41

10.4 The community-of-concern approach
42

10.5 Informed consent and sharing of clinical material
42

10.6 Telecommunications
43

10.7 Third party requests
45

10.8 Child & adolescent analyses
45

10.9 Analyses of candidates & colleagues
46

10.10 Archives
46

10.11 Comments received after the report was finished
46

11 REFERENCES
47

12 FURTHER READING
51

Further Reading for Section 3
51

Further Reading for Section 4
56

Further Reading for Section 6
57

13 APPENDICES
61

Made with FlippingBook interactive PDF creator