confidential places where free association is encouraged. In all other contexts, clinical material should be anonymised. ● Encourage each society to find a way to make thinking about the challenges of protecting confidentiality into a continuous learning project. This might, for example, take the form of the occasional workshop about the issue. The IPA could publish regular bulletins with case discussions from the different regions problematizing this issue, starting with examples drawn from the literature. 3.4 Presentations of clinical material in congresses & other scientific events Analysts need to be aware that clinical material, whether written or oral, once presented has a potentially unlimited audience. Although the risks of recognition may be judged to be low, any such risk raises the crucial issue that it is not only the reality of a consequent breach that is of concern, but also any perception that there has been or could be a breach. The following guidelines represent the Committee’s view of ‘best practice’ when presenting clinical material in congresses and other scientific events: 6 ● Prepare a statement about confidentiality in calls for papers. Presenting analysts should be alerted to some of the documented negative consequences of poorly controlled confidentiality on patients and analysts. Since research has shown (Kantrowitz, 2004, 2006) that analysts may not always be sensitive to the negative impact of their scientific activities on their patients, they could also be advised to consult their peers early on about their wish to share clinical material in the congress setting. One way of reducing the risk of leaking sensitive clinical material in group presentations would be to avoid circulating this material in written or digital form, either before or after the scientific event. ● Review submitted papers carefully. The scientific committee should vet particularly carefully each submission containing clinical material and – when in doubt – ask for feedback from a select team of advisors about the protection of confidentiality. Since these members may not know the author and his or her milieu, consultation at the local level may be an alternative form of protection. When clinical material cannot be changed, as in the narration of a dream, disguise, anonymization, or a carefully considered asking for permission might be used to protect the patient. ● Include a statement on confidentiality in the printed programme if there is one. Some examples of such statements are given in Appendix B. ● Have chairs read a statement aloud before every panel or workshop. Chairs of events in which clinical material will be shared could be asked to read aloud a statement such as the one that was proposed for the 2017 IPA Congress (see Appendix B). ● Announce that some details of the material have been omitted and/or changed to preserve patient confidentiality. 6 A preliminary version of some of the guidelines in 3.4 was accepted by the Officers on behalf of the Board in June and July 2017 before the Buenos Aires congress.
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