● In large groups and any other groups in which not everyone knows everyone else, ensure that special precautions have been taken to protect confidentiality. ● Although informed consent is always complicated by transferential implications, in some jurisdictions, the presentation of clinical material may be legally safe only with the written consent of the patient. Legal safety might not, however, fully discharge our ethical responsibility towards the patient and the treatment. When informed consent is proposed as an option, the presenting analyst should consider, if possible in consultation with colleagues, the possible impact of such consent upon an ongoing or completed treatment. ● Minimize the biographical details of the patient, revealing only what is necessary to illustrate the ideas of the author. In smaller gatherings where everyone knows everyone, this by itself may be adequate, and is certainly advisable. There should be an evaluation, preferably with colleagues, in cases in which the aspects of interest could even conceivably identify the patient. ● Disguise clinical material. This should be done so thoroughly in all clinical presentations that the likelihood of the patient being identified is remote. ● Ask each presenting analyst for a brief statement justifying the strategy chosen for protecting confidentiality within his or her ethical framework (see 3.2, penultimate paragraph). ● Have chairs announce that non-authorized audio or audio-visual recording of presentations containing clinical material is not allowed. ● Candidates are especially vulnerable when their personal analyses are spoken or written about by their analysts, given the risk of recognition by the candidate or by someone in the candidate’s professional and social circles. Possible consequences include undermining a candidate's identification with psychoanalysis as a future career and even adversely affecting a candidate's opportunity to pursue analysis as a career if, for example, those hearing the material take it to indicate a serious problem with the treatment. Presenting clinical material about a candidate could thus border on becoming a reporting analysis by another name. Similar considerations apply to the analysis of professional colleagues. 3.5 Publications in psychoanalytic journals and e-journals A number of psychoanalytic journals already have editorial policies in place for protecting confidentiality. It would be valuable to survey these systematically and to formulate proposals for enhancing their effectiveness, but we have not yet done this. The presence of clinical material on psychoanalytic e-journal sites and publications is a particular cause for concern. Increasingly, e-versions of articles become available at the same time as the print edition or may be republished electronically at a later date. Protection and control of this material is often seriously inadequate, while its readership is
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