One respondent wrote: “ I would strongly suggest adding clear practical guidelines to your description of the situation about how to proceed. For example which editorial policies do you recommend? Which of these do you consider as absolutely obligatory and which are discretionary, that is according to the editor´s criteria?... If we don´t have these clear procedural steps to move forward, it will not be possible to overcome the situation of paralysis of on-line publications which we are currently suffering from .” It was also pointed out that even from a legal point of view, the patient's consent may not always give sufficient authority as it could instead be regarded by a court as evidence of the analyst's influence on the patient. 10.6 Telecommunications There was a very wide range of responses relating to confidentiality when using telecommunications and a considerable polarization of views was evident regarding both the extent of the risks and the implications of these risks for psychoanalytical practice. For example, one respondent described the contents of section 4 of the draft report as “… extremely valuable and very well presented in a balanced manner. A great deal of technical information has been digested …” Another agreed with our assessment that telecommunications are inherently insecure but criticised the draft report for not drawing stronger conclusions from this and for not recommending that the IPA take a more authoritative stance against the practice of remote analysis. On the question of long-term risks due to mass surveillance this respondent wrote that it was: “ excellent that the report takes this seriously and does not regard it as scare-mongering .” At the opposite end of the spectrum of opinion one respondent thought that “ a degree of paranoia crept into the report when some of the possibilities of electronic surveillance were being discussed .” Another thought that the report shows “ an unfortunate bias against teleanalysis ”, and that “ the technical detail in this report may augment fear, and inflate the relative risks of distance-mediated analysis over in-office analysis ”. Some respondents appeared to treat the draft report as if it were intended as an assessment of remote analysis, which it is not. The debate about remote analysis that is currently taking place in the psychoanalytic community, in which strong views are being advanced both for and against remote analysis, has a much wider scope than just confidentiality. It includes fundamental questions about the role of physical presence and embodiment in the setting, and the effects of technology on the mind. This report is concerned only with those aspects of this wider debate which touch upon confidentiality. It may nevertheless be relevant to note that there appears to be a correlation between the positions taken in response to the sections of the draft report that deal with telecommunication, and positions taken in that wider debate. Perhaps unsurprisingly, those in favour of remote analysis tend to be less concerned about the insecurity of telecommunications than those who are opposed to it.
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