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Journal of Bioethical Inquiry

, Volume 16, Issue 3, pp 469–471 | Cite as

Competing Ethical Interests Regarding Privacy and Accountability in Psychotherapy

  • Shaun N. HalovicEmail author
Case Studies
  • 19 Downloads

Abstract

“Jane” is a mother of two, who was referred for psychotherapy. However, Jane had misgivings about engaging in the offered psychotherapy because of threats made by her domestically violent partner. The therapy sessions are audio recorded for the purpose of professional supervision and clinician reflective practices. Jane’s partner had threatened to subpoena the therapy recordings to legally separate Jane from her children. This article focuses on how three different parts of Jane’s multidisciplinary care (i.e. clinicians, policy professionals and medico-legal professionals) exhibit different competing ethical priorities. Psychotherapeutic clinicians private use of audio recordings of the therapy enhances patient care and their own professional development but with the risk of concealing possible unethical behaviour by either party. Medico-legal access to the therapy recordings preserves potentially relevant evidence in the pursuit of justice but risks the interpretation of the psychotherapeutic information outside of the therapeutic context. Policies advocating the inclusion of the therapy recordings in the medical record improves clinician (and health service) accountability but risks harming the vulnerable patient due to threats to patient-therapist confidentiality.

Keywords

Psychotherapy Patient privacy Health policy Medico-legal Confidentiality 

Notes

References

  1. Lambert, M.J, and D.E. Barley. 2001. Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, Research, Practice, Training 38(4): 357.CrossRefGoogle Scholar
  2. Martin, D.J., J.P. Garske, and M.K. Davis. 2000. Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. American Psychological Association 38(Winter): 357-361.Google Scholar
  3. NSW Parliament, NSW. Evidence Act NSW, 1995. https://www.legislation.nsw.gov.au/#/view/act/1995/25, Accessed June 19, 2019.
  4. NSW Parliament, NSW. Health Records and Information Privacy Act, 2002. https://www.legislation.nsw.gov.au/#/view/act/2002/71/full, Accessed June 17, 2019.

Copyright information

© Journal of Bioethical Inquiry Pty Ltd. 2019

Authors and Affiliations

  1. 1.Westmead Psychotherapy ProgramSydney UniversityNorth ParramattaAustralia

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