|
Basic InformationMore InformationLatest NewsCrowdsourcing Raises Billions for Families Hit Hard by Medical BillsBiden Says He Will Release All Vaccine Doses After Taking Office1 in 4 Doctors Harassed Online, Study FindsMoves, Evictions Often Trigger Harmful Breaks in Health Care: StudySome Americans Can't Access Telemedicine, Study ShowsHealth Care After COVID: The Rise of TelemedicineNeurologists Much Tougher to Find in Rural AmericaAs Testing Costs Rise, Neurology Patients May Skip Screening1 in 7 Studies in Nutrition Journals Have Food Industry TiesUSPS Cuts Could Pose Harm If Mail-Order Meds Delayed: Study329 Americans Are Injured by Guns Every Day: StudySome Talc Products Contain Asbestos: StudyAHA News: Why People Fear Performing CPR on Women – and What to Do About It'Green Prescriptions' May Backfire for SomePreventive Health Care Falls by Wayside During PandemicSmoking Bans Don't Work If Not Enforced, NYC Study FindsTelemedicine Out of Reach for Those Who Can't Get OnlineLies Spread on Social Media May Mean Fewer Vaccinations1 in 3 Americans Prescribed Inappropriate DrugsColon Cancer Screening Should Start at Age 45: Task ForceWhat Will It Take for People to Embrace a COVID Vaccine?What Will Convince Americans to Get a COVID-19 Vaccine?CDC Recommends Face Masks in All Public Transportation SettingsInsured Patients Are Getting Surprise Bills After ColonoscopiesBogus 'Cure' Claims Have U.S. Consumers Snapping Up CBD ProductsPediatricians' Group Tackles Racism in Health CareAs Virtual Doctor Visits Spike, Concerns About Equity, Missed Diagnoses GrowWas FDA Lax in Approving Opioids Too Easily?Allowing More Gay Men to Donate Corneas Could Save Sight for Thousands: StudyAccuracy of COVID-19 Antibody Tests Varies Widely, Study FindsSevere Mental Illnesses Often Overlooked at Hospital Admission: StudyCould Drones Delivering Defibrillators Save Lives?Statins Going Generic Saved Medicare BillionsAHA News: Looming Wave of Evictions, Housing Instability Pose Threat to HealthAHA News: Health Apps Pose Privacy Risks, But Experts Offer This AdviceCould You Save a Life After Mass Violence? Most Americans Say NoGun Violence Costs U.S. Health Care System $170 Billion AnnuallyWith COVID Vaccine in Works, 1 in 5 Americans Doesn't Believe in ShotsTelehealth Skyrocketing Among Older AdultsPharmacists in All U.S. States Can Give Kids Childhood ShotsAHA News: COVID-19's Economic Fallout Expands Food Insecurity, as Groups Scramble to HelpCOVID-19 Clinical Trials Lack Diversity, Researchers SayLook Beyond Fossil Fuels to Curb Air PollutionTelemedicine Is Here: Experts Offer Tips for SeniorsMany Older Adults Can't Connect With Telehealth: StudyAHA News: High-Speed Internet Offers Key Connection to Health, But Millions Lack It11 States Could Face ICU Doc Shortages as Coronavirus Cases SurgeWill the Telemedicine Boom Outlast the Pandemic?Yet Another Study Finds Vaccines Are SafeIn Rush to Publish, Most COVID-19 Research Isn't Reliable, Experts Say Questions and AnswersLinksBook Reviews |
| |
by Christopher Cordess (editor) Jessica Kingsley, 2000 Review by Danny Sullivan, MBBS on Jan 17th 2002 It is timely to
publish a collection of British perspectives on confidentiality. Legislators
are grappling with issues of privacy, access to medical records and justifiable
releases of confidential information. In Australia, new federal and state
statutes regulate the collection of, and access to information related to
health. In Canada, the ethics of mandated breach are vigorously debated. And in
the USA, the terrain beyond Tarasoff has fundamentally altered
psychotherapeutic practice.
In the United
Kingdom, pressures on confidentiality are felt from, on the one hand, the Human
Rights Act 1998; and, on the other, a blame culture which retrospectively
determines the causes of medical errors and publicises these. A frequent
finding is of poor communication between different agencies.
This book arose from
a conference on held in Sheffield in 1998. Nevertheless, it seems to have
avoided the faults of collections that collate disjointed papers but avoid the
words conference proceedings. The authors cover a number of fields, in
particular those of psychotherapy and psychoanalysis. Professions allied to
medicine, and legal contributors also contribute chapters, although it would
have been interesting to hear more of non-doctors, in particular describing
clinical scenarios specific to those disciplines.
The introduction is
by Bill Fulford. He identifies the challenges posed to practitioners and to
traditional bioethics, and successfully grounds the issue in clinical practice.
Fulford argues that the issues are best addressed not by regulation, but by
communication; and not by seeking universalisable action-guiding principles,
but by learning from casuistry and the values of service users.
The next three
chapters address adult services, and specifically suggest a number of realistic
vignettes which express problems of confidentiality in psychiatric practice. In
forensic psychiatry, community psychiatry and the doctor-patient relationship,
the authors explore ways of addressing breach of confidentiality, maintaining a
focus on awareness of ethical principles as well as legal consequences.
Child protection and
the status of information about children and adolescents are then discussed.
These two chapters successfully communicate the complex loyalties invoked by
dealing with children and families, and the vulnerability of the patient group.
Following this, four
different perspectives are offered, focussing on social work, nursing,
situations of dual responsibilities (eg prisons) and the challenges posed to
psychoanalysis.
The two legal contributors
provide an interesting overview of contemporary case law, including cases from
the European Court of Human Rights. Their reasoned commentaries are succinct
and thought provoking.
In the penultimate
chapter, the research implications and their regulation are addressed
comprehensively. The book finishes with a discussion of the group processes
during the conference, drawing parallels between the vexed issues raised by
confidentiality, and their exploration by groups of psychiatrists. There is an
appendix containing the General Medical Council guidelines on confidentiality.
This is, overall, an
excellent collection. The contributors have a wide range of experiences, and
succeed in developing arguments rather than merely pointing out the issues.
Some positions are quite polemic! The volume is reasonably consistent, although
some of the middle chapters are weaker than the initial chapters and legal
commentaries.
This book will date,
but in the meantime it provides an invaluable resource for understanding the
pressures on mental health professionals in an increasingly complex terrain.
Dealing simultaneously with increasingly paternalistic laws providing for
detention, and with the expectation of partnership with service users, is
highly challenging. This book doesnt set out to provide answers, but explores
the nature of the tension between confidentiality and breach. It should be
mandatory reading for mental health professionals in the UK, and the
contributors have solid ideas to offer to an international audience.
© 2002 Danny Sullivan
Confidentiality and Mental Health is also
available from Amazon.co.uk.
Danny Sullivan graduated in
medicine in Australia in 1994. He has since completed a Masters Degree in
Bioethics and a Masters Degree in Medical Law. He is training in psychiatry at
the Maudsley Hospital and Institute of
Psychiatry in London, UK, and remains an Honorary Research
Associate of Monash University.
|