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McGill Reporter
May 10, 2001 - Volume 33 Number 16
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Bob Parkinson: Mac's keeper of the trees

Photo Psychiatry professor Phil Beck

What you tell your psychiatrist in the privacy of her office is nobody's business but yours and hers, right? Maybe not.

Governments, insurance companies, law enforcement agencies and the courts are exerting greater pressure to gain access to the detailed information in psychiatrists' files, says psychiatry professor Phil Beck, the chair of the Canadian Psychiatric Association's standing committee on professional standards and practice. He is the principal author of a new CPA position paper on the subject.

Notes Beck, "With the arrival of the digital age and the relative ease with which huge databases can be created and exchanged, the risks to individual privacy have grown even more rapidly. Individual health care information, once entrusted only to one's physicians or close family members, has now become routinely available to a much broader audience."

Insurance companies might argue that they have a right to know if a potential policy-holder harbours suicidal fantasies, but Beck makes the case for patient/doctor confidentiality.

"I think the statistics indicate quite clearly sometimes suicidal tendencies ... may indicate an increased risk," Beck told the Medical Post. "But a lot of things that go on in discussion between a psychiatrist and a patient are really things happening on a fantasy level or happening in terms of exploring various kinds of things."

In the policy paper, Beck notes that patients "are able to reveal sensitive or embarrassing information about themselves because they understand that this information will remain within the therapeutic context."

In his view, psychiatric records should only be disclosed with the patient's informed consent. The only exceptions, related to potential acts of violence or the interests of justice, would "be required by law and judged by an impartial authority as being relevant to the situation at hand."

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