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When Can Psychologists Break Client Confidentiality?

Fuseworks Media
Fuseworks Media
When Can Psychologists Break Client Confidentiality?

By Vaughan Elder of NZPA

Wellington, Aug 9 NZPA - A High Court decision to throw out an appeal by a psychologist struck off for sharing information about a patient without her consent has raised the question of when it is acceptable to break client confidentiality.

Ian Russell Geary, who practised in Timaru, had his registration stripped by the New Zealand Health Practitioners Tribunal in December 2009, for disclosing information about a client, whom he believed had committed fraud and perjury.

Mr Geary was found guilty of professional misconduct for giving information about a client to the woman's ex-husband and police, in the belief she had lied to ACC about being a victim of sexual abuse.

He appealed the tribunal's decision and punishment in the High Court at Wellington, which last month supported the tribunal's decision.

The New Zealand Psychological Society's immediate past-president, Jack Austin, said client confidentiality was key to building trust which was a "core element of all psychologists' practice".

New Zealand Psychologists Board chief executive and registrar Steve Osborne said clients would not feel free talking to psychologists unless they were assured the information would stay with them.

"People are only going to feel free to discuss very personal information if they are confident that it is not going to go any further," he told NZPA.

It was important clients felt as comfortable as possible giving psychologists personal information so they could fix their problems, he said.

There were however cases, usually when the client or public's safety was put in risk, when a psychologist was obliged to break confidentiality, Mr Austin said.

If a client went to a psychologist threatening to use violence against either themselves or a member of the public then the psychologist was obliged to give that information to authorities.

"If you come to me and say, 'hey when I go home tonight I'm so depressed I'm going to drive my car as fast as I can into a tree', then your safety overrides me not saying anything," he said.

Likewise if someone went to a psychologist and said they were going to kill their wife, the psychologist would also need to break confidentiality, he said.

"The more specific the threat... the greater the odds are that you are justified in breaking confidentiality," Mr Osborne said.

"If you have a client who simply says 'I'm really angry and I could kill someone' then that is probably a different thing."

Also a client telling a psychologist they had broken the law or a psychologist suspecting a client had broken laws was not necessarily a good enough reason to break confidentiality, Mr Osborne said.

"Just because someone has broken the law doesn't necessarily give a practitioner the right to break confidentiality, it depends on the circumstances."

If a client told their psychologist they had broken the law but there was no immediate threat to public safety then breaking confidentiality was not necessarily justified.

In Mr Geary's case there did not seem to be any immediate threat to the public and he did not properly explore other options before breaking his client's confidentiality, Mr Osborne said.

Psychologists had a code of ethics which gave clear guidelines about when a psychologist should break confidentiality and if it was not obvious they needed to discuss it with other psychologists, Mr Austin said.

Just as Mr Geary was punished for breaking confidentially, a psychologist could face punishment for not breaking confidentiality if it resulted in someone being hurt or being put in danger, Mr Austin said.

Of the six psychologists to lose their registration over the last five years, Mr Geary was the only one who was struck off for breaking confidentiality.

Four of the cases involved psychologists having sexual or inappropriate relations with clients and the other involved a psychologist committing a criminal offence.

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