Posted by psych chat on October 28, 2009, at 20:52:30
I wrote a letter and emailed it to the APA; I did not file a complaint, but sent an email inquiry.
The twittering of a link to a person's suicide plans upset me-it really crossed a line, imo. The individual may or may not be upset about it, but another individual might very well be mortified if the same thing happened to them. While individuals may choose to take information and post it anywhere, I do not think it is ethical for psychiatrists to do this, or even encourage this behavior. That individual chose to post here on this forum, to seek help from the individuals located here - if someone wants to twitter their suicidal plans to all of Dr. Bob's followers, they would have done so themself. I think it is exploitation - to promote this site which is used for Dr. Bob's research and thus, career.
Of course, policy is still evolving to catch up with technology. There is always a time slack.
Many people have nowhere to turn for support, or simply don't have the resources to get help. Some people have agoraphobia and can't leave their homes to connect with others. Others have social anxiety and may not be as adept at obtaining help. People have different reasons for seeking support here and through other forums. It would be sad if such people felt increasingly unsafe to post on these forums due to excessive information sharing, along with the lack of privacy.
I do believe these sites should be protected with a security layer so they are not all over Google. I also believe people should be allowed to edit or delete revealing posts they may have posted while in a state of mental distress. This is totally against Dr. Bob's policy. He will only delete a post if it contains the person's actual name, so I was told. A person in distress may not have the strength to read the forum's "policies" before they post revealing material.
It appears the APA's code of ethics applies mostly to clinical practice (as opposed to website administrators) and research.
So-I asked them to look into such practices by APA members who administer mental health forums and also if they are in the process of developing guidelines for mental health medical professionals who administer websites (if they already haven't). I also provided some links to this website/our concerns about privacy, along with the post concerning suicide.
I hope they consider this in their ethics code, and that lawmakers do the same.
http://www.psych.org/Departments/EDU/residentmit/ethicsprimer.aspx
"For psychiatric patients, because of the widespread stigma and many cultural contexts of mental versus physical illness, confidentiality is even more important than in most areas of medicine (American Psychiatric Association Committee on Confidentiality
1987).Section 4, Annotation 1 of the Principles of Medical Ethics With Annotations
Especially Applicable to Psychiatry (hereinafter Principles) defines psychiatric medical records and comments on the necessity for confidentiality: Psychiatric records, including even the identification of a person as a patient, must be protected with extreme care. Confidentiality is essential to psychiatric treatment. This is based in part on the special nature of psychiatric therapy. The Principles go on to note that this is an era of growing concern about the civil rights of patients
and the possible adverse effects of computerization, duplication equipment,
and data banks (Section 4, Annotation 1). These advances in technology may provide relatively easy access to data, but because of
the sensitive and private nature of the information with which the psychiatrist
deals, he/she must be circumspect in the information that he/she chooses to disclose to others about a patient. The welfare of the patient
must be a continuing [dominant] consideration (Principles, Section 4, Annotation 1).
Section 4, Annotation 2 of the Principles deals with how and when confidential information may be released: A psychiatrist may release confidential information only with the authorization of the patient or under proper legal compulsion. The continuing duty of the psychiatrist to protect the patient includes fully apprising him/her of the connotations
of waiving the privilege of privacy. This may become an issue when the patient is being investigated by a government agency, is applying
for a position, or is involved in legal action. The same principles apply to the release of information [about a patient] to medical departments of government agencies, business organizations, labor unions, and insurance
companies. [For example,] information gained in confidence about patients seen in [college] student health services should not be
released without the students explicit permission.Clinical information is often used in teaching or in publishing articles in professional journals. Section 4, Annotation 3 of the Principles states that clinical and other materials used in teaching and writing must be adequately disguised in order to preserve the anonymity of the individuals involved. Section 4, Annotation 10 of the Principles also deals with this issue, stating that with regard for the persons dignity
and privacy and with truly informed consent, it is ethical to present a patient to a scientific gathering, if the confidentiality of the presentation is understood and accepted by the audience. Section 4, Annotation 11 of the Principles also touches on this issue, stating that it is ethical to present a patient or former patient to a public gathering or to the news media only if the patient is fully informed of enduring loss of confidentiality, is competent, and consents in writing without coercion.
poster:psych chat
thread:923225
URL: http://www.dr-bob.org/babble/admin/20090813/msgs/923225.html