From: anon-1326@twwells.com (The Captain)
Newsgroups: alt.sexual.abuse.recovery
Subject: More on a breach of confidentiality (LONG)
Date: 5 Nov 92 05:15:13 GMT
Organization: Anonymous Posting Service at twwells.com
X-Email-Accepted: yes

Hi again!  Yes, it's the Captain.  As you all know, I had a little problem
with my counselor and my dean.  My counselor divulged personal information to
my dean, thus violating my confidentiality.  I told this to my dean, and I
got what I feel was a response of utter denial.  Judge for yourself.  I've
included our complete correspondence so far below.  As usual, I have deleted
the names of myself, my dean, and my counselor in order to protect my own
privacy.

Dean [name of dean]:
    During our telephone conversation last Thursday morning, there were a few
things I wanted to talk to you about.  However, I was so angry that I decided
to wait until I could calm down and instead send you a [letter by email].
    When you started talking about the letter I intended to write to my
father, it became clear to me that you had been talking with [my counselor]. 
I do not know exactly what precipitated this conversation, but your
conversation with [my counselor] constitued a clear violation of my
confidentiality as a patient.  In letting [my counselor] divulge my personal
information and break his professional ethics, I feel that you were an
accomplice to this violation of confidentiality.
    The confidentiality and privacy of the patient is, in my opinion, one of
the most fundamental aspects of the doctor patient relationship.  Indeed,
breach of confidentiality (when not an instance of state-mandated reporting
of suicidality, homicidality, or child abuse) is a violation of the code of
ethics of every professional organization existant.  I gave [my counselor] no
permission to give you any information about what happened in our meeting
last Tuesday, and he did.
    In short, I feel that what has happend is inexcusable and unconscionable. 
I demand not only an explanation of what happened, but an apology as well.  I
feel that I cannot let this breach of confidentiality go unnoticed.  Please
email your explanation to me as soon as possible; I feel that what has
happened is so serious that an immediate response is necessary.  Additionally
I ask that you do not call or request a meeting in your office to explain
this; I would like your explanation in writing in case I should decide to
file a formal complaint against [my counselor].

[signed]

My dean replied:

[Captain],

For your information I have no information about your discussion with [your
counselor].  [Your counselor] wants you to arrange medical insurance for
counseling because you are not enrolled this term and therefore aren't
eligible to see [your counselor] without family insurance [name of insurance
plan deleted]. His recommendation to the Dean's Office that you have
counseling this term and arrange coverage prompted my call.

I had asked you to make an appointment this week to discuss your situation.
Please call the office [phone number deleted]] to set up a time that is
convenient.

[signed by my dean]

[a copy of my first letter to the dean deleted]

I replied:

Dean [name of dean]:
    In our telephone conversation on Thursday, you went into great detail on
the fact that I was going to send a letter to my father about getting
counseling.  You even mentioned the fact that I was planning to mail this
letter when I went out of town over the weekend.  I know that in our meeting
last Tuesday I had not told you any of this information.  As I had told this
to only one other person ([my counselor]), it is clear to me that you must
have received this information from [my counselor].  Indeed, when we talked
on Thursday, you yourself said that [my counselor] had said this to you.
    In your letter to me this morning, you claim to have no information about
my discussion with [my counselor].  You then proceed to go into detail about
my situation regarding counseling.  In my meeting with [my counselor] last
Tuesday, he specifically asked me whether he wanted me to call you; I did not
give him the permission to do this.  Obviously some agreement has been
violated here.

[signed]

My dean replied:

[Captain],

I'd suggest you schedule an appointemnt to discuss this and also consult
[your counselor].  Apparently you are unclear about medical confidentiality. 
The Dean's office routinely talks with the counselors about what
reocmmendations they have to support students whom we have referred.  

[signed by the dean]

[A copy of my second letter to the dean deleted]

I replied to her:

Dean [name of dean]:
    I beg to differ with you-- apparently YOU are unclear about medical
confidentiality.  I believe I sent you the following about confidentiality:
    "The confidentiality and privacy of the patient is, in my opinion, one of
the most fundamental aspects of the doctor patient relationship.  Indeed,
breach of confidentiality (when not an instance of state-mandated reporting
of suicidality, homicidality, or child abuse) is a violation of the code of
ethics of every professional organization existant."
    My case is clearly not one of suicidality, homicidality, or child abuse;
therefore what happened was a breach of ethics.  The mere fact that you have
a policy of talking with counselors about those students who have been
referred by you does not make the policy ethical.  As a rather extreme
analogy, Oliver North had a policy of shredding any documents he thought
would incriminate him in the Iran-Contra affair.  The mere fact that he had a
policy does not make what he did ethical, does it?
    Additionally, I find it deeply offensive that you can simply dismiss my
concerns over this breach of confidentiality as mere confusion.  I was very
hurt to find out that [my counselor] was revealing information to you about
what was brought up in my meetings with him.  Indeed, at my meeting with him
last Tuesday, I specifically told him NOT to contact you and talk about the
meeting-- I felt that if I any information about the meeting revealed, I
could do it myself.  Apparently you called him and he revealed information
about the meeting, in direct violation of my agreement with him.  In fact, I
have NEVER given [my counselor] ANY permission to release ANY information
about what has transpired in my meetings with him.
    Do you still consider this not to have been a breach of confidentiality?

[signed by me]

My dean replied:

[Captain],

Obviously I don't know what you discussed.  I don't care to know.  [Your
counselor] recommended you arrange insurance through your parents, and he
asked your class dean to help you.

Please make an appointment if you have other questions.  

[signed by my dean]

[A copy of my third letter to the dean deleted]

I replied:

*** [My dean] writes ***

[Captain],

Obviously I don't know what you discussed.  I don't care to know.  [Your
counselor] recommended you arrange insurance through your parents, and he
asked your class dean to help you.

Please make an appointment if you have other questions.  

[signed by my dean]

*** end of message ***

I did not claim that you knew any highly personal details of what I discussed
with [my counselor] last Tuesday, nor did I claim you cared to know. 
However, I did not discuss any insurance arrangements with you. 
Additionally, I told [my counselor] at the meeting last Tuesday not to call
you.  To requote you: "[Your counselor] recommended you arrange insurance
through your parents, and he asked your class dean to help you."  [My
counselor] disregarded my requests and divulged information given at the
meeting.  If this doesn't constitute breach of confidentiality, I don't know
what does.

[signed by me]

This last letter was sent Tuesday afternoon.  Since then I have not received
a reply with my dean.  My dean still wants me to schedule a meeting with her. 
So far I have refused to do so.  My feeling is that I deserve an apology from
my dean (at the very least); if I go to a meeting at her office, I'm only
going to get the same line parroted from her as she has given me in our
correspondence so far.  Why waste my time?

In dealing with my abuse, I wrote my brother a letter rather than confronting
him face to face.  As he ignored my letter completely, I'm not certain
exactly what a response of denial is like.  Maybe some of you out there
reading ASAR could answer this for me: Do you think what's happened here so
far is a denial that my confidentiality was actually violated?

The Captain



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