It is estimated that today even the simplest medical encounter involves over 100 exchanges of individually identifiable information among providers, laboratories, payers, and administrators. Limited privacy protections which can be extended to medical information within such a system are hardly relevant today to the confidentiality requirements of psychoanalytic patients. To illustrate the divergence. Let me close by quoting form a recent book on the subject of Ethics of Psychiatry. No longer do psychiatrists own complete control over information generated clinically, if they ever did.
Confidentiality is no longer of overriding importance, overcoming all other interests.
Treatment relationships are no longer simply and forever dyadic. It is therefore inevitable that psychoanalysts will have to assume the responsibility we have evaded for so long the responsibility of defining both an ethical code and standard of care regarding confidentiality which suit the unique and enduring arrangements that we must make in our work with our patients, rather than aping the diverging standards of our much more diverse core professions of Medicine, Psychiatry, Psychology and Social Work. That process has already begun and I believe will continue. In this I am sure Dr. Bollas would agree.