Abstracts
| Published date | 01 December 1971 |
| Date | 01 December 1971 |
| DOI | http://doi.org/10.1177/000486587100400416 |
| Subject Matter | Abstract |
262 AUST. &N.Z. JOURNAL OF CRIMINOLOGY (Dec., 1971): 4, 4
Abstracts
Con
f
ide
n t ia
lit
yand
the
Forensic
Psychiatrist in
the
Correctional
Setting
(1970) Bartholomew, Allen A. Aust.N.Z.J.
Psychiat.
~
183.
THE article begins by suggesting
that
the
Hippocratic
Oath
is
not
to be
rea~
as com-
manding
that
all
matters
learnt
In
a pro-
fessional
respect
are
to be classed as
"sacred secrets". The
major
question of
confidentiality is
then
considered
under
five headings: The Pretrial stage; The Post-
conviction-presentence stage; The Im-
prisonment (preparole) stage; The Parole
stage and the
matter
of
treatment
of per-
sons
not
subject
to
any
correctional ord-
ers.
Whenever
the
question of communi-
cating facts concerning
patients
(offenders
for
the
most
part)
arises,
there
is a prob-
lem which
may
be
set
out
as
the
three
"Cs"
-Does one caution
the
patient?
What
content
shall
any
communication
have?
What
degree of confidentiality does
the
report
have? Clearly one should
not
misrepresent
the
psyc~iatrist's
~ositi~n
by
suggesting
that
anything
told
him
wIll. be
confidential - some
warmng
(caution)
should be given. Equally clearly
the
con-
tent
of
any
communication (report)
v-:ill
depend on who will see
the
report; Its
confidentiality.
The question of misprision of felony is
discussed
and
considered to be of
very
little importance to
the
psychiatrist,
whether
working in private practice
or
in
the
correctional setting. One basis for
this point of view is
that
the
psychiatrist
will very
rarely
have
kno~n
that
afelony
had been committed -
'Rumors,
gOSSIp
or suspicion
are
not
enough".
It is suggested
that
the
term
"confiden-
tial"
should
not
be understood as con-
noting an absolute state: there
are
degrees
of confidentiality. _
Five modifications of presently
practised
techniques
are
suggested
that
would re-
duce some of
the
problems in relation to
confidentiality. These
are
(i)
the
Crown
not
to receive a full psychiatric
report
re-
garding apossible defence of
insanity
until the defence have indicated
that
they
will raise
such
adefence; (ii)
that
there
should be a plea of
"not
guilty on
the
grounds of insanity"; (iii) sentencing
b~
a
sentencing
tribunal
or committee which
would be closed for discussion
rather
than
have presentence hearings; (iv) psychia-
trists attending Parole Board meetings
rather
than
writing
out
reports,
and
(v)
doing
away
to 9.
much
greater
extent
of
the artificial distinction between punish-
ment
and
treatment.
Finally,
it
j~;
suggested
that
the whole
question boils down to using one's dis-
cretion
and
acting in good faith.
Confidentiality
and
the
Psychiatrist In
Private
Practice (1970 Ellard, J. Aust.N.Z.J.
Psychiat.
~
191.
THE
author
sets
out
a
number
of different
circumstances
where
the issue of con-
fidentiality
may
well arise e.g, when in-
formation is
transmitted
to a third
party
whether
that
third
party
be a government
department or a solicitor; when a
patient
who has previously been
treated
returns
to
the
psychiatrist
and
solicits his aid in
some pending litigation, or when
the
patient
first comes to the psychiatrist
seeking a"psychological defence"; prob-
lems related to matrimonial
matters
when
the psychiatrist
may
be called
sub
poena
"by
the opposite side";
the
problems posed
by group psychotherapy,
and
the
problem
of microfilming clinical records -
"The
notes of a
particular
patient
then
exist
only as a few frames on a roll of film,
which also contains
the
records of
many
other
patients".
When
the
author
turns
to his
answer
to
the conundrum of confidentiality he writes:
"I think
that
Iwould be comfortable with
my patients if I
knew
that
Iwould be com-
pelled to reveal confidences only if
the
patient
himself
later
raised issues in litiga-
tion which
caused
my appearance in
court, or if it
were
clear
that
justice could
not
be achieved because he
was
withhold-
ing important
and
relevant information
which directly
related
to
the
matter
at
issue.
That
such
asituation
had
arisen
would be a
matter
for the trial judge to
decide: Iwould
ask
for complete privilege
only in matrimonial cases".
Mental
Integrity
and
the
Nature
of Life
(1970) Welford, A. T. Med.J.Aus.t. i1135.
THE problem is raised of how
far
main-
taining
the
survival of
patients
with
terminal illnesses whose mental powers
are
gravely impaired, competes with
the
medical
treatment
of
patients
who
can
expect to recover fully. The
human
and
religious consequences of defining life in
terms
of
mental
integrity
are
discussed,
especially as regards
the
senile
and
serious-
ly defective infants. It is
stated
that
"the
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