O'Neil Mary Kay
1515 Dr Penfield Avenue, Suite 1005, Montréal, QC, Canada.
Int J Psychoanal. 2007 Jun;88(Pt 3):691-711. doi: 10.1516/0334-5427-247w-x038.
Burgeoning external threats to confidentiality by claims to clinical information create unprecedented challenges for psychoanalysts. Internal threats arise from the use of clinical material for educational, scientific and historical purposes. Traditionally, confidentiality is considered a patient's right and an analyst's obligation; privacy is not usually stated as a professional requirement. Little consideration has been given to the impact of the confidentiality and privacy dilemmas that analysts encounter throughout their careers. There has been no systematic examination of the confidentiality policies of psychoanalytic organizations, nor has their role in facilitating maintenance of patient confidentiality and analysts' privacy been made explicit. The research reported here was undertaken to address these issues and to obtain baseline information about the current confidentiality policies and practices of psychoanalytic organizations in three English-speaking countries (Britain, Canada and the USA). The author discusses survey results in the light of the challenges which arise at each phase of the analytic career. She makes suggestions as to how psychoanalytic organizations can and should facilitate analysts' resolutions of contemporary confidentiality and privacy dilemmas.
对临床信息的索取引发的对保密性与日俱增的外部威胁给精神分析学家带来了前所未有的挑战。内部威胁源自将临床资料用于教育、科学和历史目的。传统上，保密性被视为患者的权利和分析师的义务；隐私通常未被列为一项专业要求。对于分析师在其整个职业生涯中所遇到的保密性和隐私困境的影响，人们很少予以考虑。对于精神分析组织的保密政策，既没有进行系统的审视，其在促进维护患者保密性和分析师隐私方面的作用也未得到明确阐述。此处所报告的这项研究旨在解决这些问题，并获取有关三个英语国家（英国、加拿大和美国）精神分析组织当前保密政策和做法的基线信息。作者根据分析职业生涯各个阶段所出现的挑战来讨论调查结果。她就精神分析组织能够且应该如何促进分析师解决当代保密性和隐私困境提出了建议。
