Breach of Confidentiality

Maintaining confidentiality in psychiatric practice is both a legal obligation and a long-standing ethical norm. Patients rely upon such assurances when divulging personal information to providers, and open communication is a necessary component of care. Yet this duty is not absolute. Mental health providers are increasingly “dual agents” who serve both their own patients and the public welfare; they may be legally bound or permitted to breach confidentiality in cases of significant danger to third parties. State courts historically deferred to the judgment of physicians in such matters, and it was not until the 1980s that negligence claims based on the principle of breach of confidentiality began to succeed. Federal privacy statutes like the Health Insurance Portability and Accountability Act of 1996 and Part 2 of 42 Code of Federal Regulations do not permit private causes of action. However, federal law can shape the industry custom among physicians, thereby serving as a basis for a new standard of care in state malpractice litigation.

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Confidentiality and Privilege

Confidentiality and Privilege

Privacy and Confidentiality

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Acknowledgments

Some of the conceptualizations in this chapter were previously presented in Appel (2019).

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Authors and Affiliations

1. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA Jacob M. Appel

1. Jacob M. Appel

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Editors and Affiliations

1. Psychiatry and Law Service, Emory University, Atlanta, GA, USA Peter Ash
2. Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, SC, USA Richard L. Frierson
3. Forensic Psychiatry, Case Western Reserve University, Cleveland, OH, USA Susan Hatters Friedman

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Appel, J.M. (2022). Breach of Confidentiality. In: Ash, P., Frierson, R.L., Friedman, S.H. (eds) Malpractice and Liability in Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-91975-7_15

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