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There are unalienable human rights determined by the Constitution and the notion of privacy is among them. In the chapter the author poses a dilemma between a right to private information and a possibility to prevent a threat by revealing this information, which cannot possibly be solved satisfactory for all of the parties concerned. The ambiguity of a question requires it to come under closer scrutiny. It is also an opposition between citizens` rights and law, which cares only about the order and peace using any means.
At first glance, it is each man’s right to private life that is crucial. The information confided to a psychologist often is of the most secrecy for the patient and should be unquestionably concealed. Only the trust established between a psychotherapist and a patient can help the latter to undergo treatment successfully. The disclosure of any personal information may end in deterioration of a patient’s mental condition on the one hand and in his mistrust not only of this particular therapist but in the psychological treatment in general, on the other hand. It is also confidentiality on which the relationship between a client and a doctor should be based on and it is what each patient expects. Psychotherapist is like a priest who should not reveal what someone has said in the confessional even though he may hear about something illegal.
The opposite side of the coin is that a patient may confess that he or she is going to do a harm to a third party, especially when it concerns child abuse, threat to kill somebody, or to commit a suicide. In such a case a psychotherapist should make a difficult decision to reveal this danger. However he or she has to remember that in situation of a false alarm his or her professional reputation can be harmed.
There are no troubles when the facts confided do not contain anything dangerous, but it may be difficult to differentiate between serious threats, expressed by a patient, and his doubtful presumptions or vague intentions. To distinguish whether it is needed to inform police or to hospitalize a patient, either voluntarily or involuntarily, or just to continue treatment and prevent the possible danger personally, is a formidable task for a psychotherapist.
He or she is placed in a moral dilemma, where professional ethic demands total security for the patient’s personal information, but the common sense indicates that only the exposure may help to avert possible danger. Even the highest ethical standards may wane in the face of a threat that can be reduced.
Also so-called certain conditions, under which a psychotherapist is obliged to take drastic measures and reveal the information, should be considered. However, a patient should be warned in advance about the exceptions and the limits of confidentiality so the following misunderstanding may be avoided. On the other hand there is no clear boundary, which could distinctly separate the cases in which it is allowed to disclose some information and in which nothing should be ever revealed.
Also a careful attention should be paid when a psychotherapist works with a couple, because one would be always interested in the personal facts about the other. Working with a child, whose parents would be eager to be well informed about the results of treatment, includes a dilemma of confidentiality and it’s breach as well. In addition, a therapist should be incredibly careful when sharing his experiences and information about some clients with the other doctors, and take measures to disguise a patient under discussion.
Finally, a problem may arise when a psychotherapist either is not successful enough in treating a patient, so the latter still has destructive ideas, or is not sufficiently skillful in determining real threats. A highly qualified doctor will not encounter so many troublesome situations as a novice or a dilettante. Moreover, absolute discretion is required when dealing with such ambiguous cases. So it should be concluded that it is only a high level of morality and ethics of a psychotherapist that can help to make a right decision in every situation.
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