Confidentiality and Privilege

This chapter seeks to elucidate the intersection of confidentiality and privilege laws and healthcare practices. It demonstrates where the law outlines a minimally unifying moral code beyond which clinicians must utilize their clinical and ethical judgement to provide the highest standard of medical care. Law informs the clinician’s mental healthcare practice. This discussion emphasizes the delicate challenge for clinicians of meeting the ever-changing requirements of the law to minimize patient risk and maximize patients’ safety. Legal definitions of confidentiality, privilege, and the duty to warn are surveyed in their broadest legal context and conveyed with the aim of being practically useful to clinicians, enabling them to incorporate these legal requirements as they provide optimal care. This chapter presents selected federal and state statutes as examples illustrating the wide variety of laws which may apply to the cases before them. How the law may be differently interpreted is also addressed. It is suggested that this task of giving the very best care while concomitantly pushing the envelopes of the law to treat patients in the best ways possible is among the most difficult tasks that clinicians may confront.