Competing Ethical Interests Regarding Privacy and Accountability in Psychotherapy.

"Jane" is a mother of two, who was referred for psychotherapy. However, Jane had misgivings about engaging in the offered psychotherapy because of threats made by her domestically violent partner. The therapy sessions are audio recorded for the purpose of professional supervision and clinician reflective practices. Jane's partner had threatened to subpoena the therapy recordings to legally separate Jane from her children. This article focuses on how three different parts of Jane's multidisciplinary care (i.e. clinicians, policy professionals and medico-legal professionals) exhibit different competing ethical priorities. Psychotherapeutic clinicians private use of audio recordings of the therapy enhances patient care and their own professional development but with the risk of concealing possible unethical behaviour by either party. Medico-legal access to the therapy recordings preserves potentially relevant evidence in the pursuit of justice but risks the interpretation of the psychotherapeutic information outside of the therapeutic context. Policies advocating the inclusion of the therapy recordings in the medical record improves clinician (and health service) accountability but risks harming the vulnerable patient due to threats to patient-therapist confidentiality.

Audio recording nurse-patient interactions.

BACKGROUND: Clinical supervision is accepted as important in all areas of nursing. There are various methods available for conducting clinical supervision but the most commonly used is self-reporting by the supervisee to his or her supervisor. However, other methods might also be applicable. CONCLUSION: This article discusses the merits of using audio recordings of nurse-patient interactions in clinical supervision and suggests that such a method may help to improve patient care.

Spying on psychiatrists: surreptitious surveillance of the forensic psychiatric examination by the patient himself.

Lawyers have argued that surveillance of the forensic psychiatric examination is often necessary to protect clients' rights and assure more accurate reporting of the findings. This paper reports a new phenomenon which adds a disconcerting dimension to the current controversy over surveillance of such examinations, namely, surreptitious recording by patient/examinees of their own forensic examination. Their motivations range from psychotic delusions to perceptions that they are acting to protect their legal interests. Neither legal nor ethical code prohibitions in any way serve to bar such conduct. Moral arguments for and against secret recording by patient/examinees are explored, and its relationship to other techniques used to monitor professional practices in the health fields (such as pseudopatient studies) is discussed.