Patient Confidentiality: College President Dr William Flannery speaks with the Irish Times

College President Dr William Flannery was featured in an Irish Times article entitled ‘Is your conversation with your therapist truly confidential?’ Excerpts from the article are included below. It follows a recent RTÉ Prime Time Investigates which alleged that the private information of autistic children and their families was disclosed without their knowledge or consent.

The article reiterates the College statement following the Prime Time Investigates programme, available on our website here and available in full at the bottom of this article.

The College of Psychiatrists of Ireland says psychiatrists have obligations to patients, employers and the Medical Council, but ethical obligations to patients take primacy and clinical information can be disclosed only with patient consent, by court order or “when otherwise mandated by law”.

If doubtful about information requests, the [C]ollege encourages psychiatrists to consult colleagues or their insurer. President of the [C]ollege and Mater consultant psychiatrist William Flannery says: “It’s accepted practice, and politeness, to let someone know about a court order. This may also have an impact on the person, who might need support in response.”

While “the patient/doctor relationship is the same”, Flannery says “that trust we’re meant to have in the civil system is being talked about. What does give me pause is the dark heart at the centre of Government. It goes back to the social contract. There’s an expectation that everybody is trustworthy.”

The College of Psychiatrists is “confident in the process, in our practice, which has been in place for decades”, but Flannery questions whether “the processes, the ethical code, the culture” and values of trust and empathy are replicated elsewhere in the health system. “How is the regulatory system implemented and regulated? What are the department and HSE’s overall culture and ethical code? What is the oversight? These are the questions our membership are asking. Our job as employees is to reassure our patients the values of our profession are also in the organisation where we work.”

STATEMENT FOLLOWING RTE PRIME TIME INVESTIGATES, THURSDAY 25TH MARCH 2021

The College of Psychiatrists recognises that the content of the RTE investigates programme is likely to cause significant distress to autistic people and their families to learn that, according to the programme, their private information was disclosed without their knowledge or consent.

Psychiatrists work in complex systems with obligations to their patients, employer, their contract as well as to their regulator (The Medical Council of Ireland). However, ethical obligations to their patients take primacy.

Psychiatrists are medical doctors and uphold the professional requirements for patient confidentiality. Clinical information may only be disclosed with the consent of the patient, court order or when otherwise mandated by Law.

We would encourage all psychiatrists to seek advice from their medical protection/indemnity provider if they are unsure about requests for information to be provided to a third party.

The College ‘Professional Ethics for Psychiatrists’ and the Medical Council ‘Guide to Professional Conduct and Ethics’ also contain guidance on patient confidentiality.