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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.
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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. Confidentiality is a priority 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 a 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 the situation of a false alarm, his or her professional reputation can be harmed.
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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.
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. Any information disclosed about one spouse to another may cause a serious harm to their family life, as the facts confided to a psychotherapist may be too personal and concern their ddomestic troubles. The same difficulty may arise when a doctor is working with a child, whose parents would be eager to be well informed about the results of a treatment. A breach of confidentiality in this case may be highly damaging to a child, because a psychotherapy implies confiding about his or her problems, which can be connected with the family. So, the parents should not know some details, or a child may have sufficient problems at home.
The other problem may appear if an employer makes attempts to know some details (concerning personal life, health, etc.) about his or her workers; a breach to confidentiality can result in serious problems for an employee, for example he or she may be fired or lowered in rank. In addition, a therapist should be incredibly careful when sharing his experiences with the other doctors, and take measures to disguise a patient under discussion.
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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 make a right decision in every situation.
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