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Informed consent
  1. Susanne Stevens
  1. 66 Pen-Y-Lan Road, Roath, Cardiff, CF23 5HW

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    I was concerned to read the following statement by Anne Zachary (Doctor) published by Marilyn Lawrence, Editor, (Tavistock practitioner) and Co-editors, in Psychoanalytic Psychotherapy, The Journal of the Association of For Psychoanalytic Psychotherapists in the NHS.1 “Whilst we do not want to raise too starkly ourselves the moral, ethical, legal problem of sharing what the unsophisticated patient believes to be confidential with a third party, thereby destroying our own model which we believe in for the greater good… .” This was supported by another statement in a published article in the next edition by Maureen Marks of the Institute of Psychiatry: ”… it may be that we have to decide that sometimes our concern for patient's privacy is worth sacrificing to further the psychoanalytical cause”.2 This reveals a seeming glaring ignorance not only of ethical principles of, for example, honesty and trust but also of formal guidelines and procedures in the National Health Service (NHS). It is pertinent that they do practise in the NHS, because service users have established rights to FULLY INFORMED consent to any treatment and to give or withhold permission for use of their information. Therefore the deliberate intention to deceive certain groups of persons, as wrapped up in Anne Zachary's convoluted statement, reveals a rather worrying attitude to the rights of clients which are indeed now more properly protected by General Medical Council (GMC) guidelines, Data Protection Law, common law rights to privacy and, importantly, Department of Health guidelines which support the rights of clients to consent.

    To find these being breached at a time when the public has lost a great deal of trust in NHS practitioners, in a discipline underpinned by principles of trust and a confidential relationship, is deserving of some rigorous self analysis by some psychoanalysts, including a consideration of the history of medicine, which is strewn with the corpses of those who have been subjected to the abuse of their rights by small groups of clinicians who have claimed to be acting “for the common good”, usually in secretive and closed organisations of which the public in general had little knowledge.


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