Privilege & Confidentiality

  1. Privilege and Confidentiality -- What’s the Difference

1.1.  Confidentiality

1.1.1.  Ethical and legal duties not to disclose information gained within scope of treatment

1.2.  Privilege

1.2.1.  Rule of evidence

1.2.2.  Applies primarily in legal adjudicatory context; eg., privileged communication may not be used as evidence in legal proceeding

  1. Confidentiality and the Adult Client

2.1.  Ethical Duties

2.2.  State Statutory and Regulatory Duties

2.3.  Common Law Legal Theories Protecting Client Privacy

2.3.1.  Invasion of Privacy

2.3.2.  Defamation

2.3.3.  Negligent Infliction of Emotional Distress

2.3.4.  Breach of Contract

2.4.  Federal law Issues

2.4.1.  PAMII

2.4.2.  ADA

2.4.3.  HIPPA

  1. Confidentiality and the Child Client

3.1.  Ethical Duties

3.2.  Legal Duties

3.2.1.  Minors under 14 cannot consent to treatment; no confidentiality from parents regarding fact of treatment

3.2.2.  Minors 14 and over owed same duty of confidentiality as adults; however, exceptions apply

3.2.3.  Exception to duty for deteriorated condition, risk of suicide or detoxification

3.2.4.  Parent compensation of therapist may alter duty of confidentiality to child

3.3.  Mandatory child abuse reporting

  1. Privilege

4.1.  Privilege is a rule of evidence

4.2.  Applies primarily in judicial proceedings

4.3.  Typically governed by statute

4.4.  Limited scope

4.4.1.  Psychotherapist-patient

4.4.2.  Clinical social worker-client

4.4.3.  Counselor-client

4.5.  Invoking privilege on your client’s behalf

4.5.1.  Whose privilege is it anyway?

4.6.  How do you protect your client’s privilege

  1. Subpoena

5.1.  Two types:

5.1.1.  demand of appearance;

5.1.2.  demand for documents (subpoena duces tecum)

5.1.3.  Different from court order

5.2.  Court Order

5.2.1.  Signed by judge magistrate or commissioner

5.2.2.  Specific instructions

Malpractice & Other Varieties of Professional Liability

  1. Tort Law

1.1.  Criminal acts v Tortious Acts

1.2.  Two Major categories of torts

1.2.1.  Negligence

1.2.2.  Intentional

1.3.  Joint and several liability

1.4.  Vicarious liability

1.4.1.  Partnerships

1.4.2.  Employees

1.4.3.  Shared offices

  1. Malpractice

2.1.  Negligence

2.1.1.  Generally

2.1.1.1.  Negligence equates with professional incompetence

2.1.1.2.  Error of judgment not enough

2.1.1.3.  Usually involves failure to adhere to proper standard of care

2.1.2.  Common treatment scenarios for negligence

2.1.3.  Elements of negligence

2.1.3.1.  Duty

2.1.3.2.  Breach

2.1.3.2.1.  Typically failure to adhere to “reasonable practitioner” standard of care

2.1.3.3.  Causation

2.1.3.3.1.  Cause in fact – act caused harm

2.1.3.3.2.  Proximate cause – event must have been foreseeable

2.1.3.4.  Damages

2.2.  Negligent infliction of emotional distress

2.3.  Negligence per se

2.3.1.  Typically burden of proof lies with plaintiff; however, need not prove negligence if therapist violated law and:

2.3.1.1.1.  Plaintiff is member of class law intended to protect

2.3.1.1.2.  Harm to plaintiff is type of harm law intended to prevent

2.3.1.1.3.  Violation of law caused harm

2.4.  Intentional Torts

2.4.1.  Intentional torts involving misuse of client information

2.4.1.1.  Breach of confidentiality

2.4.1.2.  Breach of Privacy

2.4.1.3.  Defamation

2.4.2.  Intentional Torts involving improper restriction of client’s freedom

2.4.2.1.  False imprisonment

2.4.2.2.  Unlawful detention

2.4.2.3.  Wrongful commitment

2.4.2.4.  Malicious prosecution

2.4.3.  Intentional Torts against the client’s person

2.4.3.1.  Assault

2.4.3.2.  Battery

2.5.  Intentional infliction of emotional distress

2.6.  Breach of Contract

2.6.1.  Types of contracts

2.6.2.  Contract liability scenarios

2.6.2.1.  Breach of confidentiality

2.6.2.2.  Failure to achieve promised results

2.6.2.3.  Abandonment