Question about Psychiatry, Therapists, records and right to privacy.

[Mike 03]

If someone dies, especially due to strange circumstances, like being a Columbine killer or murdering your family and committing suicide, in the event you had a therapist, is it the duty of the therapist or psychiatrist to come forward, after his/her client is deceased and provide some information about what the client was struggling with?

I am ambivalent on this issue and just am curious about what others think.

On the one hand, I think the testimony of the psychiatrist or therapist would be helpful in that it could shed light on why a person did what he or she did, but on the other hand, I want to respect the right of the therapist or psychiatrist to protect the privacy of the client.

What do you all think?

[cornermouse]

1. Basically, if law enforcement knows the records exist,

they can get them. Before Bush II, they would have had to take a few steps. After Bush, I don't know if they even have to do anything other than identify themselves and leave with them.

[REP]

3. Still need a subpeona

Easier to get, but still. All medical records are covered under HIPAA.

[cornermouse]

6. I'm going to politely disagree.

HIPAA had loopholes for law enforcement before Bush II. My memory is that they didn't have to work as hard as a defense attorney. I don't know whether Bush's Patriot Act and other assaults on privacy and liberty respected HIPAA or not. That said, apparently they recently made some major changes to HIPAA and I have no idea what those changes consist of but since they were worked through on Bush's watch, I doubt its good.

[SeattleGirl]

8. Records pertaining to injuries sustained on the job are exempt from HIPAA

also.

[REP]

2. They are required to report any credible threats of violence made

They are to report "I'm going to kill this person and here's how I'm going to do it" but not "I'm going to make a super laser and blow up the moon," for example.

Privacy rights survive after death.

[BlooInBloo]

4. Anybody know if the rules differ for MD's versus non-MD's?

[nomorenomore08]

5. Good question. Many psychologists are "doctors" of psychology, but that's PhD, not MD.

And some self-styled "therapists" only have something like a bachelor's in social work, so that might complicate the issue even more...

[rateyes]

7. Legally speaking, the doctor-patient privilege survives the death

of the patient. However, doctors are required to report threats to others that are made in session. I have told clients that I will maintain confidentiality unless I come to believe that they are a threat to the safety of him/herself or another person(s). I also tell them that I will not, necessarily, keep confidential the confession of a violent crime. I have made them sign waivers stating that they understand those ground rules before I speak with them at that level. If they won't agree to it, I refer them to another professional.