We should heed two recent warnings in The Post on the issue of privacy: Earl Ravenal's July 23 op-ed piece, "Heart of the Constitution," and the July 24 editorial "Mapping Medical Privacy." In the former, Mr. Ravenal asks, "Where is it written that American police officials (that is, crime, drug and tax officials) must have access to every communication, every transaction, among American citizens and any other persons in the world?" The Post editorial points out that most regulations concerning data from hospitals and health maintenance organizations "predate the era of instantaneous, and therefore dangerous, electronic data sharing."

As a physician and psychoanalyst, I am especially concerned about the issue of access to the sensitive, extremely personal material that my patients communicate to me. Confidentiality is essential to any mental health professional's work. The guarantee of privacy for a patient to express wishes, dreams, fears is the sine qua non of any effective psychological treatment in which the trained listener understands Plato's dictum, "The virtuous man is content to dream what the wicked man does."

It is of note that the only place in the United States that offers protection from this dangerous and unacceptable invasion of privacy is the District. Here, the Mental Health Information Act forbids the transmission of patient records to third-party payers. Ironically, the one exception to those protected by this act are employees using federal health insurance programs.



Baltimore-Washington Institute

For Psychoanalysis