Interviewing Patients: Abuse of Confidentiality?

Ethical issues and common-sense suggestions on how mental health professionals and journalists can collaborate in the coverage of people who have experienced trauma. 

Editor's Note: In March, the Anxiety Disorders Association of America hosted its 31st annual conference in New Orleans. One panel, "Ethics of Addressing Trauma in the Media," featured a discussion between Elana Newman, research director of the Dart Center for Journalism and Trauma, and John Pope, a New Orleans Times Picayune reporter. The talk covered how clinicians and journalists can build proactive relationships and the two fields' differing perspectives on interviewing survivors. Below, John Pope offers reflection on the conversation:

I used to think it was so easy.

I’m a newspaper reporter who spent 20 years writing about medicine. When I needed to talk to a patient to add a human dimension to a story I was working on, I simply called a specialist in that particular field and asked that individual to find someone who’d be willing to talk to me.

I thought I was doing the right thing because I wasn’t abusing doctor-patient confidentiality.

Until Elana Newman and I talked to about 125 specialists during a New Orleans meeting of the Anxiety Disorders Association of America, I had no idea of the ethical problems such a request could trigger.

For instance:

  • Would a therapist be exerting undue influence by asking a patient to speak to a reporter?
  • Would the patient feel obligated to comply as a condition of treatment?
  • If the therapist were present during the interview, would that inhibit the patient?
  • If the therapist weren’t present, would the patient exaggerate to help the reporter get a terrific story?
  • Would talking to a reporter reopen psychic wounds if no professional were on hand to guide the conversation?

Given these obstacles that the mental health professionals brought up during our session, I wasn’t surprised when many said they wouldn’t dream of letting a patient speak to a reporter. They viewed it as unethical in all circumstances. When I pointed out that stories need real people to be powerful, they said they had to think of their patients first.

But some people were willing to explore options.

One suggestion was to put a sign in waiting rooms telling patients about the project that a reporter was working on, giving the journalist’s contact information and letting the patients decide whether to participate, without involving the therapist.

That might work for a long-term project, but it would hardly be practical for a reporter on deadline.

Several people suggested that clinicians compile lists of people who would work well with reporters – people who could stand up to questioning and would answer truthfully – and have them on hand when a reporter called.

These lists, they said, could contain names of patients in a particular practice, or of people in a particular area whose privacy would be guarded by an association like the National Alliance on Mental Illness. A few doubters called that a “speakers’ bureau” approach, saying that it wouldn’t work because such interviewees would regurgitate “message points” instead of offering honest give and take.

I suggested that these professionals find out which reporters in their areas covered such stories and strike up relationships with them. That way, each side would be able to appreciate what the other does and a therapist might feel that a journalist in that relationship could be trusted to talk to a patient.

Such a rapport might help assuage the feeling that some mental health professionals expressed, to my surprise, during our session: That reporters regard clinicians only as access to information and not as regular providers of important, helpful information.

It would be worth a try.