Shared professional secrecy of psychologists
Article 14 of the code of deontology describes the specific conditions under which a psychologist can share information based on the concept of shared professional secrecy.
Art.14[1]:
Shared Professional Secrecy: The psychologist may, under their responsibility, share confidential data in their possession in order to optimize the effectiveness of their work. To this end, they apply the usual cumulative rules for shared secrecy: prior information, consent of the holder of the secret, in the sole interest of the latter, limited to what is strictly necessary, and only with individuals subject to professional secrecy working within the framework of the same mission.
The Conditions of the Article Examined in Detail
1. You have informed the client/patient in advance
It is important that you inform the client/patient in advance about the exchange of information. This allows you to explain the importance and purpose of the exchange, as well as giving the client/patient the opportunity to ask additional questions and possibly object to the transfer of information [2] .
What should you inform the client about?
Discuss the following elements with your client/patient [3] :
- The fact that you intend to exchange information;
- The purpose of the data exchange;
- The individuals with whom you will share the information;
- The content of the data transfer.
How should you inform the client?
There are no specific rules on this matter. Some psychologists inform their clients orally during the first meeting. Health care institutions, on the other hand, typically use a welcome brochure that explains the rules regarding data sharing.
Do you work with a written document that you provide to the client? If so, ensure that during a session, the client has read and understood the information given. This is also recommended for psychologists working in care institutions with a welcome brochure that was not handed to the client personally.
2. The client gives their consent for the exchange of information.
The client's consent is a prerequisite for the exchange of information. This means that you should not share any information if your client indicates that they do not consent to all or part of the information exchange [4]. If the client objects to the exchange of certain information with a particular person, you must respect their opposition.
The code is less clear on how to seek and obtain this consent:
- Explicitly or tacitly?
- Once or multiple times?
Explicit or tacit consent?
Examples:
- Tacit consent: You inform the client that you will be sharing information with their general practitioner. The client makes no objection. You conclude that their silence amounts to consent.
- Explicit consent: You explain to the client that you wish to share information with their doctor and explicitly ask if they agree. The client gives their consent verbally or in writing.
either the code nor the doctrine offers a definitive opinion on this matter. According to some, the absence of opposition is generally sufficient to share data (tacit consent) [5] either the code nor the doctrine offers a definitive opinion on this matter. According to some, the absence of opposition is generally sufficient to share data (tacit consent)
A one-time agreement or repeated for each data exchange?
In principle, a one-time agreement at the start of your intervention is sufficient, provided that the exchange of data clearly falls within the scope of the agreements made beforehand.
If you are transferring information that is clearly not in line with the prior agreements, it is advisable to ask for the client's permission again before proceeding with the exchange.
Practical advice:
Record in the client's file all discussions and decisions related to the sharing of information. This is especially important if the client's position changes over time.
3. You share information only in the interest of the client
You can only share information to the extent that it serves your client's interests in terms of the continuity or quality of your intervention
[6]. Additionally, it is important that you actively involve your client in this reflection and do not simply act based on what you think is in their best interest
[7].
4. The person with whom you exchange information is also bound by professional secrecy.
You can only exchange information with individuals who are also bound by professional secrecy. In this way, the confidentiality of the transmitted information remains protected [8].
It does not matter whether these individuals are also psychologists [9]. You can therefore also share data with other types of professionals, such as doctors, nurses, and physiotherapists. Of course, this is only possible if the other conditions are met: "Shared professional secrecy is not a tainted professional secrecy where confidential data can spread like an ink stain among all those bound by professional secrecy" [10]
n any case, the client’s family members and individuals bound by a simple duty of discretion [11]
(such as teachers) are not included in this category. Therefore, you cannot exchange information with them under shared professional secrecy. However, this does not change the fact that other grounds for data exchange may be invoked.
5. The person with whom you exchange information acts within the framework of the same mission
The person with whom you exchange data must act within the framework of the same mission in relation to your client. This means they are acting in a similar context and with the same objectives [12].
Example
The purpose of a psychologist conducting a legal expert assessment is different from that of a psychologist conducting therapy [13]. The former must provide the judge with any useful information within the scope of their defined mandate. This information transfer is not always in the client's best interest, as the mandate is not to provide care, but to investigate a particular situation within the context of a legal investigation. Under shared professional secrecy, no data transfer can occur between these two psychologists. Lawyers and teachers also fundamentally act with a different purpose than a psychologist performing a helping function.
However, the purpose of a psychologist, a nurse, and a psychiatrist who are jointly responsible for advising and caring for patients with Alzheimer's disease is generally similar. Therefore, shared professional secrecy can exist between them. An independent psychologist can also work with a general practitioner, for example, under shared professional secrecy, exchanging information so that each can tailor their advice to the client as effectively as possible.
6. You limit yourself to what is strictly necessary
he information you transmit must be "necessary" and not "pleasant." Therefore, shared professional secrecy does not apply to the exchange of information that is simply useful to the recipient [14]. It is important to note that this is a stricter criterion than the exchange of information outlined in Article 19 of the Quality Act [15]. This article is also an application of the doctrine of shared professional secrecy, but in the specific context of pursuing or completing a diagnosis or treatment. When this article applies, the information is both necessary and useful..
Sources
[1] Koninklijk besluit van 2 april 2014 tot vaststelling van de voorschriften inzake de plichtenleer van de psycholoog.
[2] Van der Straete, I. en Put, J. (2004). Het gedeeld beroepsgeheim en het gezamenlijk beroepsgeheim – Halve smart of dubbelleed? Rechtskundig Weekblad, 68 (2), p. 53.
[3] Van der Straete, I. en Put, J. (2004). Het gedeeld beroepsgeheim en het gezamenlijk beroepsgeheim – Halve smart of dubbelleed? Rechtskundig Weekblad, 68 (2), p. 53; Moreau, T., (2013). Chapitre XXV - La violation du secret professionnel. In Bosly, H.D., & De Valkeneer, C., (eds.). Les infractions. Volume V. Les infractions contre l’ordre public. Bruxelles : Larcier, p. 716.
[4] Moreau, T., (2013). Chapitre XXV - La violation du secret professionnel. In Bosly, H.D., & De Valkeneer, C., (eds.). Les infractions.Volume V. Les infractions contre l’ordre public. Bruxelles : Larcier, p. 716; Van der Straete, I., & Put, J. (2005) Beroepsgeheim en hulpverlening. Brugge: Die Keure, p. 220.
[5] Van der Straete, I. en Put, J. (2004). Het gedeeld beroepsgeheim en het gezamenlijk beroepsgeheim – Halve smart of dubbelleed? Rechtskundig Weekblad, 68 (2), p. 53-54.
[6] Versweyvelt, A.-S, Put, J., Opgenhaffen, T. en Van der Straete, I. (2018). Beroepsgeheim en hulpverlening. Brugge: Die Keure, p. 226.
[7] Zie de verwijzing naar Balthazar, T. (2000). Arts, werknemer en sociaal verzekerde. De taak van de arts bij de toepassing van het sociaal recht. Proefschrift UGent, p. 641. In Blockx, F. (2013). Het beroepsgeheim. Antwerpen: Intersentia, p. 99.
[8] Hausman, J.-M. (2016). Droits et obligations du patient et du psychologue clinicien. In Hausman, J.-M., & Schamps, G. (dir.). Aspects juridiques et déontologiques de l’activité de psychologue clinicien. Bruylant : Bruxelles, p. 228.
[9] Dierickx, A., & Buelens, J. (2012). Het gedeeld beroepsgeheim erkend door het Hof van Cassatie. Tijdschrift voor Gezondheidsrecht, 2012 (2), p. 149 (geraadpleegd via www.jurisquare.be).
[10] Balthazar, T. (2004). Het gedeeld beroepsgeheim is geen uitgesmeerd beroepsgeheim. Tijdschrift voor gezondheidsrecht, 2004 (2), p. 145 (geraadpleegd via www.jurisquare.be).
[11] Versweyvelt, A.-S., Put, J., Opgenhaffen, T. en Van der Straete, I. (2018). Beroepsgeheim en hulpverlening. Brugge: Die Keure, p. 221.
[12] Opgenhaffen, T., Put, J., & Tans, A. (2017). Informatie-uitwisseling tussen artsen en hulpverleners: het beroepsgeheim als splijtzwam of bindmiddel. Tijdschrift voor Gezondheidsrecht, 2017 (1), p. 10. Geraadpleegd via ( www.jurisquare.be).
[13] Hausman, J.-M. (2016). Droits et obligations du patient et du psychologue clinicien. In Hausman, J.-M., & Schamps, G. (dir.). Aspects juridiques et déontologiques de l’activité de psychologue clinicien. Bruylant : Bruxelles, p. 228.
[14] Versweyvelt, A.-S.,, I., & Put, J., Opgenhaffen, T. en Van der Straete, I. (2018). Beroepsgeheim en hulpverlening. Brugge: Die Keure, p. 225.
[15] Wet van 22 april 2019 inzake de kwaliteitsvolle praktijkvoering in de gezondheidszorg.