Is it acceptable for a psychiatrist to break confidentiality to prevent spousal violence?
OBJECTIVE
When is it acceptable for a psychiatrist to break confidentiality to protect the wife of a potentially violent patient?


METHODS
153 lay persons, 13 nursing personnel, 10 physicians, and 10 psychologists in France indicated this acceptability in 48 scenarios. The scenarios were all combinations of 5 factors: gravity of threat (death or beating), certainty of mental illness (certain or not), time spent talking with patient (considerable or little), his attitude toward psychotherapy (rejection, indecision, or acceptance), and whether the physician consulted an expert.


RESULTS
Lay people favored breaking confidentiality more than did nursing personnel or psychologists. Consulting an expert had greatest impact. Lay participants were composed of groups that found breaking confidentiality "always acceptable" (22 participants), "depending on many circumstances" (106), requiring "consultation with an expert" (31), and "never acceptable" (27).


CONCLUSIONS
Lay people in France are influenced by situational factors when deciding if a psychiatrist should break confidentiality to protect a patient's wife.
Guedj
Myriam
M
Université du Mirail, Toulouse, France.
Sastre
Maria Teresa Muñoz
MT
Mullet
Etienne
E
Sorum
Paul Clay
PC
D000293:Adolescent; D000328:Adult; D000368:Aged; D003219:Confidentiality; D005260:Female; D005602:France; D006801:Humans; D008875:Middle Aged; D010817:Physician-Patient Relations; D011570:Psychiatry / Q000379:methods*; D013179:Spouse Abuse / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D035502:Trust; D014342:Truth Disclosure; D055815:Young Adult