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Fichtner, G. (1997). Professional secrecy and the case history: A problem for psychoanalytic research. Scand. Psychoanal. Rev., 20(1):97-106.

(1997). Scandinavian Psychoanalytic Review, 20(1):97-106

Professional secrecy and the case history: A problem for psychoanalytic research

Gerhard Fichtner

Does the physician's pledge of professional secrecy also apply to the historian working with historical sources which describe actual patients, that is to say, case histories of patients recorded by their physicians, medical reports, etc.? Or is it absurd to make such a demand on the historian, since, in his professional capacity, he has never had to submit to the physician's pledge of professional secrecy? And what about the researcher writing on the history of psychoanalysis? Is he also bound by this medical pledge of secrecy?

I raised these questions in my criticism of the Freud-Ferenczi correspondence (Fichtner, 1994). This is a professional problem which is not merely of a theoretical nature. In my opinion, this question will have considerable consequences for therapeutic practice. However, it may also have a general impact on the fate of medical records. It would be useful to continue discussing this question until we come to a broadly-held agreement. In this paper, I shall elucidate these postulates with new material which came to my attention while doing research in 1995 at the Freud-museum in London.

Surprisingly enough, the medical pledge of secrecy was very early universally accepted in the domain of medical ethics. It was already declared unequivocally in the Hippocratic oath:

“Whatever I may see or hear in the course of the treatment or even outside the treatment about the lives of people which must on no account be disseminated, I will keep to myself in the conviction that it is despicable to speak of such matters”. (Quotation, Edelstein, 1969, p. 8. transl. G.F.).

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