Building A More Secure Basis for Psychoanalytic Psychotherapy: Conflicts in Sharing the Data*

In 1995 the editors of the world's most distinguished medical journals made an important statement about what they thought should henceforth be considered ethical good practice when data from patients was disclosed in their publications.

First, bearing in mind what they considered the patient's interest, they stated that:

Patients have a right to privacy that should not be infringed without informed consent. Identifying information should not be published in written descriptions, photographs, and pedigrees unless the information is essential for scientific purposes and the patient (or parent or guardian) gives written informed consent for publication. Informed consent for this purpose requires that the patient be shown the manuscript to be published. (ICMJE 1995, italics added)

Second, bearing in mind what they considered the interests of good science, they added that:

Identifying details should be omitted if they are not essential, but patient data should never be altered or falsified in an attempt to attain anonymity. Complete anonymity is difficult to achieve, and informed consent should be obtained if there is any doubt. For example, masking the eye region in photographs of patients is inadequate protection of anonymity.… (ICMJE 1995, italics added)

Since 1999, following some debate, these requirements for informed consent have been included in these leading journals' instructions for authors and, when informed consent has been obtained, it has been indicated in the published article.

The Editors of the International Journal of Psychoanalysis considered themselves unable to follow the ICMJE guidelines. It seemed to them, given the psychoanalytic understanding of transference relationships and their implications for relating to patients, that obtaining real and meaningful consent would be difficult and intrusive and so not necessarily in the