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Except for extreme and obvious violations of a profession's published principles of ethics, what is unethical behaviour or practice is seldom beyond question. I am reminded of the traditional joke regarding an alleged ethical violation brought before an orthodox rabbi in a small village in Eastern Europe during the nineteenth century. The claimant presented his view of what had happened. The rabbi listened with great care, pondered the matter, and finally broke his silence to say, “You are right.” His opponent, full of affect, presented his view, which was in no way consonant with the first party's claim. The rabbi again pondered the matter with obvious care, and then proclaimed, “You are right!” A neutral observer was dumbfounded and protested, “Rabbi, the two views are totally incompatible. How can they both be right?” After an even longer silence the rabbi said, “You are right, too.” Those who seek resolutions of subtle conflicts and dilemmas about confidentiality will find few in this volume. The apparent plethora of conflicting views does not mean that careful examination of ethical dilemmas is unwarranted, however.
The practice of psychoanalysis has often remained silent on obvious ethical problems. This has been especially true in the case of confidentiality, despite its being an imperative for clinical practice since Hippocrates. Freud himself was notorious for his lack of discretion in this area, as scholarly research has amply disclosed (Grosskurth, 1991; Lynn & Vaillant, 1998).
In our time, the unfortunate phrase “I heard it from the couch” is too often spoken in conversations between or among colleagues and even at times when a psychoanalyst is speaking to non-professionals. A book like Confidentiality: Ethical Perspectives and Clinical Dilemmas is long overdue. The editors have done a splendid job in addressing many salient issues. What was missing in the Montreal conference that gave rise to this volume has been supplied by expanded or entirely original