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In recent years there has been a growing debate concerning the appropriate practices to adhere to when seeking to report clinical events for the purpose of journal publication. In the medical field the International Committee of Medical Journal Editors (ICMJE) has recently issued a statement that makes two very definite points1 First, the Editors declare that it is necessary that in all cases where patients' clinical records are disclosed in any way there should be no attempt to disguise or misrepresent details. They have been heavily influenced by the possibility of drawing false conclusions from data. Second, they state that the patient's informed consent should be secured prior to inclusion in any study or case report in which the patient could possibly be identified and this fact should be published. Although the statement has been the subject of considerable debate it remains in place (see ICMJE, 1999; Doyal et al., 1998).
At the present time papers containing clinical material submitted to this Journal do not require authors to obtain consent nor to abstain from disguise. For many years we have required authors to assure us that they have considered the issues and that no breach of confidentiality has occurred, but this is not defined. We are thus not in synchrony with our editorial colleagues in the medical field.2
This editorial and the following article by Glen O. Gabbard (2000) are both intended to initiate debate about our policy in the pages of this and other journals and on the Internet. The ICMJE's statement raises issues about how the ethics of informed consent, the ethics of practice, the integrity of the psychoanalytic setting and the ‘fact’ of our need to communicate with each other can be reconciled. How