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The practice of psychoanalysis, more than any other speciality, depends substantially for its success on the confidentiality of communication between analyst and patient. For a person to overcome the usual resistances and inhibitions to the basic rule of “free association,” he must have the utmost faith and confidence in the fact his productions will be completely confidential and not disseminated to other parties, unless he, with as full understanding of the problem as possible, believes it to be in his best interests to disclose these confidences.
With the coming of National Health Insurance, PSRO's, peer review and utilization review mechanisms, the increasing amount of private insurance payments for medical care, and with the concommitant increase in the use of computers, data banks and automated information systems, the danger to confidentiality will become greater, unless organized steps are taken to protect it.
Since the commercial introduction of the computer seventeen years ago, increasingly sophisticated methods have been utilized to tap data banks. A recent article in the New York Times by W. Thomas Porter Jr. (1974) entitled “Computer Raped by Telephone” tells of sophisticated and not so sophisticated methods of