LANDMARK CASES IN FORENSIC PSYCHIATRY:

Privacy, Confidentiality, & Privilege

Dr. Lifschutz, a psychiatrist, was held in contempt of court after he refused a court order to answer questions and produce records related to communications with a former patient who had filed a civil lawsuit.
Dr. Lifschutz filed a writ of habeas corpus, arguing the order was invalid and infringed on his and his patients’ rights to privacy, and his right to practice his profession. He also argued denial of equal protection, drawing a comparison to clergy.
Supreme Court of CA found that as the patient had made his mental health an issue, therapist-patient privilege had been waived.
Equal protection claim was denied as the practice of religion doesn’t serve the same purpose as the practice of psychotherapy.

The patient, not the therapist, has a right to privacy- only the patient can waive that right.
Making mental or emotional state an issue waives patient-therapist privilege

Dr. Roe, a psychiatrist, was sued by Doe, a former patient, after Dr. Roe published a book including verbatim from her psychoanalysis sessions.
Doe claimed violation of her right to privacy, requesting publication of the book to be halted.
Dr. Roe claimed that Doe’s identity was disguised, and that she had obtained oral consent, but no written consent. She also claimed that the book advanced scientific knowledge.
NY Supreme Court ordered publication stopped and awarded compensatory damages.

The physician patient relationship requires confidentiality
The patient’s right to privacy limits the physician’s right to free speech

Redmond, a police officer, shot and killed Allen after he disregarded commands to drop his weapon. Jaffee was the administrator of Allen’s estate. Jaffee claimed Allen’s rights were violated by excessive force.
Redmond and her LCSW therapist were court ordered to provide records from Redmond’s counseling sessions.
They declined to provide records, and at trial, the jury was instructed that their refusal was legally unjustified.
The Court of Appeals found that the therapy notes should have been protected, recognizing therapist-patient privilege.

Federal courts acknowledge a therapist-patient privilege, which protects therapy notes
“Psychotherapists and patients share a unique relationship, in which the ability to communicate freely without the fear of public disclosure is the key to successful treatment.”
Extends privilege to LCSWs, psychiatrists, & psychologists.
Privilege would not apply if, in the interest of justice, the need for disclosure outweigh’s the patient’s right to privacy.