Secrets of the Couch and the Grave: The Anne Sexton Case
Pellegrino, Edmund D.
Cambridge Quarterly of Healthcare Ethics. 1996 Spring; 5(2): 189-203.
I will examine the confidentiality issue in a series of questions: What is the nature of confidentiality in general? How does it differ in psychotherapeutic relationships? When, if ever, may confidentiality be breached? Does it belong solely to the patient, or is it shared by family, friends, and others who might be hurt by revelations of secrets? Does the public have a right to know all the details of the lives of public personages? Do psychiatric patients have a special claim on knowledge of the psychotherapy of other persons similarly afflicted? Does the moral right of confidentiality extend beyond the couch to the grave? Do dead persons have a claim on their psychiatrist, and, if so, for how long? On the way to examining these questions, I will examine the ethical propriety of the conduct of Anne Sexton's psychiatrist, her daughter and executor, Linda, and her biographer, Professor Middlebrook. My purpose is not so much to pass judgment as to provide an ethical framework against which such judgments might be made. I will use the details in the biography, but only parenthetically, to illustrate the ways in which Sexton's biographer, literary executor, and therapist justified their release of the tapes.
Autonomy; Codes of Ethics; Confidentiality; Consent; Death; Disclosure; Duty to Warn; Ethics; Family Members; Famous Persons; Freedom; Friends; Health; Informed Consent; Knowledge; Legal Aspects; Literature; Medical Ethics; Mental Health; Moral Obligations; Nature; Patients; Physician Patient Relationship; Physicians; Privacy; Psychiatry; Psychotherapy; Third Party Consent; Trust;
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