c. Purpose of Privileged Communications. In Tarasoff vs Regents of the
University of California, discussed earlier (MD0066, lesson 1), the majority opinion held
that the therapist has a duty to protect an intended victim from violence. But a minority
opinion, underscored the importance of confidentiality to the therapy process and to
society at large. Without it, dangerous people would not seek therapy at all, and those
who did would be less open in the therapy process and, thus, less likely to be cured.
As the dissenting opinion suggests, it is critical to protect privileged communications.
Otherwise, people would not speak openly about their conditions, and correct treatment
would be jeopardized. Confidentiality is of paramount importance in health care,
perhaps secondary only to the main goal of the relationship, namely providing quality
care for the patient. (It should also be noted that besides encouraging full and frank
disclosures to the physician by the patient, confidentiality also protects the patient from
possible public embarrassment.)
d. The Triangle of Confidence. Medical details and anything else, which the
physician may discover about the patient in consultation or treatment, is strictly
confidential. When a clinician refers a patient to the radiology department for a
diagnostic examination, the radiologist must be admitted to the clinician's confidence.
Therefore, the radiologist must be told facts about the patient relevant to his or her
diagnosis and treatment which the clinician has discovered. In a reciprocal manner, the
radiologist admits the clinician to his or her confidence, sharing opinions based on the
results of the radiographs that have been taken.
Figure 3-3. The radiographer, as technical assistant to the radiologist, belongs to the
extension of the triangle of confidence and may be privy to confidential
(1) The exchange of confidential information within the triangle formed by
the clinician, the radiologist, and the patient is totally appropriate. X-ray technologists,
as technical assistants to the radiologist, must also be admitted, by extension, into this
area of confidence, in order to perform their duties.