I work for a company that holds itself to be highly ethical. Recently, a senior-level consultant joined the team and on at least one occasion recorded closed meetings without consent. I want to speak up, but I fear retaliation. What is the right thing to do? Name Withheld
What’s being recorded here isn’t a private conversation but a work meeting, and this lands us in a gray zone. Different employees may have different expectations, and a reputable consultant will have agreed to keep nonpublic information confidential. You could quietly inform management, or the consultant, that you find this practice troubling. But if you really think you’ll be adversely affected by raising the issue officially, you can simply let your colleagues know what you’ve learned. That won’t stop the recordings; it will stop people from being recorded unawares.
My partner is a psychiatrist who, as a resident, treated a patient with severe mental-health disabilities. The doctor-patient relationship was severed after the residency was completed, and the patient was inherited by a subsequent resident. The patient is a talented visual artist, and my partner encouraged the patient to create art as part of a therapy regimen. Is it ethically acceptable for my partner to contact the former patient in the capacity of an art collector? The patient occasionally posts work on social media and has expressed the desire to sell it but isn’t good at self-promotion. As a result, the artwork remains largely unseen. It has been more than a year since my partner and the patient ended their clinical relationship, but I can see how an issue of doctor-patient boundaries might arise. I have found no guidance on this question, so I humbly submit it to you. Name Withheld
Like you, I don’t know of any statement of clinical ethics that deals directly with this situation. What’s plain is that there are different schools of thought here. Some hew to the motto “Once a client, always a client” or hold that any post-therapy contact should be initiated by the client. But the American Counseling Association, which prohibits sexual or romantic relationships with former clients for a period of five years post-therapy, says only that practitioners should avoid entering nonprofessional relationships with former clients “when the interaction is potentially harmful to the client.” And though the American Psychiatric Association has cautions about a “dual relationship” with clients, it offers no clear rules about nonsexual interactions with former patients.
We’ll do better to proceed from principles, rather than rules. Will this contact be confusing or upsetting to the former patient? Will this person be particularly vulnerable (out of transference or simply gratitude) to the doctor? Exploiting a therapeutic relationship for personal gain would obviously be wrong, and so would complicating whatever current clinical relationship the artist might have.
But there are reassuring features of this situation. The therapy wasn’t terminated in some problematic way; the treatment began and ended when your partner cycled in and out of the residency program. Since then, you note, more than a year has elapsed. What’s being sought now is more of a transaction than a relationship. And examples of the art that your partner admires are publicly visible: What your partner has learned within the context of therapeutic privilege need not come into play.
It’s easier to see the potential upside to the former patient — that, if your partner displays the work, it could spark interest among others — than the downside. Professional associations are rightly concerned with maintaining the integrity of the clinical relationship. But in a world where talent so easily goes unrecognized, other considerations, too, deserve weight where a patient’s welfare is concerned.
Kwame Anthony Appiah teaches philosophy at N.Y.U. His books include “Cosmopolitanism,” “The Honor Code” and “The Lies That Bind: Rethinking Identity.” To submit a query: Send an email to [email protected]; or send mail to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, N.Y. 10018. (Include a daytime phone number.)