The New Social Worker Vol. 19, No. 4, Fall 2012 | Page 6

Ethics Clinicians in Court: Thwarting Disclosure by Allan Barsky, JD, MSW, Ph.D. Editor’s Note: This article is an excerpt from Allan Barsky’s book, Clinicians in Court, which addresses issues facing social workers when they are called on to testify. This excerpt addresses the issue of disclosing records in court. Look for more from Dr. Barsky in upcoming issues of THE NEW SOCIAL WORKER. victim’s past sexual behavior or alleged sexual predisposition, although there are some exceptions (see Federal Rules of Evidence, 2010, Rule 412, at http://www. law.cornell.edu/rules/fre/rule_412). Also, most states have laws granting privilege to advocates, crisis counselors, and transition house staff working with victims of domestic violence, according to the American Bar Association. Still, there are many other areas of practice where clinical records could be subpoenaed and the client could be embarrassed. Consider, for instance, a client who has received vocational counseling. The counselor’s records may include information about the client’s problems, including poor performance in school or prior work settings, irresponsible behavior leading to dismissal, or ethically questionable behavior. If a clinician wants to protect his client from disclosure of this type of information in a public legal process, there are several options, described below. Unfortunately, each option has major drawbacks. Before adopting any of these options, consult with your attorney, professional association, or other expert on law and professional ethics. Minimal Records T reating clinicians often wish they could prevent disclosure of records. Some reasons are ethically justifiable, others not. Clinicians treating victims of sexual assault, for example, may be concerned that their clients will be subjected to intense scrutiny before and during the trial of the alleged perpetrator. Historically, defense attorneys could subpoena complainants’ records from clinicians, crisis services, and transition houses in order to discredit the complainant by saying that she is emotionally unstable, tends to fabricate stories, or is motivated to lie because she is trying to hide having had sex with someone else. For the most part, current evidentiary rules prohibit use of evidence of the 4 The New Social Worker To protect their clients, some clinicians resort to maintaining minimal records (e.g., limiting details to the name of the client, the problem presented, and the dates seen). They deliberately exclude any information that could harm the credibility of the complainant or embarrass her. Unfortunately, some of this information may be clinically important, legally relevant, and ethically necessary. Suicidal or homicidal thoughts, alcohol or drug use, and high levels of stress are just a few examples. Although minimal records may thwart disclosure in legal processes, they may not meet the standards required for competent clinical practice. Further, the clinician may still be called to testify about client information not included in case records. If you want to keep minimal records, ensure that these records are consistent Fall 2012 with agency policy, laws regulating your agency, and your professional code of ethics. Double Records Some clinicians keep two sets of records—an official set and a personal set. The official set excludes potentially damaging information. The personal set includes all information, assessments, and speculations that the clinician uses for her own purposes. Although some clinicians believe that a subpoena applies only to the official records, all records are subject to subpoena. Some clinicians hide the fact that they have a set of unofficial records. However, if found out, failure to disclose all records can result in obstruction of justice or contempt of court charges against the clinician. The question raised by some clinicians is, “How will anyone know?” The real question is, “What does your sense of ethics and risk taking tell you?” Few agencies or professional associations would officially condone hiding a second set of records. There is no ethical foundation for keeping two sets of records. Ethically as well as statutorily, one set of records is what is appropriate. Coded Information Some clinicians use secret coding to make parts of their records indecipherable to people unfamiliar with the coding. Some codes are so subtle that the reader does not even know that coding is being used (e.g., a double asterisk may denote past suicide attempts; “FLK” for funny looking kid). During a hearing, you may be asked to explain your codes or shorthand. Some codes may not be directly significant to the case but may indicate bias, lack of respect, or lack of professionalism. If it appears that you have deliberately tried to mislead the reader, your credibility as a witness may 1 TTFO is sometimes used as slang for “told to f**k oneself.” If asked what the initials mean, the practitioner might say “to take fluids only.” Patients have sued agencies based on derogatory notations in their records.