Confidentiality

From Star Trek: Gamma One

Starfleet Medical recognizes the following policy of confidentiality with regards to the patient-counselor relationship, and it is considered to be referenced under the more general Starfleet Regulations, punishable both within the regular chain-of-command by court-martial (which can exercise military discipline in the matter, including loss of rank, imprisonment, discharge from service, and so on), or by a review by Starfleet Medical's Board of Ethics (which can impose a temporary or permanent ban on medical or counseling practice), or both:

Discussions with a Counselor, or with a Medical Officer acting formally in the capacity of a Counselor, are confidential, but this confidentiality is not absolute. Confidentially is affected by the following circumstances:

1. Should the patient waive confidentiality either by explicit waiver (such as when requesting a counterintelligence/security clearance review) or by implicit breach (such as insisting on the presence of a non-privileged third party during talks with a Counselor, or by sharing information substantially the same as that shared with a counselor with an additional non-privileged third party), the Counselor may in turn breach confidentiality and disclose information either to the limits of an explicit waiver or to the limits of the already disclosed information in the case of an implicit waiver.
2. Due to the operational need of a Starfleet posting to allow for scheduling and flexibility of personnel, all patients are expected to understand that all counseling staff -- including a ship's senior and junior counselors, counseling interns, the Chief Medical Officer, and medical doctors with psychiatric rotation experience and the explicit permission of the Chief Medical Officer -- have daily access to all counseling records, but are also held to these selfsame standards of confidentiality on what those records contain. Should a counselor require a second opinion or other assistance in a patient's case from another psychological or medical professional, the counselor may include the other professional in the course of treatment, and make them privy to details not contained in the formal record, such as word-for-word transcripts of conversations, and so on.
3. Should the counselor have reason to believe that the patient, the Counselor, or others are at immanent risk of direct physical harm, the Counselor may breach confidentiality to share enough information as necessary under the limits of common sense and professional judgement to end the risk of harm.
4. The Commanding and Executive Officer shall have access upon request to the records of counseling sessions and to the content of otherwise confidential information shared in the counseling relationship, but are expected to use careful judgement in requesting and making use of any such information. These officers are allowed to relay limited portions of confidential information to third parties in order to ensure the safety of their personnel and their post, but again, are expected to use careful and considered judgement to limit disclosed information only to what is strictly necessary.
5. Other department and section heads will not have immediate access to counseling records except as covered by exceptions above or by the review clause below. However, should there be a need for an officer to be restricted from duty for mental health reasons, the Counselor is permitted to publish this finding within the ship's chain of command as necessary, though details of the finding shall be kept confidential.

In all other cases in which a Counselor, or other Medical Officer acting formally in the capacity of a Counselor, believes that there is a need to breach confidentiality and disclose confidential information, that officer is expected to file for a consultation of professional ethics with Starfleet Medical; should the need for such disclosure be urgent, or should the disclosure be made in contravention of the decision of such a consultation, or should any disclosure of counseling information be so wanton as to be in material breach of either the letter or the spirit of the rule of confidentiality, a Board of Inquiry shall be convened at the first possible opportunity to hear the facts of the case and determine whether the disclosure was valid, or whether a potential crime has been committing requiring further disciplinary action.

OOC Information
The following information should be considered Out of Character information. Do not use it in roleplay without permission from staff.
Players should +Request for any consultation of ethics with Starfleet Medical. Note that if a situation does not come under the heading of one of the bullet points which allow clear permission to breach confidentiality, you are best off +requesting the consult rather than assuming or trying to pull an IC 'fast one'.