Professional secrecy in psychology: scopes, exceptions and what to do if you are summoned to testify

Professional secrecy is probably the most important ethical obligation of a psychologist. It is what makes it possible for a patient to speak freely, without fear that what he says will come out of clinical practice. Without professional secrecy, there is no possible therapeutic alliance.

But the secret is not absolute. There are situations where you are legally obliged to break it, and others where someone will pressure you to do it without proper. Knowing how to distinguish between the two is fundamental.

What is professional secrecy?

Professional secrecy is the legal and ethical obligation not to disclose information you know in the exercise of your profession. In psychology, this includes:

• Everything the patient tells you in session
• Your clinical observations, diagnoses and interventions
• Just the fact that that person is your patient.
• Information about family members or other persons in session
• Data in the medical records

Legal framework in Argentina

The professional secrecy of the psychologist is protected by multiple rules:

Criminal Code — Article 156

"He shall be punished with a fine of one thousand five hundred pesos to ninety thousand pesos and a special disqualification, if any, for six months to three years, who, by reason of his state, office, employment, profession or art, is informed of a secret whose disclosure may cause harm, shall reveal it without just cause."

This means that the violation of professional secrecy is a criminal offence, not just an ethical misdemeanour. The penalty includes a fine of $1.500 to $90.000 plus special disqualification from 6 months to 3 years.

Civil and Commercial Code — Article 1770

It establishes civil liability for breach of privacy. The patient may claim damages if his or her confidential information was disclosed.

Law 26.529 — Rights of the Patient

Article 2.c enshrines the right to intimacy and the confidentiality of the patient's sensitive data. Article 2.d establishes the right to confidentiality: any person who participates in the preparation or has access to clinical documentation must keep the necessary reservation, except as provided by the competent judicial authority or authorization of the patient himself.

Law 26.657 — Mental Health

Art. 7.i recognizes the right to not be identified or discriminated against by a current or past mental condition. Art. 7.l establishes the right to treatment with protection from privacy and full respect for his private life. Art. 7.j guarantees the right to be informed in an adequate and understandable manner, according to the rules of informed consent. Art. 5 states that the existence of a mental health diagnosis does not authorize to presume risk of harm or incapacity.

Law 25.326 — Protection of Personal Data

Health data are sensitive data with enhanced protection.

Codes of professional ethics

All codes of ethics (FePRA, provincial codes) include professional secrecy as a fundamental principle. Their violation may result in penalties ranging from warning to suspension of registration.

Professional Activity (Provincial) Act

Each province has its own law on the exercise of psychology that regulates professional secrecy.

• Buenos Aires: Law 10.306
• CABA: 153 Law and CPPC Regulations
• Cordoba: Law 7.106

What does professional secrecy achieve?

WHAT IS PROTECTED

What Is NOT Protected

• Information that the patient makes public voluntarily
• Data that you tell the patient about himself (it's not secret to him)
• Information you need to share with another care professional (with patient consent)

The 4 exceptions to professional secrecy

Professional secrecy is not absolute. There are situations where not only can you but you must break it:

1. Imminent risk of harm

When the patient represents a concrete and imminent danger to himself or to third parties.

Examples:

• Suicide ideation with structured plan and means available
• Specific threats of harm to an identifiable person
• Patient driving under substance effects and putting others at risk

What to do?

• Assess the severity and imminence of the risk
• Try first that the patient will voluntarily accept help
• If the risk is imminent, contact emergency services or a relative
• Document everything in your medical records: what you evaluated, what you decided and why

2. Abuse or abuse of children and vulnerable persons

When you have founded knowledge or suspicion of physical, sexual, emotional, or negligent abuse of minors or persons in vulnerable situations.

Legal framework:

• Law 24.417 (Protection against Family Violence), Art. 2: Health professionals are obliged to make the complaint when the victims were minors, incapacitated, elderly or disabled
• Law 26.061 (Integrated Protection of Children and Adolescents): Strengthens the reporting obligation for health professionals
• International conventions with constitutional status

What to do?

• You don't need certainty, just a reasonable suspicion.
• The complaint is filed with the protection body of your jurisdiction or with the prosecution
• Document the indicators observed in the medical records
• Do not confront the alleged aggressor

3.

When a judge specifically orders disclosure of information through a well-founded court decision.

Important:

• It must be a judge's order, not a simple request from a lawyer.
• You must specify what information is requested
• You have the right to deliver only what is strictly relevant to the case.
• You can raise your objections with the judge if you consider the request excessive.

What to do?

• Verify that it is a formal court order (not a lawyer's letter)
• Read carefully what information is requested
• Deliver only the pertinent, not "all medical records"
• If you have doubts, consult a lawyer before responding.
• Documenting in the medical records what information you provided and under what order

4. Involuntary detention

When the patient requires mental health internation and does not consent.

Legal framework (Law 26.657):

• Art. 14: Internation is a therapeutic resource of a restrictive nature.
• Art. 20: Involuntary hospitalization only occurs when it mediates a situation of certain and imminent risk for itself or for third parties, and outpatient approaches are not possible. It requires an opinion signed by two professionals from different disciplines, one of whom must be a psychologist or psychiatrist
• Art. 21: Involuntary internment must be mandatoryly notified within 10 hours to the competent judge and the review body. The judge has 3 days to authorize, require expanded reports or deny

Important: It is not prior judicial authorization. The internment is performed first in the face of the certain and imminent risk, and the judge is notified afterwards, who can confirm or deny it.

What to do?

• Evaluate whether the criteria of Art. 20 are met (true and imminent risk, no ambulatory alternative)
• Obtain opinions from two professionals from different disciplines (Art. 20.a)
• Notify the judge and the review body within 10 hours (Art. 21)
• Add all records within 48 hours (Art. 21)
• Document exhaustively in medical records (Art. 15: evolution must be recorded daily)

Grey situations: when you are pressured to speak

Relatives Asking

"How's my son? What's wrong with him? What are you talking about?"

Answer: Article 4 of the 26.529 Act is clear: health information can only be provided to third parties with the patient's permission. In case of incapacity or impossibility, it can be provided to the legal representative, spouse/cohabitant or family members up to the fourth degree of consanguinity. With minors, general information about the process can be given without revealing session contents.

Lawyers requesting reports

An attorney contacts you asking for a report on your patient for a divorce, tenure or employment trial.

Answer: Without written consent of the patient or without a court order, it is not appropriate to provide information. If the patient asks you to make a report, you can do so but remember that you can only report what you observed clinically, not issue legal opinions.

health insurance and private health plans

They ask you for session notes, detailed clinical content or the "complete" diagnosis to authorize sessions.

Answer: You are only required to report:

• Diagnosis (CIE or DSM code)
• Frequency of meetings
• General treatment plan
• Estimated duration

No are allowed to access the content of the sessions and the complete medical records.

Employers

An employer contacts you because the patient is his employee and wants to know "what's wrong with him."

Answer: Not applicable. Not even confirming that that person is your patient.

Colleagues commenting on cases

At a congress, a training or even a luncheon among colleagues, someone mentions a case with identifiable data.

Answer: Even among professionals, sharing clinical information without anonymizing and without purpose of formal care or supervision is a violation of professional secrecy.

What to do if you're summoned to testify?

This is one of the most stressful situations for a psychologist. Step by step:

1. Read the subpoena carefully

• Who issues it? (judged, prosecutor, lawyer)
• In what character do they quote you? (witness, expert, treating professional)
• What information do you require?

2. Distinguish between subpoena and disclosure order

• Citeion to declare: You must introduce yourself, but you may invoke professional secrecy not to answer questions about the content of the attention.
• Order to disclose information: the judge specifically orders you to deliver information. This applies the exception nro 3

3 Invoking professional secrecy

If you are summoned as a witness, at the time you testify you can (and in many cases you must) invoke professional secrecy to refuse to answer questions about the content of the sessions.

The formula is simple:

"With all due respect to the court, I am obliged to invoke the professional secrecy provided for in article 156 of the Penal Code and the codes of ethics of my profession, so I cannot answer that question."

4. Determine what you can report

There's information you can share without violating the secret:

• Yes: that you served that person, during what period, how often
• With care: general diagnosis, if requested by the judge
• No: session content, what the patient said, your clinical notes

5. Consult with a lawyer

If the situation is complex, consult with a lawyer specializing in health law before declaring. Your professional college can guide you.

6. Document everything

It records in the medical records:

• That you were summoned, by whom and in what cause
• What information was asked of you
• What did you answer and what did you invoke?
• If you submitted documentation, which documentation

The professional secrecy after the death of the patient

The professional secrecy survives death of the patient. Death does not free the psychologist from his obligation to reserve.

Exceptions:

• Forced heirs may request medical records with the patient's permission, or when the patient is unable to give them (Art. 19.b, Law 26.529)
• A court order may require post-mortem information
• If the patient left an express authorization in life

Professional secrecy in the digital age

Technology poses new challenges:

Electronic communications

• WhatsApp messages, emails or patient chats are protected by secrecy
• Use secure and encrypted channels
• Avoid discussing cases by courier with colleagues informally

Clinical Management Software

• The system you use for your medical records must comply with the 25.326 law.
• Encryption, access control and backups are minimum requirements
• Checks that the provider does not access clinical content

Social networks

• Do not publish information that can identify a patient, even indirectly
• Do not confirm or deny therapeutic relationships in networks
• Be careful with the "clinical cartoons" that can be identifiable

Online monitoring

• If you do video surveillance, make sure the platform is secure.
• Do not share unencrypted clinical material by email
• Consider a confidentiality agreement with your supervisor

Complaints of irregularities in mental health institutions

Article 29 of the 26.657 Law states that the members of the health team are responsible for informing the review body and the competent judge of any suspicion of irregularity involving unworthy or inhuman treatment of persons under treatment, or undue limitation of their autonomy. The law expressly clarifies that this communication will not be considered a violation of professional secrecy and may be made subject to a reservation of identity.

Consequences of breach of professional secrecy

Criminal

Article 156 of the Criminal Code: fine of $1.500 to $90.000 and special disqualification from 6 months to 3 years. It is a private action, offence which means that the patient must initiate the complaint.

Civilians

The patient may sue for damages (article 1770 of the Civil and Commercial Code). Compensation depends on the damage proven.

Ethics

The professional college may apply penalties ranging from:

• Warning
• Warning
• Suspension of registration (temporary)
• Cancellation of registration (in serious cases)

Professionals

Beyond formal sanctions, breach of professional secrecy destroys trust. A psychologist who does not respect confidentiality loses professional credibility irreversibly.

How Brauni Protects Professional Secret

Brauni is designed with confidentiality as an architectural principle:

1. End-to-end encryption: Not even the Brauni team can read your clinical records
2. Restrictive Access Control: Only you access the information of your patients
3. No data training: Clinical information is never used to train AI models
4. Access Log: You know exactly who agreed to what and when
5. Safe storage: Encrypted data at rest and in transit
6. Confidentiality Agreements: Generate and manage agreements with your team directly from the platform

And if a court or health insurance asks for a report, you can issue it with digital verification: any third party can check that it was not altered.

Summary