Disguise or consent: Problems and recommendations concerning the publication and presentation of clinical material

'The author argues that the use of clinical material for educational purpos es or for publication presents the analyst with a conflict of interest betw een the protection of the patient's privacy and rite educational and scient ific needs of the field, and also that it places analysts in the position o f using confidential patient material in the service of their own professio nal advancement. The strategies of dealing with this dilemma can be classif ied as follows: (1) thick disguise, (2) patient consent, (3) the process ap proach, (4) the use of composites and (5) the use of a colleague as author. Some of these options may, of course, be used in combination with one anot her. All of these methods have a place, and the author argues against a uni form approach. Each of these strategies is discussed in terms of its advant ages and disadvantages. While no choice is without various risks, some guid elines ale offered to assist analysts who wish to present or write about cl inical cases.