A few years after I began to practice psychotherapy, HIPAA became the law of the land. The Health Insurance Portability and Accountability Act of 1996 covers a great deal of medical practice, but its primary thrust in law and practice is the protection of patients’ privacy under the strictest confidentiality. Rules covering electronic conveyance of medical information on fax machines between medical providers, the end of using Social Security numbers as patients’ ID’s, no more calling out patients’ names in waiting rooms, etc.—all of these provisions became (or should have become) standard practices for all of us with medical licenses. Federal punishment for violations includes prison time and fines running into the hundreds of thousands of dollars.
The philosophy behind the law is the belief—well founded in my view—that individuals have a natural right to privacy about themselves. It is not an absolute right; the public good comes into play, of course. Communities have a vested right in the issue of child vaccinations. (My ear specialist believes that my third grade case of measles may have cost me the hearing in one ear). But as adults I think we stand most appropriately on the assumption that human beings in most cases have a right to reveal themselves in the manner they see fit.
I have to admit that in my practice I was often distressed at the loose or sometimes nonexistent sense of boundaries that my patients displayed in everyday life. A very common scenario goes something like this: a couple is experiencing marital difficulty, and one of the parties takes the domestic issue to his or her family of origin, and discusses marital problems with brothers, sisters, parents, and possibly the man who cleans the swimming pool. The other party feels, rightly so, that marital confidentiality has been broken and counseling sometimes grinds to a halt. (Also, I have come to believe that the term "Facebook boundaries" is an oxymoron.)
Confidentiality and the protection of human privacy is the backbone of all human interactions that occur in a church setting. I sometimes suspect that Catholic schools may have greater consciousness of this, given that they are legal repositories of the academic, financial, and medical records of minor children. On the whole, however, from observations over the years I would think that the danger of breaches in a typical parish is more likely to be oral than written. (There are exceptions, though; years ago my parish printed our private and confidential home phone number in the parish directory; we had to change the number and were assigned an available one, previously held by someone with 20 years of debts.)
Two principles to recall here: the first is that anyone who is involved with parish work must monitor the information shared; and second, there must also be the appearance of confidentiality. With regard to the first, the parish minister makes it a professional practice to reveal nothing about any information learned in ministry including identity, except in cases of emergency or addressing official ministerial or personal business with a supervisor or staff associate. Over the last several decades the use of the term "community" has been stretched like taffy in church life. I get the sense that when we ask for prayers for a sick individual, those doing the praying expect medical reports on how their prayers are progressing. Or, in the case of the Catechumenate, some programs I have seen put great pressure on the catechumens to reveal every aspect of his or her conversion. What if that conversion involves recovery from substance abuse? Or marital infidelity? Or an abortion? Parish community and the desire to improve it never condones the pressuring of individuals to reveal what is much better handled with a priest in confession, or a diocesan sanctioned therapeutic group led by a certified professional.
An equally critical consideration is what I call the appearance of confidentiality. New and old parishioners alike need to feel a sense of safety and dignity. A catechist or other parish minister strives to be a beacon of restraint. A few examples will suffice. Some parish ministers themselves have poor personal boundaries and talk about themselves, which hardly does anything to engender confidence from the parishioners we serve and prevents the talker from learning what the pastoral need really is. In undertaking interviews and other ministerial encounters, we "need to know what we need to know" and nothing more, as an old psychology professor put it to us one day. Another roadblock to professionalism can be the church front office. I have visited a great many of them in 40 years, and as often as not I find myself surrounded by church employees and volunteers or even just other parishioners (I have no way of knowing); no one in such a parish office has evidently given much thought to the privacy that is becoming of physicians, lawyers, estate planners, counselors and other professionals who handle delicate personal matters.
The casual treatment of delicate personal information is a serious breach of ministerial ethics. Someday, if it has not already happened, a breach in this area is going to cost the church plenty of money, not to even begin to speak of the wound to its evangelization efforts.