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joel p August 20th, 2005 07:24 PM

job interview vs confidentiality
hi, i recently was interviewed for a postion which entails working with a small staff of psychologists (5+-). during the course of the interview - which went extremely well - the names of my prospective colleagues came up. i immediately recognised one of the names as a parent of a child i had been seeing a while back suffering from a severe mental condition. in the course of our sessions i had also met the parents a number of times. for a number of considerations, i decided that to work together with this parent/therapist would be quite uncomfortable for both of us, thus my decision was to decline accepting the position.
here is my dillema, since the interrview had been very positive, with a clear intial message on my part of being interested in accepting the job, to decline for some made-up reason could have damaging effects to my credability. my thought was to share with the interviewer that in the course of our interview i realized that i had had a therapeutic relationship with a family member of someone on his staff -obviously without mentioning names - which would possible create an awkward situation for all. i would request of him to keep this in confidence.
how does this sound ethically (especially in light of the small amount of staff members - potentially being the one alluded to)?

William Reid August 21st, 2005 10:20 AM

Re: job interview vs confidentiality
Interesting question, and not an uncommon situation., particularly in small professional communities. Accepting or declining the position is your choice. There are many employment and association circumstances in which a professional treats someone associated with the group (or a relative). Some people are more sensitive to (small or large) potential conflicts than others, but one thing to consider is whether or not the treater is the best choice. If I worked for a heart surgery group, I might have lots of confidence in the members and really want one of them to do my bypass procedure. Similarly, if I got an attractive offer from, say, a clinical department of a hospital or university, I probably wouldn't turn it down just because I was treating a faculty family member (except maybe the chairperson's spouse, and then I might consider an appropriate referral).

But speaking strictly of the question of what to say to the interviewer: Although I'd probably not tell the interviewer about treating some unidentified family member (e.g., what if only one or two of the other clinicians has a family?), I'm not sure it is necessarily unethical, either, especially if there are lots of other clinicians and families. Potential identifiability is the issue, and you may not be aware of all the ways the person might be identified. (Gossiping or bragging about unidentified patients is another issue, which isn't professional.)

Having said that, you should realize that the interviewer is under no obligation of confidentiality to you or colleagues (unless one has been spelled out beforehand). You may ask him or her to keep something private, but should be under no illusions that it will be kept private. Further, the interviewer's agency and duty is to his/her employer, not you.

There are lots of ways to politely decline the position. If you think you must include the professional discomfort reason (and I don't see much reason to do so), you could simply say something more vague, such as "I really appreciate the opportunity and the trouble you've gone to in considering me, but I have just discovered a professional conflict that makes me a little uncomfortable. I hope you understand."

I'll bet lots of readers have had similar experiences and been in similar circumstances, both as the treater and the patient (or family member). Maybe they'll comment.

joel p August 23rd, 2005 10:41 AM

Re: job interview vs confidentiality
thanks for taking the time to respond. i think you hit the nail on the head - 'small professional communities', being relatively early on in my career i think i'm i a bit concerned with issues of 'self-marketing' (or should i say preservation...). in any case, thanks for the helpful clarifications.

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