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Confidentiality in Munchausen’s syndrome

INVITED COMMENTARY ON... Neuropathica diabolica

Anne Farmer is Professor of Psychiatric Nosology at the Institute of Psychiatry, London (Social, Genetic & Developmental Psychiatry, Research Centre, Institute of Psychiatry, London SE5 8AF, UK. Email: a.farmer{at}iop.kcl.ac.uk). She has had a number of research interests over the years, and is currently focusing on genetic research in affective disorders. In addition, she is lead consultant in the Affective Disorders Unit at the South London and Maudsley NHS Foundation Trust, where she runs a tertiary referral service for hard-to-treat patients with affective disorders as well as a special service for healthcare professionals.

This commentary questions whether the usual ethical and legal requirements for maintaining confidentiality of individuals who fabricate illness should be breached in order to prevent further harm to themselves as well as cost to society. A case report of an individual with Munchausen’s syndrome submitted for publication in Advances in Psychiatric Treatment provoked considerable Editorial discussion regarding the absence of written informed consent from the individual described. It is hoped that this commentary will widen the debate regarding the requirement for confidentiality in the exceptional circumstances of patients with Munchausen’s syndrome.

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