law where others (relatives, other doctors, social workers, police, ambulance officers) become involved even if this is contrary to the patient's wishes.Other situations corn monly arise, short of those warranting compulsory treatment, in which the interests of patient or others, especially family, appear to necessitate disclosure of confiden tial information.But uncertainty prevails about when such action is justified.Psychia trists' concerns may hinder both effective treatment of the seriously ill and the addressing of their carers' needs.Before offering our ideas on dealing with these challenging circumstances, we provide an ethical framework for engaging families in treatment, which seeks to clarify key aspects of their participation.
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Szmukler et al. (1997) studied this question.