Domestic Diversions

Releases and subpoenas

The APA’s Monitor summarized the 2002 revisions to the APA’s Ethics Code (effective June 1, 2003). The effort led by Celia Fisher gave psychologists more discretion on the question of releasing test data to patients and attorneys. Under Standard 9.04, psychologists may: provide test data to attorneys pursuant to a clients/patients release; withhold test data requested by a client/patient if they believe its release would be harmful to the client/patient or others or lead to misuse or misrepresentation of the test; and withhold the test data in the absence of a client/patient release (until ordered to do so by a court).

Deborah Smith writes (excerpt):
Release of test data Standards 9.04 and 9.11

The 2002 code eliminates a prohibition in the 1992 code that prevents psychologists from releasing raw test data to individuals who are not qualified to use them. Beginning June 1, psychologists must release test data to clients and their designees when clients provide a written release. The code also stipulates that, in the absence of a client release, psychologists provide test data only as required by law or court order.

The Ethics Code Task Force made the change to clarify the amount of discretion psychologists had in refraining from releasing test data under the Health Insurance Portability and Accountability Act (HIPAA), which directs providers to release certain health information to clients upon request. “What this represents is a shift from a kind of paternalistic, beneficence stance to a more autonomy-based stance that stresses the client/patients’ rights to make decisions for themselves about health care,” says Fisher.

The 2002 code does permit psychologists to withhold test data to protect the client from “substantial harm or misuse or misinterpretation of the data or the test.” However, Fisher cautions that HIPAA does not recognize the misuse or misinterpretation of tests as a legitimate reason to withhold health records, so psychologists should take caution in such situations.

“We understand in 9.04 that all psychologists will not come under HIPAA, and therefore their ethical decision to protect the misuse of tests can certainly be appropriate,” she adds.

One other noteworthy change is that the code now includes definitions of “test data” and “test materials.” Test data are “raw and scaled scores, client/patient responses to test questions or stimuli, and psychologists’ notes and recordings concerning client/patient statements and behavior during examination” as well as “portions of test materials that include client/patient responses.” Test materials, as defined in standard 9.11, are “manuals, instruments, protocols, and test questions or stimuli,” and do not include test data.

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