The ethics of e-mail communication in psychiatry

In both medicine and science, practice has historically preceded ethical scrutiny and legal regulation. Recent examples include the debates over stem cell research and cloning. The technology existed and was in the initial stages of study prior to the sounding of alarms by ethicists and lawmakers. The same state of affairs has occurred with the use of electronic (E)-mail in psychiatric practice. The convenience and possibilities of E-mail have already entered into the practice of physicians without pause to consider the ethical implications: specifically, those related to privacy and confidentiality. The authors do not discuss the more questionable uses of the Internet such as physician prescribing to patients they have not evaluated face to face. In this article, the authors confine their discussion to situations in which E-mail communication is used as an adjunct to ongoing face-to-face meetings.