Health professional-patient confidentiality: does the law really matter?

Confidentiality is often tested in the health professional-patient relationship, particularly given that both the law and ethics permit disclosure of confidential information in the public interest. This column outlines the results of an Australian Research Council project indicating that mental health professionals may place more weight on their ethical responsibilities relating to confidentiality than what the law requires. The outcomes of the project, which used both questionnaires and focus group discussions, suggests that there is some confusion as to legal requirements in this area and that many mental health professionals rely on ethical frameworks to justify disclosure even where there is no legal requirement to do so. It is suggested that ethics training for health professionals should be of primary importance to ensure responsible decision-making in this area.     

‘Developmental’ policies and rent: comparing Russia and Sub-Saharan Africa

The article evaluates the concept of ‘developmental’ policies, comparing post-communist Russia and Sub-Saharan African (SSA) states. Asian ‘developmental state’ policies have been identified as developmental because of successful industrial policies and leaders’ ability to implement them. The comparison shows that while these features have been absent in SSA, notably due to the trapping effects of commodity dependence, Russia exhibits an original dualistic model where the negative impact of commodity dependence (such as the creation of rents) is compatible with developmental industrial policies. The evidence presented demonstrates the importance of constraints that stem from both economic and political structures, in turn explaining variations in developmental policy effectiveness.