## Facts

- A former psychiatric patient underwent two extended courses of treatment with a psychiatrist.
- During treatment, the patient disclosed intimate personal information for purposes of diagnosis and care.
- The psychiatrist allegedly disclosed that confidential information to the patient’s wife without the patient’s consent and without justification.
- The patient alleged resulting harms, including deterioration of his marriage, loss of employment, financial distress, and severe emotional distress requiring further psychiatric treatment.

## Issues

1. Whether a psychiatrist may be civilly liable in damages to a former patient for unauthorized disclosure of confidential information learned during treatment.
2. If liability may exist, what legal theory properly supports recovery (e.g., implied contract, breach of confidence/public policy, statutory privacy, fiduciary duty).

## Decision

- The appellate court modified the lower court’s order on the motion to dismiss.
- The court held that an unjustified, nonconsensual disclosure of a patient’s confidential treatment information may constitute a breach of the psychiatrist’s fiduciary duty of confidentiality and is actionable in tort.
- The court rejected a distinct implied-contract cause of action as an independent theory of recovery where the alleged wrong is more properly treated as a fiduciary-duty tort.
- The statutory privacy claim under New York Civil Rights Law article 5 remained dismissed (no cross-appeal; plaintiff conceded statutory requirements were not met).

## Legal Principles

- A psychiatrist owes a fiduciary duty to maintain confidentiality of information obtained in the course of treatment.
- Wrongful disclosure of confidential treatment information can give rise to a tort claim for breach of fiduciary duty of confidentiality.
- Although the physician–patient relationship has contractual features, breach of treatment confidentiality is properly characterized as a fiduciary-duty tort rather than a separate implied-contract claim.
- Confidentiality is not absolute; disclosure may be permissible when justified by overriding interests (e.g., protection from serious harm), but justification cannot be presumed against the plaintiff on a pleading-stage motion to dismiss.

## Conclusion

The court recognized that a former patient may pursue tort damages for a psychiatrist’s unauthorized disclosure of confidential treatment information as a breach of fiduciary duty, while declining to treat the same alleged misconduct as an independent implied-contract claim.


MacDonald v. Clinger, 84 A.D.2d 482, 446 N.Y.S.2d 801 (N.Y. App. Div. 4th Dep’t 1982)