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Why Misconduct Trumps Patient–Therapist Confidentiality and Ways to Avoid the Disclosure Dilemma

This case illustrates the importance of understanding how different forms of misbehavior in academic research are defined and regulated. The mental health professional and the director of counseling believe a graduate student has committed research misconduct. It is not clear what they understand to be “research misconduct.” If this is a U.S. institution that receives federal funding, the institution presumably has a formal definition of research misconduct that includes “fabrication, falsification and plagiarism” (Office of the President 2000). The graduate student could have falsified or fabricated research records to cover up his diversion of the investigational drug, but it seems unlikely that the two professionals gathered enough information to reach this conclusion. Their institution also could have included “failure to follow research regulations” in its definition of research misconduct, as many institutions do. If the institution had such a definition, then the failure to follow the research protocol is a violation under the university’s definition of misconduct and should be reported. The student also presumably has committed a crime by stealing the investigational drug. In addition, by sharing the investigational drug with his family, the student is potentially putting them at risk as well. There is more to this case than research misconduct. As to the question of disclosure, had the mental health professional been a research integrity officer (RIO), she or he should have been trained to warn the student about revealing sensitive or incriminating information. I would assume in this case that the mental health professional did not provide any warning about sharing confidential information, as she or he now feels conflicted. Therefore, the first piece of advice for the director of counseling would be to review staff training and the guidance provided to mental health professionals. Anyone working on an academic campus should know that studies predict that about 1% of researchers engage in formally defined research misconduct and 10% or more engage in other forms of unprofessional behavior (Fanelli 2009; Steneck 2006). The counseling staff