Medical Register Act: Psychotherapists warn of data use without consent

The German Psychotherapists Network (DPNW) sharply criticizes the current draft of the Medical Register Act and warns against the increasing processing of sensitive health data without the active consent of those affected. It calls for the “retention of genuine informed consent” and criticizes the trend towards opt-out solutions, as with the electronic patient record (ePA), where insured persons must object to not have an ePA. “Many citizens already find it difficult to understand today which health data is stored, linked, or evaluated where. Especially with psychotherapeutic data, a mere opt-out solution is not sufficient from our point of view,” says the DPNW.

The draft goes “far beyond classic research registers” and creates the basis for an “ever more comprehensive consolidation and evaluation of sensitive health data.” It also points out that psychotherapeutic treatments often address topics such as “traumas, family conflicts, relationship patterns, anxieties, or intimate biographical experiences” and that “even the impression of increasing state or institutional data collection” could impair the trust necessary for treatment. Therefore, it demands that psychotherapeutic data cannot be linked across registers.

Concern about health profiles

The network sees the danger that with the expansion of cross-register data use and the increased use of health insurance numbers, comprehensive personal health profiles could emerge in the long term. This is particularly problematic for psychotherapeutic data, which contain highly personal information about traumas, family conflicts, or intimate biographical experiences. “An infrastructure is gradually being created here that can have significant long-term effects on data protection, informational self-determination, and therapeutic confidentiality,” explains the DPNW.

Critics also see a health policy development towards increasingly extensive use of health data for research, management, and quality assurance. The network also criticizes AI-supported evaluations. It is feared that data linkages between registers, health insurance, and research data will be gradually expanded, while individual consent and transparency for those affected could lose importance.

Associations alarmed for a long time

Professional associations have long warned that increasing state or institutional access options could impair the trust relationship between patients and therapists. Susanne Berwanger, Vice President of the Professional Association of German Psychologists, had warned, for example, that certain registers or the relaxation of confidentiality would lead to patients being “more critical of treatment.” This would reduce the chance of help for the sick people and also prevent potential crimes. Furthermore, mentally ill people are “in general no more dangerous than mentally 'healthy' people,” Berwanger explained.

Specifically regarding planned changes in the context of the Psychologically Ill Persons Act (PsychKG), professional associations had already warned against an expansion of state access and networking possibilities for sensitive health data.

(mack)