ABSTRACT
It is often asserted that confidentiality is one of the most important ethical duties of a health care practitioner. Confidentiality is an ethical requirement which is borne out of the patient’s expectations of the therapeutic encounter. Patients, it is argued, would not be willing to divulge highly personal information about themselves unless they believed that the practitioner would safeguard that information and use it only for the benefit of that patient. The principle of confidentiality is enshrined in numerous codes and declarations, and is affirmed by the amended Declaration of Geneva (1983), which extends the duty of confidentiality beyond a patient’s death. From where does the duty of confidentiality arise and how wide is its scope?
The ethical justifications for respecting confidentiality fall into two main categories.1 The first relies on the concept of confidentiality as being morally valuable in itself, comprising principles such as respect for autonomy and respect for privacy, along with the explicit or implicit promise on the part of the practitioner not to disclose that patient’s secrets. The second reason for respecting confidences is based on consequences. A consequentialist would argue that people’s health and overall happiness are more likely to be attained if patients are able to make full and frank disclosures to their health carers. Patients are only likely to do this if practitioners do not
