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Logo of jmedethJournal of Medical EthicsCurrent TOCInstructions to authors
J Med Ethics. Sep 1986; 12(3): 117–122.
PMCID: PMC1375347

Medical confidentiality: an intransigent and absolute obligation.


Clinicians' work depends on sincere and complete disclosures from their patients; they honour this candidness by confidentially safeguarding the information received. Breaching confidentiality causes harms that are not commensurable with the possible benefits gained. Limitations or exceptions put on confidentiality would destroy it, for the confider would become suspicious and un-co-operative, the confidant would become untrustworthy and the whole climate of the clinical encounter would suffer irreversible erosion. Excusing breaches of confidence on grounds of superior moral values introduces arbitrariness and ethical unreliability into the medical context. Physicians who breach the agreement of confidentiality are being unfair, thus opening the way for, and becoming vulnerable to, the morally obtuse conduct of others. Confidentiality should not be seen as the cosy but dispensable atmosphere of clinical settings; rather, it constitutes a guarantee of fairness in medical actions. Possible perils that might accrue to society are no greater than those accepted when granting inviolable custody of information to priests, lawyers and bankers. To jeopardize the integrity of confidential medical relationships is too high a price to pay for the hypothetical benefits this might bring to the prevailing social order.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Thompson IE. The nature of confidentiality. J Med Ethics. 1979 Jun;5(2):57–64. [PMC free article] [PubMed]
  • Pheby DF. Changing practice on confidentiality: a cause for concern. J Med Ethics. 1982 Mar;8(1):12–18. [PMC free article] [PubMed]
  • Carli T. Confidentiality and privileged communication: a psychiatrist's perspective. Prog Clin Biol Res. 1980;38:245–251. [PubMed]
  • Havard J. Medical confidence. J Med Ethics. 1985 Mar;11(1):8–11. [PMC free article] [PubMed]
  • Robins RS, Rothschild H. Hidden health disabilities and the presidency: medical management and political consideration. Perspect Biol Med. 1981 Winter;24(2):240–253. [PubMed]

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