Confidentiality

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"Confidential" redirects here. For other uses, see Confidential (disambiguation).
Confidentiality is an ethical principle associated with several professions (e.g., medicine, law, religion,
professional psychology, and journalism). In ethics, and (in some places) in law and alternative forms
of legal dispute resolution such as mediation, some types of communication between a person and one
of these professionals are "privileged" and may not be discussed or divulged to third parties. In those
jurisdictions in which the law makes provision for such confidentiality, there are usually penalties for
its violation.
Confidentiality has also been defined by the International Organization for Standardization (ISO) in
ISO-17799 [1] as "ensuring that information is accessible only to those authorized to have access" and
is one of the cornerstones of information security. Confidentiality is one of the design goals for many
cryptosystems, made possible in practice by the techniques of modern cryptography.
Confidentiality of information, enforced in an adaptation of the military's classic "need to know"
principle, forms the cornerstone of information security in today's corporations. The so called
'confidentiality bubble' restricts information flows, with both positive and negative consequences.

Legal confidentiality
Lawyers are often required by law to keep confidential anything pertaining to the representation of a
client. The duty of confidentiality is much broader than the attorney-client evidentiary privilege, which
only covers communications between the attorney and the client.
Both the privilege and the duty serve the purpose of encouraging clients to speak frankly about their
cases. This way, lawyers will be able to carry out their duty to provide clients with zealous
representation. Otherwise, the opposing side may be able to surprise the lawyer in court with something
which he did not know about his client, which makes both lawyer and client look stupid. Also, a
distrustful client might hide a relevant fact which he thinks is incriminating, but which a skilled lawyer
could turn to the client's advantage (for example, by raising affirmative defenses like self-defense).
However, most jurisdictions have exceptions for situations where the lawyer has reason to believe that
the client may kill or seriously injure someone, may cause substantial injury to the financial interest or
property of another, or is using (or seeking to use) the lawyer's services to perpetrate a crime or fraud.
In such situations the lawyer has the discretion, but not the obligation, to disclose information designed
to prevent the planned action. Most states have a version of this discretionary disclosure rule under
Rules of Professional Conduct, Rule 1.6 (or its equivalent).
A few jurisdictions have made this traditionally discretionary duty mandatory. For example, see the
New Jersey and Virginia Rules of Professional Conduct, Rule 1.6.
In some jurisdictions the lawyer must try to convince the client to conform his or her conduct to the
boundaries of the law before disclosing any otherwise confidential information.
Note that these exceptions generally do not cover crimes that have already occurred, even in extreme
cases where murderers have confessed the location of missing bodies to their lawyers but the police are
still looking for those bodies. The U.S. Supreme Court and many state supreme courts have affirmed
the right of a lawyer to withhold information in such situations. Otherwise, it would be impossible for
any criminal defendant to obtain a zealous defense.
California is famous for having one of the strongest duties of confidentiality in the world; its lawyers
must protect client confidences at "every peril to himself or herself." Until an amendment in 2004,
California lawyers were not even permitted to disclose that a client was about to commit murder.
Recent legislation in the UK curtails the confidentiality professionals like lawyers and accountants can
maintain at the expense of the state. Accountants, for example, are required to disclose to the state any
suspicions of fraudulent accounting and, even, the legitimate use of tax saving schemes if those
schemes are not already known to the tax authorities.

[edit] History of the English law of confidentiality

The modern English law of confidence stems from the judgment of the Lord Chancellor, Lord
Cottenham,[3] in which he restrained the defendant from publishing a catalogue of private etchings
made by Queen Victoria and Prince Albert (Prince Albert v Strange).
However, the jurisprudential basis of confidentiality remained largely unexamined until the case of
Saltman Engineering Co. Ltd. v Campbell Engineering Co. Ltd.,[4] in which the Court of Appeal
upheld the existence of an equitable doctrine of confidence, independent of contract.
In Coco v A.N.Clark (Engineers) Ltd [1969] R.P.C. 41, Megarry J developed an influential tri-partite
analysis of the essential ingredients of the cause of action for breach of confidence: the information
must be confidential in quality, it must be imparted so as to import an obligation of confidence, and
there must be an unauthorised use of that information to the detriment of the party communicating it.
The law in its then current state of development was authoritatively summarised by Lord Goff in the
Spycatcher case.[5] He identified three qualifications limiting the broad general principle that a duty of
confidence arose when confidential information came to the knowledge of a person (the confidant) in
circumstances where he had notice that the information was confidential, with the effect that it would
be just in all the circumstances that he should be precluded from disclosing the information to others.
First, once information had entered the public domain, it could no longer be protected as confidential.
Secondly, the duty of confidence applied neither to useless information, nor to trivia. Thirdly, the public
interest in the preservation of a confidence might be outweighed by a greater public interest favouring
disclosure.
The incorporation into domestic law of Article 8 of the European Convention on Human Rights by the
Human Rights Act 1998 has since had a profound effect on the development of the English law of
confidentiality. Article 8 provides that everyone has the right to respect for his private and family life,
his home and his correspondence. In Campbell v MGN Ltd,[6] the House of Lords held that the Daily
Mirror had breached Naomi Campbell’s confidentiality rights by publishing reports and pictures of her
attendance at Narcotics Anonymous meetings. Although their lordships were divided 3-2 as to the
result of the appeal and adopted slightly different formulations of the applicable principles, there was
broad agreement that, in confidentiality cases involving issues of privacy, the focus shifted from the
nature of the relationship between claimant and defendant to (a) an examination of the nature of the
information itself and (b) a balancing exercise between the claimant’s rights under Article 8 and the
defendant’s competing rights (for example, under Article 10, to free speech).
It presently remains unclear to what extent and how this judge-led development of a partial law of
privacy will impact on the equitable principles of confidentiality as traditionally understood.

[edit] Medical confidentiality

Confidentiality is commonly applied to conversations between doctors and patients. Legal protections
prevent physicians from revealing certain discussions with patients, even under oath in court.[7] The
rule only applies to secrets shared between physician and patient during the course of providing
medical care.[8]
The rule dates back to at least the Hippocratic Oath, which reads: Whatever, in connection with my
professional service, or not in connection with it, I see or hear, in the life of men, which ought not to be
spoken of abroad, I will not divulge, as reckoning that all such should be kept secret.
Confidentiality is mandated in America by HIPAA laws, specifically the Privacy Rule, and various
state laws, some more rigorous than HIPAA. However, numerous exceptions to the rules have been
carved out over the years. For example, many American states require physicians to report gunshot
wounds to the police and impaired drivers to the Department of Motor Vehicles. Confidentiality is also
challenged in cases involving the diagnosis of a sexually transmitted disease in a patient who refuses to
reveal the diagnosis to a spouse, and in the termination of a pregnancy in an underage patient, without
the knowledge of the patient's parents. Many states in the U.S. have laws governing parental
notification in underage abortion.[9]
Traditionally, medical ethics has viewed the duty of confidentiality as a relatively non-negotiable tenet
of medical practice. More recently, critics like Jacob Appel have argued for a more nuanced approach
to the duty that acknowledges the need for flexibility in many cases.[10]

[edit] Clinical psychology

The ethical principle of confidentiality requires that information shared by the client with the therapist
in the course of treatment is not shared with others. This is important for the therapeutic alliance, as it
promotes an environment of trust. However, there are important exceptions to confidentiality, namely
where it conflicts with the clinician's duty to warn or duty to protect. This includes instances of suicidal
behavior or homicidal plans, child abuse, elder abuse and dependent adult abuse. [11]

Confidentiality.
You are a bachelor level human services professional working as a therapeutic aide (mental health
technician) in a community mental health center where you have a client who is 17. He reveals that he
has a baby on the way with his current girlfriend; he asks you not to tell his parents about this. He lives
with his parents and the girl lives with her parents - she has already told her parents and is receiving
pre-natal care through her doctor, but she has refused to name the father. What factors would you need
to know/consider to assist the client and address confidentiality issues? Would you consider breaking
his confidentiality to his parents? To his girlfriend's parents?
Mr. Zenner adheres to the Professional Code of Conduct for his practice which is
formulated by the Louisiana Licensing Board of Examiners, which governs his
practice. In addition, Mr. Zenner adheres to the Code of Ethics of the National
Association of Social Workers.
A client is anyone who makes contact with anyone on the staff, even one time, for the
purpose of personally seeking mental health information, referrals, counseling,
advocacy, and the like. The contact may be indirect, such as a phone contact, or direct,
like face-to-face.
We regard confidentiality in all matters concerning clients as essential to providing any
services and as the legal and ethical responsibility of all personnel associated with our
office. Observing client's confidentiality protects the safety, well-being and confidence
of people we serve. It also honors the trust which a client places in our personnel and in
Acadiana Counseling as a whole.
Confidentiality applies to any contacts with a client as well as to written client records,
documents, and/or files. Unless written authorization for the release and/or exchange of
confidential information is given, no knowledge of or revealing information about the
client may be shared outside the office. This written consent may be given by an adult
client or the parent/guardian of a minor client. Within the office, information-sharing
about a client is limited to what is necessary to providing coordinated, effective services
to the client.
There are legal exceptions to the rule of confidentiality. One exception occurs in the
case of suspected or acknowledged child abuse. State law identifies the obligation to
report cases of child abuse is encountered in the course of duty. The law outlines the
legal consequences of failure to report and also provides protection for the reporter
unless the information if given maliciously or without reasonable grounds for
suspicion. Reports of suspected or known child abuse will be made to the Louisiana
Office of Human Development. In making such reports, whatever information
necessary to the allegation of child abuse will be given. Another exception relates to life
threatening situations. The law requires a report to law enforcement of knowledge from
a client of serious intent to harm others or if someone is a real danger to her or his own
self. Reports of this type will be made in compliance with the law and only necessary
client information would by revealed in such reports.

Topics : Confidentiality and Duty to Report

Ethical and Legal Reasons for Confidentiality
Exceptions to Strict Confidentiality
Confidentiality for Minors
Statutory Duties
Court Order
Legal Defense
Case for Discussion : A Family’s Secrets
Medical diagnosis and treatment produce information useful to direct patient care and a variety of other
social circumstances. It has been a traditional precept of medical ethics, however, that confidentiality in
health care is the best way to protect the well-being of patients. For this reason, there is a strong
presumption that information produced in the course of health care may not ordinarily be disclosed
without the patient’s permission. This chapter examines the ethical and legal foundations of
confidentiality within medical relationships. Both ethics and the law support a strong presumption in
favor of medical confidentiality. That confidentiality is not, however, absolute, and there are justifiable
exceptions, as described below.

Ethical and Legal Reasons for Confidentiality

There is strong ethical and legal agreement that medical relationships ought to be respected as
confidential. This agreement is as old as the Hippocratic Oath which says: “What I may see or hear in
the course of the treatment or even outside of the treatment in regard to the life of men, which on no
account one must spread abroad, I will keep to myself holding such things shameful to be spoken of.”
This counsel was designed to protect patients from rumor and social judgment. Many of the purposes
of confidentiality remain the same 2500 years later. The Declaration of Geneva oath (formulated
following World War II and updated in 1982), which is administered to many medical school graduates,
declares: “I will respect the secrets which are confided in me, even after the patient has died.” The
American Medical Association asserts “The physician should not reveal confidential communications
or information without the express consent of the patient, unless required to do so by law.”
Many ethical theories insist on respecting individuals as the central figures in decisions affecting their
life choices. One way to do so is to respect the confidentiality of medical information: regardless of
consequences, it is important to respect the way in which patients want information to be kept
confidential. This is a way of respecting the individual dignity of a person, and not as a means to some
other social end.
There are also consequentialist reasons for maintaining confidentiality. Confidentiality protects people
in vulnerable states. It also encourages patients to be entirely candid about their injuries and disorders.
If patients fear that information about their illnesses and treatments will be broadcast, they may
withhold information, and medical management may be compromised. If physicians routinely breach
confidentiality, it is feared patients will not trust them. This effect may be highly prejudicial to the
management of somatic disease and may be especially damaging in psychiatric relationships.
The law also respects the need for confidentiality in medical treatment. It approaches the matter as one
of privacy. Both statute and court interpretations protect patients from unwanted disclosures of
information gathered in the course of health care. Most state laws protect patient communications as a
matter of privileged communication, something not to be disclosed without permission or legally
recognized reason.
Because many health care workers need access to information about a patient, protecting
confidentiality is often a challenge in health care institutions. For example, well-meaning family
members may want to know a diagnosis the patient does not wish disclosed. For example, a man might
not want his family to know, for example, that he has been diagnosed with AIDS. Family members
visiting in the hospital may, however, press medical staff to disclose a specific diagnosis. Under these
circumstances, doctors and nurses can feel an obligation to advise the family even against the wishes of
the patient. Indeed, the most tempting reasons to breach confidentiality are those in which it appears
that some good can be achieved. Nevertheless, a strong presumption of confidentiality should be
maintained in health care relationships.
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Exceptions to Strict Confidentiality

Both ethics and the law agree that the right to confidentiality is not absolute. Physicians may disclose
or are required to disclose in the following circumstances.
Patient Waiver. Confidential information may be disclosed with the consent of the patient. Under such
circumstances, a patient is considered to have waived his or her right to confidentiality. In practice, this
may be the most common form of disclosure made by physicians who routinely file medical reports
with insurers and employers.
Specific Diseases, Injuries, or Treatments. Public health agencies monitor the incidence and
prevalence of certain diseases and doing so requires access to a broad range of medical information.
Public health laws also may require the reporting of certain injuries, especially those of an involuntary
nature. Such injuries include those caused by the discharge of a firearm or any injury sustained in the
course of a criminal offense such as sexual assault or child abuse.
Threats of Self-harm. If a patient threatens harm against him or herself, there can be ethical and legal
justification for disclosing that information to a third party if that disclosure will help prevent that
harm. For example, a physician of a 24-year old suicidal patient might advise the patient’s mother--
with whom he lives--that her son is in imminent danger of committing suicide, provided the mother is
somehow situated to help prevent that harm. If a relative (a distant cousin or aged uncle) had no
identifiable relationship with the patient, and indeed lived on the other side of the country, and the
physician had no reason to believe that this disclosure would help prevent the harm, there would be
correspondingly far less justification for this breach of confidentiality.
Endangered Third Parties. Much discussed in the literature – perhaps out of proportion to its
likelihood – is the question of physician responsibility to advise third parties about dangers posed by
their by patients. Such dangers include threatened violence or infectious disease. It is the consensus of
that law that if a physician has reason to believe that a patient in his or her care is highly likely to harm
a specifically identified individual, that physician has a duty to make reasonable efforts to warn that
individual.
The 1976 case, Tarasoff v. Board of Regents of the University of California, was decisive in
establishing this legal duty to warn. In this case, a physician failed to warn a woman that a man whom
she had previously dated had declared his intentions to kill her. When he did kill her, her parents
successfully sued the physician and university who employed him for failure to warn of the danger. The
court held that the physician had a duty to disclose a specific threat to a specific individual.
There does not exist a comparable duty when a threat is made against society in general or a group that
the physician could not possibly hope to identify or forewarn. If a patient, for example, swore that he
wanted to hurt all left-wing sympathizers, there is no duty to identify and warn all left-wing
sympathizers since a physician obviously has no way to identify and warn all left-wing sympathizers in
the nation.
The extent of a duty to warn is also a matter of debate since it is not always clear what counts as a
believable threat of imminent harm to another. Threats against particular individuals do not inevitably
end in violence. Some patients routinely make threats of violence that do not in fact materialize. For
example, an adolescent patient may routinely threaten to kill her mother, without any form of violence
against the mother ever materializing. That being the case, physicians are sometimes in grey areas with
regard to their duties to report. It is also feared that this duty to report will undermine patient’s
willingness to be open in psychiatric (and other) relationships. Some practitioners, however, advise
patients at the beginning of relationships that they will be obliged to disclose threats to harm.
At the present time, questions of the duty to warn endangered parties have often been raised in regard
to tuberculosis and HIV infection. In some states, certain diseases may be reported to a public health
agency which will then conduct “contact tracing” in order to warn people that they may have been
exposed to a communicable disease. In these instances, physician’s duties to warn are, in practice,
limited to report their patients to the relevant state agency. Nevertheless, physicians may have duties in
regard to involuntary disclosure of, say, HIV infections to identified spouses or sexual partners of their
patients. The extent of this responsibility remains, to be sure, a matter of continuing debate.
All states have laws that require reporting of circumstances that endanger child welfare. While a patient
without children may be protected in regard to medical information regarding his drug use, a patient
with children has no such guarantee--as state laws require that physicians identify to state agencies
those parents whose drug use endangers their children. This breach is justified in the name of
protecting the welfare of children, judged to be more socially important than medical confidentiality in
regard to drug use under these circumstances. Under some circumstances, physicians may wonder
whether it is better to try and keep a family intact rather than report the endangerment of children that
may see state agencies dismantling a family altogether.
Physicians will, therefore, continue to face difficult questions about whether and to what extent to
breach confidentiality in regard to patients with, for example, HIV infection and other communicable
conditions as well as threats of violence.
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Confidentiality for Minors

Minors are not recognized by either ethics or the law as having the same entitlement to confidentiality
as adults. As a matter of course, physicians ought to involve parents in decisions about the medical
treatment of their children. Children do have, though, some rights to confidentiality and entitlement to
make treatment decisions independent of their parents' wishes, especially maturing adolescents.
According to the specifications set by law in each state, adolescents may seek, for example, psychiatric
treatment, birth control measures, and abortions without notification or parental consent. Under these
circumstances, adolescents are entitled to the sort of medical confidentiality that would be accorded an
adult. In Illinois, for example, children aged 12 and higher may receive treatment in regard to sexually
communicable diseases, drug use, alcohol use without parental notification or consent.
Even with these provisions in place, adolescent patients will pose dilemmatic questions about breach of
confidentiality in regard to their sexual behavior, contraceptive and other birth control practices, drug
use, and so on – because there can be ambiguity about what the best way to serve the adolescent’s
interests is. A duty to disclose may also fundamentally disrupt a family, even when undertaken in the
child's best interest. For example, a physician’s duty to report a child endangered by parents’ drug use
(reports required by law) can destroy that family if the responsible state agency decides that children
are so endangered that they should be removed from the home. It is not always clear that removing a
child from a troubled home is better than putting that child into the custody of the state, especially
when foster parenting arrangements and the like are problematic.
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Statutory Duties
Every state provides that certain conditions are reportable to prosecuting authorities. For example, in
Illinois, gunshot injuries are reportable conditions. Every physician who comes to treat a gunshot
wound must report the injury to a local law enforcement agency. The logic of this duty is that it is better
for society to know who is being injured by guns than to have that information shielded as a matter of
individual medical records. In effect, this kind of reporting duty presumes that every gunshot injury
involves a crime until proven otherwise.
In fact, Illinois statute provides that physicians are obliged to report any injury sustained in the
commission of a crime or any injury sustained as the result of a crime. For example, physicians are
obliged as a matter of statute to report the sexual abuse of children and the physical abuse of elderly
people.
So strongly is the view held that child abuse must be reported that Illinois statutes go to great length to
impose a duty to report on a very broad class of people who may come into contact with injured
children: physicians, residents, interns, hospitals, hospital administrators, surgeons, dentists, dental
hygienists, chiropractors, podiatrists, substance abuse treatment counselors, Christian Science
practitioners, coroners, medical examiners, crisis hotline personnel, truant officers, social workers,
nurses, licensed practical nurses, nursery school directors, and so on.
In Illinois, these reports are ultimately filed with the Department of Children and Family Services,
though they may be filed by way of local law enforcement agencies.
Reporting instances of suspected abuse may require physician testimony in court, as to the nature and
extent of the injuries and their probable origin. Certain statements made by patients in these
circumstances may be admissible in court even if they constitute hearsay. That is, the patient may tell
the physician how he or she came to have the injuries in question, and the physician may be called
upon to report those statements to a court even though the physician was not a witness to the
circumstances and has no independent ability to confirm whether those statements are accurate or not.
Physicians are liable with both criminal and civil penalties failure to report injuries specified by statute.
Physicians who fail to refer will also be referred to the state medical disciplinary board for
consideration of the effect of their failure on their medical license to practice.
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Court Order
Patient records may sometimes be opened to public scrutiny by reason of a court order. For example,
the investigation of a physician for criminal activity may require prosecutors to examine that
physician’s records. For example, a Maryland physician was using his own sperm in inseminating
women patients, but he had represented that sperm as coming from a donor sperm bank. A court order
permitted a full examination of the relevant records in this case. A court may also permit prosecutors to
examine the medical record of a patient who is being investigated for criminal wrong-doing. In these
instances, the courts have concluded that an important public good is served by the breach of
confidentiality.
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Legal Defense
Should a patient or other party accuse a physician of criminal or civil wrong-doing, every state has
some provision for the introduction of patient records into the defense of the physician. For example, if
a patient accuses a physician of failure to diagnose and treat a particular condition, the physician is
entitled to use documents regarding the diagnosis and treatment of that patient in defense proceedings.
These state provisions rectify what had been a problem in some jurisdictions earlier in the century,
namely the claim that because medical records were confidential they could not be used in court
proceedings.
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Case for Discussion : A Family’s Secrets

Mr. John Robertson is a 30-year-old man with Klinefelter Syndrome (KS), in which means he has an
XXY sex chromosome karyotype. He and his wife consult a family medicine physician in their
neighborhood, Dr. Jason Fullerton, in order to receive counseling about the likelihood of passing this
condition on to any children they might have. In fact, Lana Robertson is at that time 8 or 9 weeks
pregnant. Dr. Fullerton immediately counseled amniocentesis, but Mrs. Robertson failed to keep the
appointment and showed up again at Dr. Fullerton’s office only in her 26th or 27th week of pregnancy.
She previously had a stillborn daughter in a previous marriage and told Dr. Fullerton that she didn’t
want to have any “bad news” during pregnancy because she couldn’t face the prospect of an abortion.
In fact, she went on to deliver a healthy son.
Mr. Robertson remained in contact with Dr. Fullerton, calling from time to time to inquire about any
developments in the study of Klinefelter Syndrome and to inquire whether Dr. Fullerton was sure his
son was not affected. In fact, Mr. Robertson told Dr. Fullerton that he was surprised that he could father
a child at all. He remembered that a counsellor had told him a long time ago he would probably not be
able to have children. He wondered, therefore, whether the child was really his and suspected his wife
had become pregnant by another man.
Dr. Fullerton responded by saying that while most men with Klinefelter Syndrome were not fertile,
there were a few reported cases of affected men fathering children. In the meantime, during this same
period, Mrs. Robertson began dropping broad hints to Dr. Fullerton that Mr. Robertson was not the
father of here child. She broached this topic by asking Dr. Fullerton if the boy should be tested for more
genetic conditions, “you know, if his father had some genetic conditions that weren’t obvious.”
Dr. Fullerton wondered what his responsibilities were in regard to testing the paternity of the child and
disclosure of the results to both Mr. and Mrs. Robertson.

Study Questions
1. Would Dr. Fullerton be within his rights to conduct a paternity test on the child without
consulting Mr. Robertson?
2. If Dr. Fullerton did conduct a paternity test, would he be within his rights to withhold the test
results from Mr. Robertson?
3. What, if any, genetic tests should Dr. Robertson be running on this child, and which parent has
entitlement to the results of those tests?
4. Could Dr. Fullerton decline to offer any paternity tests or genetic tests to the child?

Ethics and confidentiality

When gathering, storing or obtaining any data, schools need to consider the issues of confidentiality
and ethics.
‘Ethics serve to identify good, desirable, or acceptable conduct …’
From National Statement of Ethical Conduct in research involving Humans (2007)
The protection of individual privacy and confidentiality also includes individual rights within specific
local and national cultural contexts.The cultural diversity within Australia means there is a range of
views on the relative weight of individual and community values. The research or information gained
will need to be of benefit to the participants.
Some of the ‘Principles of justice’ that need to be considered include the balance of public interest with
the interests of the school, the capacity of individuals to make decisions about their lives and the right
to exercise this capacity within the school community, and maximising the possible benefits and
minimising possible harms in relation to any data that is collected.
We comply with ethical principles to ensure:
• Protection of individual rights to privacy and confidentiality
• The information benefits the participants
• We keep in mind the principles of justice, autonomy and beneficence
Ethics & Confidentiality paper, NSW Rural Doctors, April 2001
A range of data methodologies can be an advantage if there is sufficient time and energy – pieces of
quantative data that confirm qualitative data can mean the school leadership or core team can feel
confident about the survey results. The school could also consider other ways to gather perceptions –
using focus discussion groups with external observers and recorders; learning conversations with
students; student art and performance;playground language surveys; point of service surveys at the
school counsellor's office; or academic and behavior data.
Confidentiality relates to the duty to maintain confidence and thereby respect privacy. People's right to
privacy is enshrined in Article 12 of the United Nations (UN) Universal Declaration of Human Rights
(1948). UN member countries are morally, if not legally, bound by such declarations. Privacy relates to
personal information that a person would not wish others to know without prior authorization. Under
the ethical principle of respect for a person's autonomy, public health workers have an obligation to
respect privacy. Privacy relates to a person's right to be free from the attention of others. What a person
regards as private is a personal choice, and it can change throughout one's life. For example, illicit drug
use in youth may be something about which one boasts. Later in life, however, one might prefer that
such information not be known to others.
When people agree to participate in research, they are expected to provide personal information, and
researchers must commit to respecting and maintaining the confidentiality of their subjects. When
people disclose private information for any public health purpose it is expected that the information
will be held in confidence. Only with this trust can public health programs succeed.
Anonymity differs from confidentially, in that the name of a person is not known. However, where
certain characteristics of a person are known, it could be possible for others to establish who the person
is. For example, if it were said that a person of color's income exceeded a certain amount, and there is
only one person of color being described in the community, then that person's privacy is no longer
protected. The unauthorized disclosure of personal information provided in confidence would be
deemed a breach of confidentiality. The public health system depends on the public's confidence and
trust in the system's ability to maintain confidentiality.

Read more: http://www.answers.com/topic/confidentiality#ixzz19HNt1Gy7