empirical research on effects of confidentiality

26 – 33 Examples are exchanges of confidential information in cafeterias, elevators, waiting rooms, 34 with physician's spouses, or at social occasions. 11, 16, 25Īpart from these ethically difficult issues, clearly unjustified breaches of confidentiality also occur. 21, 24Įmpirical evidence indicates that erosion of confidentiality has negative consequences for society, because many victims of violence and sick patients would, fearing disclosure, abstain from seeking medical care. 21 – 23 Some physicians consider confidentiality as an absolute rule, whereas many try to balance confidentiality and the prevention of harm. 10 – 13 Physicians have conflicting opinions concerning the reporting of competent victims of violence who oppose the disclosure, 14 – 16 concerning giving information to sexual partners of an HIV-positive test against the will of the patient, 17 – 20 and when confidentiality conflicts with the patient's own good.

Several studies have shown that physicians disagree whether and when breaches are justified when presented with potentially socially threatening behaviour by their patients. In most countries, a breach of confidentiality is permitted to warn third parties against the wish of the patient if: reasonable efforts to elicit voluntary consent to disclosure have failed harm is imminent the harm that identifiable individuals would suffer is serious there is a high probability both that harm will occur if the information is withheld and that the disclosed information will efficiently avert harm and if appropriate precautions are taken to ensure that only the information needed to prevent the harm in question is disclosed. 4 – 6 In Switzerland, similar to the UK and many other countries, 7 the physician is allowed - but not obliged - to breach confidentiality in the case of child abuse. In the US and Australia, reporting of suspected child abuse is mandatory. Nevertheless, the law authorises some breaches of confidentiality, which most commentators would find ethically justified.

2, 3 According to Swiss criminal law, violations of medical confidentiality are punished by a fine or a prison sentence.

1 Codes of professional ethics and the laws of most countries affirm its importance. Confidentiality is a central aspect of the physician–patient relationship.

Empirical research on effects of confidentiality