Confidentiality involves a set of rules or a promise usually executed through
confidentiality agreements
A non-disclosure agreement (NDA) is a legal contract or part of a contract between at least two parties that outlines confidential material, knowledge, or information that the parties wish to share with one another for certain purposes, but wish ...
that limits the access or places restrictions on certain types of
information
Information is an abstract concept that refers to that which has the power to inform. At the most fundamental level information pertains to the interpretation of that which may be sensed. Any natural process that is not completely random ...
.
Legal confidentiality
By law, lawyers are often required 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 can 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 he did not know about his client, which may weaken the client's position. Also, a distrustful client might hide a relevant fact he thinks is incriminating, but that a skilled lawyer could turn to the client's advantage (for example, by raising
affirmative defense
An affirmative defense to a civil lawsuit or criminal charge is a fact or set of facts other than those alleged by the plaintiff or prosecutor which, if proven by the defendant, defeats or mitigates the legal consequences of the defendant's o ...
s 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
The Supreme Court of the United States (SCOTUS) is the highest court in the federal judiciary of the United States. It has ultimate appellate jurisdiction over all U.S. federal court cases, and over state court cases that involve a point o ...
and many
state supreme court
In the United States, a state supreme court (known by other names in some states) is the highest court in the state judiciary of a U.S. state. On matters of state law, the judgment of a state supreme court is considered final and binding in b ...
s 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
r herself
R, or r, is the eighteenth letter of the Latin alphabet, used in the modern English alphabet, the alphabets of other western European languages and others worldwide. Its name in English is ''ar'' (pronounced ), plural ''ars'', or in Irela ...
under former California Business and Professions Code section 6068(e). Until an amendment in 2004 (which turned subsection (e) into subsection (e)(1) and added subsection (e)(2) to section 6068), California lawyers were not even permitted to disclose that a client was about to commit murder or assault. The Supreme Court of California promptly amended the California Rules of Professional Conduct to conform to the new exception in the revised statute. 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.
Breach of confidence in English law
The "three traditional requirements of the cause of action for breach of confidence"
[.] were identified by
Megarry J in ''Coco v A N Clark (Engineers) Ltd'' (1968) in the following terms:
[''Coco v A N Clark (Engineers) Ltd'' ]969
Year 969 ( CMLXIX) was a common year starting on Friday (link will display the full calendar) of the Julian calendar, the 969th year of the Common Era (CE) and ''Anno Domini'' (AD) designations, the 969th year of the 1st millennium, the 69th ...
RPC 41; 968
Year 968 ( CMLXVIII) was a leap year starting on Wednesday (link will display the full calendar) of the Julian calendar.
Events
By place Byzantine Empire
* Emperor Nikephoros II receives a Bulgarian embassy led by Prince Boris (th ...
FSR 415.
The 1896 case featuring the royal ''accoucheur'' Dr
William Smoult Playfair
Dr William Smoult Playfair FRCP (27 July 1836 – 13 August 1903) was a leading Scottish obstetric physician and academic. In 1896 a trial, Kitson v. Plafair, found against him for a breach of medical confidentiality.
Biography
Playfair was ...
showed the difference between lay and medical views. Playfair was consulted by Linda Kitson; he ascertained that she had been pregnant while separated from her husband. He informed his wife, a relative of Kitson's, in order that she protect herself and their daughters from moral contagion. Kitson sued, and the case gained public notoriety, with huge damages awarded against the doctor.
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.
[Dr. Coburn's Peculiar Privilege](_blank)
2 October 2009 This
physician-patient privilege only applies to secrets shared between physician and patient during the course of providing medical care.
The rule dates back to at least the
Hippocratic Oath
The Hippocratic Oath is an oath of ethics historically taken by physicians. It is one of the most widely known of Greek medical texts. In its original form, it requires a new physician to swear, by a number of healing gods, to uphold specific e ...
, 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.''
Traditionally, medical ethics has viewed the duty of confidentiality as a relatively non-negotiable tenet of medical practice.
United States
Confidentiality is standard in the United States by
HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA or the Kennedy– Kassebaum Act) is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1 ...
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.
European Union
Due to the
EU Directive 2001/20/EC
The Clinical Trials Directive (Officially Directive 2001/20/EC of 4 April 2001, of the European Parliament and of the Council on the approximation of the laws, regulations and administrative provisions of the Member States relating to implementati ...
, inspectors appointed by the Member States have to maintain confidentiality whenever they gain access to confidential information as a result of the
good clinical practice Good clinical practice (GCP) is an international quality standard, which governments can then transpose into regulations for clinical trials involving human subjects. GCP follows the International Council for Harmonisation of Technical Requirements ...
inspections in accordance with applicable national and international requirements.
A typical patient declaration might read:
HIV confidentiality
In the United Kingdom information about an individual's HIV status is kept confidential within the
National Health Service
The National Health Service (NHS) is the umbrella term for the publicly funded healthcare systems of the United Kingdom (UK). Since 1948, they have been funded out of general taxation. There are three systems which are referred to using the " ...
. This is based in law, in the NHS Constitution, and in key NHS rules and procedures. It is also outlined in every NHS employee's contract of employment and in professional standards set by regulatory bodies. The National AIDS Trust's Confidentiality in the NHS: Your Information, Your Rights outlines these rights. All registered healthcare professionals must abide by these standards and if they are found to have breached confidentiality, they can face disciplinary action.
A healthcare worker shares confidential information with someone else who is, or is about to, provide the patient directly with healthcare to make sure they get the best possible treatment. They only share information that is relevant to their care in that instance, and with consent.
There are two ways to give consent: ''explicit consent'' or ''implied consent''. Explicit consent is when a patient clearly communicates to a healthcare worker, verbally or in writing or in some other way, that relevant confidential information can be shared. Implied consent, means that a patient's consent to share personal confidential information is assumed. When personal confidential information is shared between healthcare workers, consent is taken as implied.
If a patient doesn't want a healthcare worker to share confidential health information, they need to make this clear and discuss the matter with healthcare staff. Patients have the right, in most situations, to refuse permission for a
health care
Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...
professional to share their information with another healthcare professional, even one giving them care—but are advised, where appropriate, about the dangers of this course of action, due to possible drug interactions.
However, in a few limited instances, a healthcare worker can share personal information without consent if it is in the public interest. These instances are set out in guidance from the General Medical Council, which is the regulatory body for doctors. Sometimes the healthcare worker has to provide the information - if required by law or in response to a court order.
The
National AIDS Trust has written a guide for people living with HIV to confidentiality in the NHS.
Clinical and counseling psychology
The ethical principle of confidentiality requires that information shared by a client with a
therapist
Therapist is a person who offers any kinds of therapy. Therapists are trained professionals in the field of any types of services like psychologists, social workers, counsellors, life coachers and others. They are helpful in counselling individuals ...
in the course of treatment is not shared with others. This principle bolsters the
therapeutic alliance
A therapeutic alliance, or working alliance, is a partnership between a patient and his or her therapist that allows them to achieve goals through agreed-upon tasks.
The concept of therapeutic alliance dates back to Sigmund Freud. Over the cour ...
, as it promotes an environment of trust. There are important exceptions to confidentiality, namely where it conflicts with the clinician's
duty to warn
A duty to warn is a concept that arises in the law of torts in a number of circumstances, indicating that a party will be held liable for injuries caused to another, where the party had the opportunity to warn the other of a hazard and failed to ...
or
duty to protect
In medical law and medical ethics, the duty to protect is the responsibility of a mental health professional to protect patients and others from foreseeable harm. If a client makes statements that suggest suicidal or homicidal ideation, the cli ...
. This includes instances of
suicidal behavior
Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and subs ...
or
homicidal
''Homicidal'' is a 1961 American horror-thriller film produced and directed by William Castle
William Castle (born William Schloss Jr.; April 24, 1914 – May 31, 1977) was an American film director, producer, screenwriter, and actor.
Orph ...
plans,
child abuse
Child abuse (also called child endangerment or child maltreatment) is physical, sexual, and/or psychological maltreatment or neglect of a child or children, especially by a parent or a caregiver. Child abuse may include any act or failure to a ...
,
elder abuse
Elder abuse (also called "elder mistreatment", "senior abuse", "abuse in later life", "abuse of older adults", "abuse of older women", and "abuse of older men") is "a single, or repeated act, or lack of appropriate action, occurring within any rela ...
and
dependent adult abuse
Elder abuse (also called "elder mistreatment", "senior abuse", "abuse in later life", "abuse of older adults", "abuse of older women", and "abuse of older men") is "a single, or repeated act, or lack of appropriate action, occurring within any rela ...
. Recently, confidentiality laws have been changed so that doctors and nurses face strict penalties if they breach confidentiality.
Commercial confidentiality
Some legal jurisdictions recognise a category of commercial confidentiality whereby a
business
Business is the practice of making one's living or making money by producing or Trade, buying and selling Product (business), products (such as goods and Service (economics), services). It is also "any activity or enterprise entered into for pr ...
may withhold information on the basis of perceived harm to "commercial interests". For example: soft drink giant
Coca-Cola
Coca-Cola, or Coke, is a carbonated soft drink manufactured by the Coca-Cola Company. Originally marketed as a temperance drink and intended as a patent medicine, it was invented in the late 19th century by John Stith Pemberton in Atlanta ...
's main syrup formula remains a
trade secret
Trade secrets are a type of intellectual property that includes formulas, practices, processes, designs, instruments, patterns, or compilations of information that have inherent economic value because they are not generally known or readily asc ...
.
Banking confidentiality
Public policy concerns
Confidentiality agreements that "seal"
litigation settlements are not uncommon, but this can leave regulators and society ignorant of public hazards. In the U.S. state of Washington, for example, journalists discovered that about two dozen medical malpractice cases had been improperly sealed by judges, leading to improperly weak discipline by the state Department of Health. In the 1990s and early 2000s, the
Catholic sexual abuse scandal
There have been many cases of child sexual abuse, sexual abuse of children by Priesthood in the Catholic Church, Catholic priests, nuns, List of popes, Popes and Sexual abuse scandals in Catholic orders and societies, other members of Cons ...
involved a number of confidentiality agreements with victims. Some states have passed laws that limit confidentiality. For example, in 1990 Florida passed a 'Sunshine in Litigation' law that limits confidentiality from concealing public hazards.
Washington state, Texas, Arkansas, and Louisiana have laws limiting confidentiality as well, although judicial interpretation has weakened the application of these types of laws. In the U.S. Congress, a similar federal Sunshine in Litigation Act has been proposed but not passed in 2009, 2011, 2014, and 2015.
See also
*
Bank secrecy
Banking secrecy, alternately known as financial privacy, banking discretion, or bank safety,Guex (2000), p. 240 is a conditional agreement between a bank and its clients that all foregoing activities remain secure, confidential, and private. Mo ...
*
Classified information
Classified information is material that a government body deems to be sensitive information that must be protected. Access is restricted by law or regulation to particular groups of people with the necessary security clearance and need to know, ...
*
Confidentiality club
*
Confidential reporting system
A confidential incident reporting system is a mechanism which allows problems in safety-critical fields such as aviation and medicine to be reported in confidence. This allows events to be reported which otherwise might not be reported through fea ...
*
Data Protection Act 1998
The Data Protection Act 1998 (DPA, c. 29) was an Act of Parliament of the United Kingdom designed to protect personal data stored on Computer, computers or in an organised paper filing system. It enacted provisions from the European Union (EU) Da ...
*
Fiduciary
A fiduciary is a person who holds a legal or ethical relationship of trust with one or more other parties (person or group of persons). Typically, a fiduciary prudently takes care of money or other assets for another person. One party, for exampl ...
*
Integrity
Integrity is the practice of being honest and showing a consistent and uncompromising adherence to strong moral and ethical principles and values.
In ethics, integrity is regarded as the honesty and truthfulness or accuracy of one's actions. Inte ...
*
Mature minor doctrine
The mature minor doctrine is a rule of law found in the United States and Canada accepting that an unemancipated minor patient may possess the maturity to choose or reject a particular health care treatment, sometimes without the knowledge or ...
*
Media transparency
Media transparency (or transparent media), also referred to as Media Opacity, is a concept that explores how and why information subsidies are being produced, distributed and handled by media professionals, including journalists, editors, public r ...
*
Mental reservation
Mental reservation (or mental equivocation) is an ethical theory and a doctrine in moral theology that recognizes the "lie of necessity", and holds that when there is a conflict between justice and veracity, it is justice that should prevail. The ...
(a form of deception that does not involve outright lying)
*
Non-disclosure agreement
A non-disclosure agreement (NDA) is a legal contract or part of a contract between at least two parties that outlines confidential material, knowledge, or information that the parties wish to share with one another for certain purposes, but wish ...
, also called confidentiality agreement
*
Physician–patient privilege
Physician–patient privilege is a legal concept, related to medical confidentiality, that protects communications between a patient and their doctor from being used against the patient in court. It is a part of the rules of evidence in many comm ...
for Medical confidentiality
*
Privacy law
Privacy law is the body of law that deals with the regulating, storing, and using of personally identifiable information, personal healthcare information, and financial information of individuals, which can be Personally identifiable information ...
*
Privilege (evidence)
In the law of evidence, a privilege is a rule of evidence that allows the holder of the privilege to refuse to disclose information or provide evidence about a certain subject or to bar such evidence from being disclosed or used in a judicial or ...
*
Protection of sources
Source protection, sometimes also referred to as source confidentiality or in the U.S. as the reporter's privilege, is a right accorded to journalists under the laws of many countries, as well as under international law. It prohibits authorities, i ...
, also called ''confidentiality of (journalistic) sources''
*
Seal of the confessional
*
Secrecy
Secrecy is the practice of hiding information from certain individuals or groups who do not have the "need to know", perhaps while sharing it with other individuals. That which is kept hidden is known as the secret.
Secrecy is often controvers ...
*
Trade secret
Trade secrets are a type of intellectual property that includes formulas, practices, processes, designs, instruments, patterns, or compilations of information that have inherent economic value because they are not generally known or readily asc ...
*
Under seal
Filing under seal is a procedure allowing sensitive or confidential information to be filed with a court without becoming a matter of public record. The court generally must give permission for the material to remain under seal.
Filing confident ...
(lat. ''obsignato'')
References
External links
{{Authority control
Applications of cryptography
Sources (journalism)
Secrecy
Professional ethics