In its original expression as a medical value confidentiality may have been absolute; this concept has become eroded by patient consent, legal actions and change in the climate of public opinion. In particular requirements arising out of legal statutes and common law judgements have greatly modified the confidentiality of the doctor-patient relationship in societies deriving their law from English origins. Despite this, confidentiality remains a value which the physician must strive to preserve. He cannot however do this without considering its (...) effect upon possible innocent third parties. (shrink)

This chapter offers an explanation of, and approach to, respecting confidentiality as an ethical obligation in the practice of hospice and palliative medicine. Understood in the context of coincident ethical obligations to maximize clinical benefit, avoid preventable harm, and restore moral agency, respecting confidentiality is embedded in the most basic philosophical precepts that define hospice and palliative care. How to respect confidentiality in everyday practice, however, can be a matter of unusual complexity. As such, following a brief conceptual framework, the (...) chapter explores ways to employ the framework in the service of patients and families in clinical practice. While various regions and nationalities will have legal and regulatory requirements informing the definition and practice of respecting confidentiality, this chapter focuses instead on respecting confidentiality as an ethical value. Readers are encouraged to supplement the content of this chapter with the relevant requirements that apply in their practice location. (shrink)