A challenge to unqualified medical confidentiality

J Med Ethics. 2018 Apr;44(4):248-252. doi: 10.1136/medethics-2017-104359. Epub 2017 Oct 10.

Abstract

Medical personnel sometimes face a seeming conflict between a duty to respect patient confidentiality and a duty to warn or protect endangered third parties. The conventional answer to dilemmas of this sort is that, in certain circumstances, medical professionals have an obligation to breach confidentiality. Kenneth Kipnis has argued, however, that the conventional wisdom on the nature of medical confidentiality is mistaken. Kipnis argues that the obligation to respect patient confidentiality is unqualified or absolute, since unqualified policies can save more lives in the long run. In this paper, I identify the form of Kipnis's argument and present a challenge to it. I conclude that, as matters stand now, a qualified confidentiality policy is the more rational choice.

Keywords: HIV infection and aids; clinical ethics; codes of/position statements on professional ethics; confidentiality/privacy; truth disclosure.

MeSH terms

  • Confidentiality / ethics*
  • Dissent and Disputes
  • Duty to Warn / ethics*
  • Duty to Warn / psychology
  • Ethics, Medical
  • Humans
  • Moral Obligations
  • Physician's Role / psychology*
  • Physician-Patient Relations / ethics*
  • Social Justice
  • Truth Disclosure / ethics*