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Confidentiality and Your Physician Patients share personal information with their physician(s). You have a right that the physician will keep this information private. This requires the physician to respect the patient's privacy by restricting access of others to that information. Furthermore, creating a trusting environment by respecting patient privacy can encourage the patient to be as honest as possible during the office visit. Confidentiality provides the foundation for the physician-patient relationship. In order to make accurate diagnoses and provide optimal treatment recommendations, the physician must have relevant information about the patient's illness or injury. This may require the discussion of sensitive information, which would be embarrassing or harmful if it were known to other persons. The promise of confidentiality permits the patient to trust that the information revealed to the physician will not be further spread. The expectation of confidentiality comes from the public oath which the physician has taken and from the accepted code of professional ethics. The physician's duty to maintain confidentiality extends from respect for the patient. The obligation of confidentiality both prohibits the physician from disclosing information about the patient's case to other interested parties and encourages the physician to take precautions with the information to ensure that only authorized access occurs. In the course of treating patients, the physician will find exchanging information about his(her) patients with other physicians. These discussions are often critical for patient care and are an important part in the learning process of a teaching facility. As such, they are justifiable so long as precautions are taken to the limit for the ability of others to hear or see confidential information. Computerized patient records pose new and unique challenges to confidentiality. The physician must follow prescribed procedures for computer access and security as an added measure to protect the patient information. While there may be cases where the physician feels compelled to share information regarding the patient's health and prognosis with a family member, without unequivocal permission (such as a Durable Power of Attorney for HealthCare) from the patient, it is generally unjustifiable to do so. Except in cases where the patient is at specific risk of harm directly related to the diagnosis, it remains the patient's rather than the physician's obligation to inform the family member. Ethics in Medicine: University of Washington School of Medicine Kelly A. Edwards, MA MaryJo Ludwig, MD

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