THE CONFIDENTIALITY OF MEDICAL INFORMATION IN THE WORKPLACE

Ethical dilemmas involving confidentiality issues are frequently encou ntered in occupational medicine. The occupational physician faces a un ique challenge because in many circumstances, a physician-patient rela tionship, in the ordinary or legal sense, may not exist. The occupatio nal physician often faces a conflicting interest between the employee' s desire for privacy and the employer's legitimate need to Know. The o ccupational physician must carefully balance these interests for the b enefit of society and the parties involved. Occupational physicians al so work in a wide variety of practice situations, and the-ethical and legal duty of confidentiality may vary substantially with these roles. This article provides an overview of the ethical and legal requiremen ts of confidentiality in the workplace. The constitutional, statutory, and common law framework governing the treatment of employee medical information, as well as defenses to liability, are discussed. Recent l egislative changes such as the Americans with Disabilities Act, and ne w challenges such as the proper handling of HIV informations, present unique confidentiality problems.