THE LIMITS OF CONFIDENTIALITY

Two conditions are commonly taken to constitute an obligation of confi dentiality: information is entrusted by one person to another; and the re is an express understanding that this will not be divulged. This co nception of confidentiality, however, does not match much of the pract ice of health care. Health care practitioners-would, for example, hold themselves to be under an obligation of confidentiality in situations where neither of these conditions obtain. The-discussion proposes, th erefore, two additional grounds for confidentiality. This is in order to clarify, in general terms, the scope of this obligation (i.e. to cl arify at what point confidentiality can be said to have been broken). The 'limits of confidentiality', it is argued, are set by the wishes o f the client or, where these are not known, by reference to those whos e right and need to know relate to the care of the client. Anonymous r eferences to the client outside this limit may not be breaches of conf idence; whether they are or not depends, it is suggested, on if such r eference is responsible.