CONFIDENTIALITY

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CONFIDENTIALITY

• GUARDIAN OF
• PRIVACY AND DIGNITY

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POSITIONING CONFIDENTIALITYMAINTAINING RESPECT
FOR PERSONS

• PHENOMENOLOGY
• FOUNDATIONAL CHARACTERISTICS OF INDIVIDUAL
• VIRTUES
• ACTION EXPRESSION OF PHENOMENOLOGY
• DIGNITY
• SUM OF PHENOMENOLOGY
• AUTONOMY
• DECISIONAL OPERATION OF PHENOMENOLOGY
• CONFIDENTIALITY
• CLOAK OF PROTECTION FOR PHENOMENOLOGY

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REASON FOR CONFIDENTIALITY

• DERIVES FROM THE INDIVIDUALS RIGHT, FLOWING FROM
  AUTONOMY, TO CONTROL PERSONAL INFORMATION AND TO
  PROTECT PRIVACY
• DISCRIMINATION
• DEPRIVATION OF RIGHTS
• PHYSICAL EMOTIONAL HARM
• SPECIAL MORAL RELATIONSHIP BETWEEN CAREGIVERS AND
  PATIENTS
• REQUIREMENT TO REVEAL INTIMATE PERSONAL SECRETS
• PHYSICIANS DUTY OF FIDELITY
• TACIT PROMISE OF CONFIDENTIALITY
• WITHOUT CONFIDENTIALITY NECESSARY HELP MAY NOT BE
  SOUGHT

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PROTECTION OF PRIVACYPRIVATE KINDS OF THINGS

• MATTERS OF SEXUALITY
• INCOME
• HOME PHONE
• PARTICULAR HUMAN WEAKNESS
• FEARS
• VICTIM OF DISEASE
• VICTIM OF A PARTICULAR DISEASE
• PARTICULAR SYMPTOMS OF A DISEASE
• PARTICULAR RESPONSES TO A DISEASE

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PROTECTION OF PRIVACYRIGHTS AS PROTECTIONS

• RIGHTS
• ALLOW US TO PROTECT OUR INTEREST IN MATTERS (AND
  VALUES) WHICH ARE OF CENTRAL IMPORTANCE TO THE
  CONDUCT OF OUR LIVES.
• IMPOSE DUTIES ON AN IDENTIFIABLE OTHER TO ACT OR
  FOREBEAR IN WAYS WHICH WILL ADVANCE THE INTERESTS
  EMBODIED IN THE RIGHT
• RIGHT TO PRIVACY
• ESTABLISHES CONTROL FOR PATIENT
• PROTECTS PATIENTS SENSE OF SELF
• PROTECTS PATIENT FROM UNWARRENTED REVELATIONS

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REASONS FOR DISCLOSURE

• PRIMA FACIE DUTY TO RESPECT CONFIDENTIALITY
  WHICH MAY BE OUTWEIGHED BY OTHER, MORE PRESSING
  DUTIES
• WHEN TO DISCLOSE
• MINOR CHILD OR INCOMPETENT PATIENT WHO MIGHT BE
  HARMED
• THREATS OF VIOLENCE AGAINST IDENTIFIABLE THIRD
  PARTIES
• CONTAGIOUS SEXUALLY TRANSMITTED DISEASES
• AIDS IS EXCEPTED

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JUSTIFICATIONS FOR DISCLOSUREOPERATIVE PRINCIPLES

• DISCLOSURE WHEN THE HARM PREVENTED BY THE
  DISCLOSURE WOULD OUTWEIGH THE BENEFITS OF KEEPING
  THE CONFIDENCE
• HARM PRINCIPLE
• ONE SHOULD ACT IN SUCH A WAY AS TO REFRAIN FROM
  IMPOSING HARM ON ANOTHER
• VULNERABILITY PRINCIPLE
• ONE SHOULD PROTECT THOSE WHO ARE SPECIALLY
  DEPENDENT UPON OTHERS OR IN SOME WAY ARE
  SPECIALLY VULNERABLE TO THE CHOICES OR ACTIONS OF
  OTHERS

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POSSIBLY MORALLY RELEVANT DIFFERENCES RELATED TO
CONFIDENTIALITY

• NEED TO KNOW
• MAKE DECISIONS REGARDING THERAPY
• ADMINISTER APPROPRIATE THERAPY
• ENGAGE IN PROTECTIVE/PREVENTIVE ACTIONS
• CONCERN
• FAMILY MEMBER
• FRIEND
• EMPLOYER
• CO-WORKER
• CURIOSITY
• CELEBRITY
• NEIGHBOR

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THREATS TO CONFIDENTIALITY

• INSTITUTIONALIZATION OF MEDICINE
• TEAM APPROACH TO INTERDISCIPLINARY THERAPY
• THIRD PARTY PAYERS
• PUBLIC FUNDING
• RESOURCE ALLOCATION DECISIONS
• CURIOSITY