Confidentiality and Privilege

Confidentiality is a primary ethical obligation that physicians have to their patients, and it is critical to safeguard confidentiality when possible out of respect to the patient’s autonomy and right to privacy. The case of Jaffee v. Redmond provided an important legal precedent affirming the value of protecting patient privacy through recognizing the societal benefit of psychotherapist-patient privilege, and the legal protection of communications between two individuals from disclosure in court. Common exceptions to confidentiality include obtaining informed consent, communicating a threat to the patient or third party, complying with mandatory reporting duties (such as in the case of abuse or neglect of vulnerable populations), complying with a court order, and providing continued treatment. Legal obligations to patient confidentiality stem from the Health Insurance Portability and Accountability Act (HIPAA), state law, and institutional policy, which can vary widely and thus necessitate becoming familiar with state law and facility/organizational policy where one practices.