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Education And Debate

Confidentiality may be overvalued

BMJ 1998; 316 doi: (Published 03 January 1998) Cite this as: BMJ 1998;316:56
  1. Anthony S Kessel, medical philosopher and public health physiciana (
  1. a Epidemiology Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT
  1. Correspondence to: 57a Woodland Rise London N10 3UN

    With a disturbingly high prevalence of physical and sexual abuse in the community, it is not uncommon for doctors to become involved in situations of the kind described. Here, the paediatrician has presented two possible courses of action—to report the matter, thereby breaching confidentiality, or to maintain confidentiality by not disclosing the incident.

    Legally, either option is defensible. This is reflected in the General Medical Council's guidelines.1 These advise that confidentiality should be respected, but that disclosure “may be necessary in the public interest where a failure to disclose information may expose the patient, or others, to risk of death or serious harm.” Information should then be …

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