Medical Ethics: Implications of a Confidentiality Breach

Breach of Confidentiality: Ethical Implications

As a rule, a breach of confidentiality entails a range of ethical issues for both the patient and the therapist. The breach of the Hippocratic Oath, which the therapist took as they started their practice, as well as the violation of the patient’s right to secrecy of their private data, can be viewed from a number of ethical standpoints, yet each of the ethical theories applied will reveal the fault of the therapist and, therefore, require that the latter should acknowledge their responsibility for the issue.

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Ethical Theories and Key Ethical Principles

Considering the phenomenon of confidentiality from the tenets of the Kantian theory, one must admit that the disclosure of the patient’s personal information does not align with the key principle of the aforementioned theory, i.e., the Categorical Imperative, as, according to the latter, a command derived from a particular principle, the Hippocratic Oath in the specified case, does not allow exceptions (McWay, 2009, p. 404). At this point., such an ethical principle as beneficence must be mentioned. By disregarding the basic concept of the Kantian theory, a therapist violates the ethical principle of beneficence by neglecting the concept mentioned above of the Categorical Imperative, which presupposes that no action taken by a person must harm or threaten another person in any way possible (Drane, 1994).

As far as the “no harm” principle is concerned, the key Utilitarianism tenets have also obviously been violated, since the disclosure of the patient’s personal data presupposes significant drop insecurity rates. Likewise, from the position of respect for the patient’s autonomy, the specified issue cannot be considered a legitimate step for a healthcare specialist to make. It is essential that the latter should recognize the patient’s right to be independent in their decision to keep specific information private, i.e., to share such information solely with the therapist. The latter, in their turn, must maintain the patient’s personal data secret unless demanded otherwise by the patient. More to the point, by enhancing the patient’s autonomy, the therapist is capable of creating an emotional link with the latter, which is crucial for a successful therapy, especially in cases when the patient-centered approach (Rogerian therapy) has been chosen (Elliott, Watson, Greenberg, Timulak & Freire, 2013). At this point, it will be reasonable to stress that, in a range of cases, the provision of autonomy for the patient leads to the development of emotional intelligence in them (Essl, 2012); an essential tool for helping the patient embrace the necessity for the intervention, as well as acknowledge the existence of the problem that they are facing, EI is linked directly to the amount of trust that the therapist puts into the patient and, therefore, the extent, to which the patient is provided with autonomy.

The last, but not the least, the concept of justice must be viewed to address the issue of the patient’s personal data disclosure. According to the key principles of the Justice Ethics and the key tenets of bioethics, the privacy of the patient’s personal data is identified as the basic right of the latter and, therefore, must be maintained at all costs unless the life of the patient is endangered (Prainsack & Buyx, 2011).

Alternative Framework for Accessing the Dilemma

It could be argued, though, that the positive effects of the information leakage should also be taken into account in a case in point. Particularly, the situations in which the involvement of the third party into the therapy process is imperative should be considered. According to the existing evidence, sharing of the patient’s personal data may also be viewed as the necessary step when choosing between the lesser evil or preventing a specific negative outcome from taking place: “A utilitarian calculus is also involved in situations where disclosure of confidential information is contemplated in order to protect the third party from harm” (Jones, 2003, p. 348). Therefore, it can be argued that in the situations, where the disclosure of the patient’s personal data prevents a more drastic outcome, information leakage can be justified from an ethical standpoint.

Ethics Committee and Collaborative Approach

To address the emerging ethical issues, it is necessary to be able to evaluate the problem from several aspects of healthcare ethics, which is only possible once several competent healthcare staff members are employed into the analysis. Therefore, the need for the ethics committee to be designed appears. By adopting different viewpoints and analyzing a case in point from several ethical angles, the members of the committee will be able to pass their verdict and define the level of responsibility, which the therapist may have in the case of the disclosure of the patient’s personal data. Considering the factors affecting the therapist’s decision, as well as the circumstances, in which the choice was made and the reasons, which the therapist was guided by when disclosing the patient’s personal data to the third party, the committee will be able to figure out whether the therapist is to be blamed for the information leakage or whether the steps taken were an adequate solution to the situation.

Reference List

Drane, J. F. (1994). Clinical bioethics: Theory and practice in medical ethical decision-making. Kansas City, MO: Rowman & Littlefield.

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Elliott, R., Watson, J., Greenberg, L. S., Timulak, L., & Freire, E. (2013). Research on humanistic-experiential psychotherapies. In M. J. Lambert (Ed.), Bergin & Garfield‘s Handbook of psychotherapy and behavior change (6th ed.) (pp. 495-538). New York, NY: Wiley.

Essl, B. (2012). Homeopathy as a model for patient-centered medical care. Existenz, 6(1), para. 1–25. Web.

Jones, C. (2003). The utilitarian argument for medical confidentiality: A pilot study of patients’ views. The Journal of Medical Ethics, 29(6), 348–352.

McWay, D. (2009). Legal and ethical aspects of health information management. Clifton Park, NY: Delmar.

Prainsack, B. & Buyx, A. (2011). Solidarity: Reflections on an emerging concept in bioethics. Swindon, UK: Nuffield Council on Bioethics.

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