Confidentiality in medicine: how far should doctors prioritise the confidentiality of the individual they are treating?

There is a premium placed on the maintenance of our privacy and confidentiality as individuals in society. For a productive and functional doctor-patient relationship, there needs to be a belief that details divulged in confidence to the doctor will be kept confidential and not disclosed to the wider public. However, where the information disclosed to the doctor could have implications for the safety of the wider public, for example disclosures with potential criminal implications, or have serious consequences for another individual, as is the case in genetic medicine, should doctors feel confident about breaching confidentiality? This essay firstly explores the legal rulings regarding cases in which confidentiality has been breached where there was risk of significant harm to others following the patient's disclosure, and secondly, focusing on the evolving legal position with regard to confidentiality in contexts where information sharing would be beneficial to others, for example the evolving case of the implications of genetic diagnosis on families (eg, ABC v St George's Healthcare NHS Trust; 2017). © Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.