What are the Different Types of Confidentiality Guidelines?

P. Schroeder

There are several types of confidentiality guidelines. There are those that set the basis for doctor-patient, attorney-client and religious official-confessor relationships. Confidentiality agreements, nondisclosure agreements and the confidentiality of school records are other areas regulated by confidentiality guidelines. In addition, there can be national and local confidentiality guidelines that protect the confidentiality of things such as drug and alcohol treatment information and information regarding human immunodeficiency virus (HIV) and immunizations.

Doctor-patient confidentiality can be traced to Hippocrates.
Doctor-patient confidentiality can be traced to Hippocrates.

In the medical area, there are very strict confidentiality guidelines. There is doctor-patient confidentiality, which has its roots in the laws of Hippocrates; and doctor-patient privilege, a legal concept that gives doctors the right to withhold evidence and refuse to disclose information regarding their patient. Confidentiality of this type is based on the premise that patients should be able to share information about their conditions without fearing that it will be disclosed to others. There are a few exceptions to this rule, including when the safety of others is at risk. Confidentiality guidelines typically continue to apply even after the person is no longer a patient of that doctor.

There are strict confidentiality guidelines that govern psychiatrists and other medical professionals.
There are strict confidentiality guidelines that govern psychiatrists and other medical professionals.

Some laws, such as the Health Insurance Portability and Accountability Act of 1996 in the United States, protect medical information of all kinds from disclosure. Violations carry substantial civil and criminal penalties. There also are laws that protect the privacy rights of people who have HIV and those who seek alcohol or drug treatment. In many other countries, there are confidentiality guidelines that protect the health records of patients.

Attorney-client confidentiality, like that between the patient and doctor, is very strict and includes both confidentiality and privilege. In general, in the absence of the client’s consent, the lawyer must not reveal information regarding his or her representation. This extends to all information discussed with the lawyer. A violation can lead to disciplinary action from a regulatory body that oversees legal practices.

The attorney-client privilege comes from common law and the laws of each jurisdiction. It protects from disclosure any information given to the lawyer pertaining to the case at hand. There are a few exceptions to this rule that dictate when a lawyer has some obligation to report to authorities, including when there is a credible threat against another individual. Confidentiality generally ends with the death of the client.

The confidentiality guidelines for the relationship between a religious official and confessor are similar to both physician-patient and attorney-client confidentiality. Furthermore, that confidentiality typically is forever, even if the person confesses to murder. Even in religious canons, however, there often is a loophole when another person’s life is in danger from molestation or death. The religious official might repeat the confession to his superior, and that person might decide whether to disclose the information.

Some of the other confidentiality guidelines, including those pertaining to nondisclosure agreements and school records, are much more open to interpretation. Nondisclosure agreements can be used in many instances, but most often, they are utilized to protect a business interest where one or both parties are receiving confidential information that cannot be shared with others. The validity of this nondisclosure agreement depends heavily on the location where the agreement is in force. Furthermore, these agreements, most often depending on the length of time they are intended to exist, have been argued against successfully in court.

Another area of confidentiality has to do with school and student records. There are several privacy issues raised in the school arena, and the laws typically ensure that parents have access to their children’s records, and that the confidentiality of those records remains in place without the parent’s express consent. Records, however, can be disclosed to other school officials without consent. Students also are often able to see each other's test results or even grade each other's tests under the direction of a teacher.

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