Confidentiality: Doing Good, Avoiding Harm, and Maintaining Trust
Pamela A. Daniel Karen Strohm Kitchener
Consider the following scenarios: (a) Two friends are engrossed in conversation when one prefaces her remarks to the other with "Remember, this is strictly confidential" and proceeds to discuss a private matter and (b) a letter, marked "confidential," arrives at the mail room of a large corporation and is automatically opened and forwarded to the addressee. These incidents exemplify the vernacular usage of the term confidential. Given its various popular meanings, it is important that psychologists understand its professional meaning and implications.
Confidentiality is related to, but distinct from, the concept of privacy; both concepts are addressed in the "Ethical Principles of Psychologists and Code of Conduct" ( APA, 1992). Privacy concerns individuals and their right to control "access of others to themselves . . . and to information about them" ( Sieber, 1992, pp. 44-45). The right to privacy derives generally from the principle of autonomy, but in the United States the legal right is derived from the Constitution ( Everstine et al., 1980).
Ordinarily, privacy is a broader concept than confidentiality, limiting governmental, as well as individual, intrusion into aspects of life that might be considered personal. On the other hand, the legal scope of that right is quite narrow, and it is doubtful that it would legally protect access to information shared in a professional relationship ( Smith-Bell & Winslade, 1994). The APA ( 1992) ethics code upholds the concept of privacy by requiring that written or oral client, subject, or student information be