The problem

Professional codes of ethics standardly contain the expectation of confidentiality. The following plain and concise statements from the General Medical Council can well serve as a working definition of the principle as it applies in all the personal service professions (GMC, 2000):

The familiar core principle of confidentiality is well elaborated in the literature (for example, Beauchamp and Childress, 1994; Clark, 1995) and its import will therefore be taken for granted in the following discussion.

Professional codes also contain at least an implied expectation that professionals will tell the truth. Typically this is much more indirectly and less clearly expressed than the expectation of confidentiality. The following are representative discussions of the expectation of honesty or truth-telling.

From the field of medicine, Beauchamp and Childress (1994, p 307) comment that: ‘Surprisingly, codes of medical ethics generally ignore rules of veracity’, explaining the concept ‘veracity, an obligation to tell the truth and not to lie or deceive others’. They propose three arguments for rules of veracity in relationships between healthcare professionals and patients: that veracity is part of the respect we owe others; that it follows from the obligation to keep promises; and that it is necessary for fruitful interaction and cooperation. But they note that ‘nondisclosure, deception and lying will occasionally be justified when veracity conflicts with other obligations’ (p 309).