Privacy and confidentiality are fundamental concepts in law, philosophy, anthropology, political theory, medicine, health and social welfare. They are also culture-specific, complex and problematic concepts in both theory and professional practice. Confidentiality is regarded as a central tenet of practice for medical, health, social work and other professionals in the health and personal social services. These professionals handle personal and often sensitive information obtained from the citizen as client, patient or service user. They do so with the primary intention of benefiting the individual's health and social welfare, and sometimes also with the aim of realising benefits for the wider society. Citizens have both legal and moral rights to assume that the information they disclose will not be shared without their consent; and where consent is given, that information shared will be limited in scope and restricted to personnel with relevant reasons for holding it.

Professional codes of ethics provide guidance and generally set out the basic principle of confidentiality. The legal framework (primarily encompassing the 1998 Data Protection Act, common law and the 1998 Human Rights Act) and administrative protocols provide for the further regulation of the management of personal information. Codes of ethics and the law do provide for situations where confidential information may justifiably be shared without consent. In daily practice applying professional codes and legislation is often fraught with these complex decisions, some of which may pose serious threats either to the rights of citizens or to the welfare of vulnerable individuals. There is a complex balance: central to decision making are questions of proportionality and necessity and how to balance legitimate public interest with rights to privacy.

Policy, organisational, legal and technological developments in health and social services provide a further set of complex challenges. The increasing emphasis on interprofessional and interagency working that policy requires for effective, ‘joined-up’ services presents new issues and dilemmas in preserving citizens’ rights to confidentiality and privacy. In the context of the multidisciplinary team, citizens will consent to share information – but what are the limits on the nature and extent of the information shared and with whom, and how are these decisions best made? Where there are issues of individual capacity or understanding, what is the best way for these to be resolved to the benefit of the citizen?