title: Patient perspectives of medical confidentiality: a review of the literature.
abstract: OBJECTIVE
  To lay the groundwork for a better understanding of patient views on medical confidentiality.
  
  
  METHODS
  Studies were found by searching medline, bioethicsline, and selected bibliographies. Articles concerning physician perspectives or implications of legal and administrative regulations were excluded. Only peer-reviewed journal articles reporting original research on patients' confidentiality views and conduct were included.
  
  
  RESULTS
  Many patients are unaware of or misunderstand their legal or ethical right to medical confidentiality protections, which leads them to both over- and underestimate confidentiality protections. The possibility that medical information might be revealed, intentionally or not, to acquaintances in a clinic or other social community troubles patients as much as information release to insurers or employers. A significant minority of patients distrust confidentiality protections, leading some to report that they delay or forgo medical care. If doubtful that confidentiality will be upheld, patients will act independently to protect information.
  
  
  CONCLUSIONS
  Our review found a wider variety of understandings and beliefs about medical confidentiality among patients than are often indicated in the writings of practitioners or legal experts. As medical confidentiality regulations evolve, these differences need to be recognized and accounted for in interactions between practitioners and patients.
authors.affiliation: Center for Bioethics, University of Pennsylvania, Philadelphia, PA 19104-3308, USA. sankarp@mail.med.upenn.edu
authors.forename: Pamela
authors.initials: P
authors.lastname: Sankar
authors.forename: Susan
authors.initials: S
authors.lastname: Mora
authors.forename: Jon F
authors.initials: JF
authors.lastname: Merz
authors.forename: Nora L
authors.initials: NL
authors.lastname: Jones
mesh_terms: D001364:Awareness / Q000941:ethics; D032882:Comprehension / Q000941:ethics; D003219:Confidentiality / Q000941:ethics* / Q000523:psychology*; D026690:Ethics, Clinical; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000523:psychology*