Client Confidentiality: Ethical Issues in Occupational Therapy

Abstract

Confidentiality is a central ethical concern in occupational therapy practice and one that is emphasised in professional codes of ethics. This article examines the conceptual and moral basis of confidentiality, and relates it to the fundamental ethical principles of respect for autonomy, respect for persons and non-maleficence. The moral conflicts that may arise between the requirement of confidentiality on the one hand, and the need to safeguard the interests and welfare of others on the other hand, are explored with reference to the Tarasoff case. Both consequentialist (outcome-based) and deontological (duty-based) perspectives are examined. It is argued that confidentiality should be given a special status within the client-therapist relationship and, up to a certain critical threshold, should be protected from considerations of general welfare. It is argued that, whilst confidentiality may on occasions be breached in the interests of others, it Is rarely permissible to do so in the client's own Interest. In conclusion, occupational therapists are urged to give a high regard to confidentiality and to cultivate the virtue of discretion in their professional practice.