Why protect confidentiality in health records? A review of research evidence

We present the main arguments for protecting the confidentiality of health services, along with those for limiting confidentiality. These arguments are then substantiated by reference to research evidence. There is evidence that access to health care is restricted if confidentiality is not promised to some groups of patients. Fear of disclosure does diminish patients' candour, and this can compromise the quality of care. While patients are concerned about confidentiality and some are harmed by 'leaks' from health services, most people in Australia still trust health providers to keep their secrets, and patients rarely become aware of a breach of confidence. It has been claimed that strict protection of confidentiality may obstruct the pursuit of medical research and the use of electronic medical records. There is, as yet, no evidence that gaining full benefit from the use of electronic medical records entails reduced protection for confidentiality. The losses to epidemiological research if patient consent were always required are hotly debated. Confidentiality should be protected because it protects patients from harm, supports access to health care and produces better health outcomes.