Confidentiality, 'no blame culture' and whistleblowing, non-physician practice and accountability

Confidentiality is a core tenet of medical professionalism, which enables the maintenance of trust in a doctor-patient relationship. However, both the amount of personal data stored and the number of third parties who might access this data have increased dramatically in the digital age, necessitating the introduction of various national data protection acts. Paradoxically, the Freedom of Information Act 2000 allows United Kingdom citizens to access information held by public bodies, including hospitals. Furthermore, the Public Interest Disclosure Act 1998 actively protects physicians who breach their duty of confidentiality in the name of public interest ('whistleblowing'). This article explores the evolution of the law and ethics in this area, and draws attention to the difficulties in balancing confidentiality against freedom of information. In addition, the role and responsibilities of the non-physician anaesthetist are examined.