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Coggon J, Wheeler R. Ann R Coll Surg Engl 2010; 92: 113–117

Confidentiality is founded on 'the need for “reciprocal confidence”, if intimate information is to be shared'. It is applicable universally. For example, the authors cite a past injunction against a national newspaper from naming an HIV-positive dentist. Although this ruling 'inhibit(ed) a legitimate public debate over the ability or otherwise of HIV-positive dentists to continue in practice', it would have transgressed private information. When practitioners are confronted with dilemmas associated with patient confidentiality, a pragmatic approach would be 'proportionate disclosures on the basis of an obligation'. This is particularly relevant when violent crime has been perpetrated. Alternatively, permission could be sought from 'who(m) may be empowered to provide it (the patient)'. If there is an impasse, advice should be sought from the local Clinical Ethics Committee.