Abstract The fundamental principle of confidentiality is that information held for a certain objective may not be given without consent to a third party. Ethics codes and law recognize the mental health client right to confidentiality; however, there are exceptions and controversies. The aim of this thesis is to review in brief these ethical and legal commitments and give a case example on one issue on confidentiality in a mental health setting. Introduction Confidentiality is a commitment that restrains a body (psychologist, healthcare provider, or organization) from revealing information against the interest of the individual or body who gave it first. The fundamental principle of confidentiality is that information held for a certain objective may not be given without consent to a third party. Confidentiality is important to achieve the trust needed for the therapeutic bond between a client and a healthcare provider. Based on this definition, confidentiality is a commitment of a person towards another, while privacy is the information a person wants to keep and not to disclose to anyone else (New South Wales Consumer Advisory Group-Mental Health, 2004). Ethical and legal confidentiality commitments in mental health The Oath of Hippocrates states confidentiality, a principal confirmed by the UN Geneva Declaration in 1948. Ethically, confidentiality has two perspectives, the professional viewpoint, as it is an immediate precondition to ensure patient’s cooperation. Second is the duty viewpoint, since healthcare providers give a promise of confidentiality, either clearly or unspoken (implied), it is their duty to keep the promise. As the social scope is wider with competitive moral commitments; some suggest limits to confidentiality in one of two states of affairs, to achieve the patient’s best interest (rule of beneficence). Some suggest breaking confidentiality to achieve a public interest (rule of justice). In this state the question of decision making of what is in the best interest of the public is ambiguous (McClelland, and Thomas, 2002). The report of the US Surgeon General (2000) summarized the confidentiality legal dilemma. It stated that law can either expand or submit confidentiality to the rule of beneficence or rule of justice. The US Supreme Court extended the principle of confidentiality based on providing psychotherapists with the best conditions to build trust and treat their patients is concisely in the public interest (psychotherapeutic privilege principle). On the other hand, states’ laws may differ as it is with the California Supreme Court ruling that psychotherapists had a commitment to protect third parties. There are areas of wider controversies especially with adolescents with alcohol or drug abuse combined with psychological problems. The report concluded that confidentiality is not absolute. This shows the importance of extending the discussions on the rules of beneficence and justice (US Department of Health and Human Services, Surgeon General Report, 2000). The ambiguity of breaking confidentiality: An example case The law recognizes the right of youth to make a decision about medical consultation (autonomy), and grants confidentiality in healthcare-related to them. Sanci and others (2005