It is at this point that Hathaway faces her ethical dilemma. It is important to explore the background of confidentiality policies, and reasons why confidentiality can be broken, in order to determine what course of action Hathaway should take. Confidentiality is a very old concept, reaching back even to the Hippocratic oath. In order for medicine to be practiced and for therapy to be effective, patients must trust in the confidential nature of the information revealed during an examination. Respect for the individual patient should lead to respect for confidentiality.
Breaches of confidentiality are disrespectful of individual privacy and autonomy rights.
Fidelity of the physician-patient relationship requires respect for confidentiality. When patients enter into a relationship with a medical professional, an implied promise of confidentiality is made. The physician has an obligation to live up to the patient's expectations of privacy and to earn the patient's trust. While each of these arguments make a strong case for maintaining confidentiality, there are cases where confidentiality may be broken, and in fact there are circumstances where a physician has an obligation to break confidentiality. There are laws in the United States which require physicians to report certain infectious diseases to public health authorities, in order to protect the health of the community.