Care is the embodiment of reverence. As providers of care, we put as much an emphasis on our posture before the other person as we do any of the practical skills we bring to our profession. Now it is not simply trust at the core of relationships, but a sacred trust. Secondly, this reverence for the other in our relationships is governed by an ethic of prudence. Prudence implies the wisdom in making judgments.
Confidentiality puts boundaries around that trust.
Ordinarily the presumption is that what is shared in a relationship, especially one that is bound by confidentiality, remains in the context of that relationship. The notable exceptions are around the care taken that no one be placed in harm's way, either to oneself or to another person. So serious is this issue of harm that society has codified this in legal reporting requirements, i.e., threats of suicide, homicide or abuse. The difficulty comes when conflict arises around the sharing of information seen to be necessary for the good of the person. When sharing such information, we do so only as necessary.