challenges of confidentiality in clinical settings: compilation of an ethical guideline

Background: respecting patients confidentiality and privacy are considered as the patients’ rights. confidentiality is the key virtue for trust building in physician-patient relationship. while law considers confidentiality as absolute except for legal situations, despite efforts to maintaining confidentiality, sometimes breaching confidentiality is unavoidable but not necessarily unethical. there is no iranian unified ethical guideline to define clear approaches to patient confidentiality in clinical setting. to keep all medical data confidential it is necessary to identify the scope of the problem. in this study, we aimed at identifying the scope of the problem. methods: this study was conducted in three phases including literature review, qualitative study (semi-structured interview) and focus group discussion. the literature review provided a framework for the second phase. results: the content analysis of the interviews presented 3 main themes indicating problems in maintaining confidentiality in clinical setting including management issues, organizational ethics and physician-patient relationship. conclusion: based on the results a draft guideline in confidentiality in clinical setting was prepared and final-ized in focus groups discussions.