Practical responses to confidentiality dilemmas in elite sport medicine.

The authors conducted this study to explore the ethical challenges of maintaining patient confidentiality in sports medicine and the practical responses of clinicians to these challenges. For this purpose they used a questionnaire survey and follow-up semi-structured interviews with the members of the British Olympic Association’s Medical Committee and Physiotherapy Forum. Clinicians named three contextual factors that affected issues related to patient confidentiality in sports medicine: the use of confidentiality waivers; the facilities available for treatment; and the cultural norms of elite sport. They went on to identified interpersonal tactics used to lessen or eliminate conflicts, including emphasising the benefits and avoidance of disbenefits for athletes and the potential negative consequences for others.

The authors conclude that elements of clinicians’ practice environment should be designed to enable compliance with the highest degree of ethical conduct. They suggest that professional associations should set up guidelines for clinicians’ interpersonal conduct in dealing with confidentiality issues and consider their provision of ethics-based ongoing professional development. Finally, it is their assertion that these associations also need to petition for the establishment of athletes’ codes of conduct which identify a context-relevant understanding of ‘serious harm’ and how that might affect information disclosure.