Under which circumstance may confidentiality be breached without consent?

• A. Duty to warn/protect or mandated reporting (e.g., abuse) or as required by law.
• B. Patient requests to share information with family
• C. Routine sharing of information with all staff
• D. When a nurse forgets to log a note

Answer: (A)

Confidentiality is maintained to protect a patient’s privacy, but there are times when disclosure without consent is legally and ethically required to prevent harm or meet legal obligations. The circumstance that fits this exception involves a duty to warn or protect potential victims and mandated reporting or as required by law. When there is a real threat to someone or when laws require reporting (such as abuse or other mandated disclosures), information may be shared without the patient’s permission to protect others and comply with the law.

Sharing with family at the patient’s request would require consent, not a breach without consent. Routine sharing of information with all staff is not appropriate unless there is a clear, legitimate need-to-know, and failing to log a note is a documentation issue rather than a breach of confidentiality.