Confidentiality in sports medicine

This article synthesizes existing literature to provide a comprehensive summary of the ethical issues related to patient confidentiality in sport. It consists of four parts. The first outlines the medical ethical principle of confidentiality and identifies cross-cultural ethico-legal variations which shape its implementation. The second explores four factors specific to the context of sport which shape the application of patient confidentiality, namely: clinicians multiple obligations, physical environment and practice and policy context. The third reviews research detailing real life experiences of maintaining patient confidentiality in sport, and the fourth summarizes the many policy recommendations that have been made for enabling and enhancing compliance with this ethical principle. It is argued that the context of sport exacerbates pressures on clinicians to break patient confidentiality, breaches therefore occur relatively regularly, and interventions are required to enhance ethical compliance in sports medicine.