Is It Really Confidential?

“It’s Confidential”      

 “Please refrain from talking about…”

“Please be sensitive to others by not discussing….”

“I really cannot answer that question.”             

“I can’t comment”

“You shouldn’t ask those sorts of questions…….you know it’s confidential” 

     Haven’t we all heard things like this?  At work, church, school, organizations with which we are involved, and probably a myriad of other places too.

     Most of the time this isn’t a big deal.  It’s not said with any malice.  It is often a statement of fact and that is the end of it.  However, there are other times when being told something is “confidential” or being told to “refrain from speaking about…” leaves one with an uncomfortable sensation in the gut.  Although I might not be able to articulate exactly what is causing my intestinal distress, I know “something” just isn’t  quite right.  But, what is it?  I have only recently started to gain headway in sorting it out.

      A recent experience in which I was told that I “should refrain from discussing…” has helped me come to some conclusions about why one situation makes me feel disgusting and ashamed and another does not.  So, please bear with me as I try to sort this out in written form.

      In one situation, statements as those above communicate a need to keep something private and are said with no shame in the declaration and no shame or embarrassment made on the person doing the asking.  The statement is just a fact; I can’t talk about it.  I have no need to judge the reason for the question or request and I know exactly who, what, and why the information is being protected and that is easily stated.  If this conversation happens in person,  I can easily look the person in the face, smile, answer honestly, and if possible or appropriate, even engage in small pleasantries with the person doing the asking.  Further, if there is any possible remedy to the situation, it is generally easily visible.  It’s simple.  No shame. No embarrassment. No coercion.  Annoyance is possible,  but even that is generally self-limited.  What does this type of situation look like?  Let me give you an example.

      I am the nurse on duty at the hospital.  I answer the phone at the nurses’ desk and  a man identifies himself as Don Jones .  He tells me that he is calling to check on his friend Bob Smith.   Don asks how Bob is doing.  I don’t have to judge the reason why Don is calling and asking because it doesn’t really matter.  I can’t tell Don anything about Bob.  But, I also have no reason to make Don feel badly that he has called to check on his friend.  In fact, I can easily try to make Don feel better by empathizing with him that he cares about his friend and that I have no reason to judge his intentions.       I can simply and kindly say something like, “Oh, I’m so sorry, but I can’t tell you about Bob’s condition. [initial refusal]. The patient confidentiality rules and HIPPA laws prevent me from giving out patient information to people unless specifically authorized by the patient. [Simple, honest, reasonable, well-known reason.  There is no shaming of Bob involved.  Bob could ask the same question as many times as he wants, my answer will remain the same.].  But, I can connect you to Bob’s room and you can speak to him directly about how he is doing. Please hold. [Possible remedy to situation].

      But, let me give you another possible made-up example of the other kind of confidentiality.

      An employee at my child’s daycare has been placed on a leave of absence with no reason given to explain why.  Is he ill?  Misconduct?  Did his mother die?  What?

     Of course, the leave of absence with no explanation leads to many questions as this daycare provider was well-liked and engaged with many of the children.  So, people start asking questions—-of other parents, of other caregivers, of ancillary staff,  administration.   “Where is George? What is wrong with George?  Will George be returning?  My child is asking about George. What should I tell him/her?”

      Eventually, these questions will be asked of someone who knows something about the situation with George.  When I ask this person, he/she won’t quite look at my face.  The person may abruptly change the subject making as if I just asked who passed the malodorous flatulence thus pretending to save me from embarrassment, but rather it leaves me feeling very embarrassed.  What did I do wrong?  When I ask again regarding George, no matter what the question asked actually  is, eventually the response will be given with a blank facial expression and little eye contact  and will go something like this:  “This is a confidential matter.  I can’t talk about it.  Please refrain from discussing it any further for anyone.”

   Such an answer is given with no effort at connecting with the person asking the question, the answer lacks a full degree of reasonableness, few, if any, reasons are given, and it leaves the person asking the question baffled, embarrassed, sometimes feeling chastised or degraded, or even fearful  for asking a simple question.  It is clear that the person answering the question has judged quite harshly the reason why the question is being asked.  There is no possible remedy given.

     What??!!  What rules say the information cannot be shared?  Can you tell me a law?  Why??  Why am I being shamed for asking?  Why is there no empathy for the reason why the question is being asked?  Why am I being given a coercive directive about what I can ask in the future?  Why is a simple question being judged as “discussing?”  Why is it necessary to place yourself in an artificial position of greater power?  What specifically is confidential???  Why is the assumption that my intent is malicious?  Why is there no possible remedy?  Why am I being told who and about what I can talk with in the future?  The person asking walks away feeling very icky.

       And most importantly, who or what is the intention of the protection???

    To me, I think the biggest differences between the two situations are the motives for refusal to answer and the clarity (or lack of clarity) of who and what is supposedly being protected.  The more I am unable to figure out these two points and the ‘ickier’ the pit of my stomach feels, the more sure I am that the reason I am being told something is confidential or should not be talked about is as malodorous as post-baked-bean flatulence.  And, as such, what might have been asked as a simple and innocent question now becomes something I really want to know.  Now, there are so many more important questions to ask:  Why don’t you want me to know?  Why can’t you give me a rule/law/policy regarding why you can’t answer?  Why won’t you look at me?  Why do you have to puff yourself up into an air of authority which may or may not be real?  Why is there no possible remedy?  Why can’t you tell me exactly who and what is being protected?  What makes you think you can tell me who I can talk with in the future and about what topics??

    For me, the conclusion is:  You are protecting yourself because you are doing something wrong.  Period.  That’s my metric.  If you give me no other ruler to use, then you measure out a devious,  dishonest , and potentially dangerous person.  I now have become the witness to an injustice, until proven otherwise, and I will not remain silent.   Now, the only remedy I see as acceptable is the full light of day on the situation.

* All names and situations are fictional.