Association of American Physicians and Surgeons (APS). Physician Oaths [Internet]. 2016. http// (cited 2017 Oct 20)

Edelstein L. The Hippocratic Oath.: Hopkins Press; 1943

Confidentiality - guide for registrants. 2012;

HPC vs. Harling. HPC. 2009. http//

Jackson E. Medical law: text, cases and materials.: Oxford University Press; 2013

Johns Hopkins Library. Hippocratic Oath: Modern Version [Internet]. 2016. http// (cited 2017 Oct 20)

Nicholas N. Risk Management: Confidentiality, disclosure and access to medical records. The Obstetrician & Gynaecologist. 2007; 9

Percival T. Percival’s Medical Ethics.: Trieste; 2017

World Medical Association (WMA). Declaration of Geneva [Internet]. 1948. http// (cited 2017 Oct 20)

Z v Finland. European Human Rights Report. 1997; 25

Does precedence trump in the origins of confidentiality?

02 December 2017
Volume 9 · Issue 12


Good clinical practice has to be entwined with good ethical practice. Therefore, it follows that the clinical acumen of a modern paramedic develops at the same rate as their moral and ethical practice. As a newer profession, paramedics have relied on rules and codes from others to help maintain this balance, but their ancient and basic structure fails to address the nuances of modern practice. The paramedic profession has required a heuristic approach, as well as relying on the precedent of modern laws and codes, to underpin practice while simultaneously recognising the limitations of oath-based principles. This response has been necessary to address the increasingly complex and complicated situations paramedics encounter in their clinical environment.

While confidentiality and ethics hold a key position within modern paramedic practice, they are not new phenomena. As an embryonic profession, paramedics turned to medical colleagues who recall the Hippocratic Oath as a source in which the principle meaning of medical confidentiality can be traced back some 2500 years (Edelstein, 1943).

The Oath, in its original form, provided a rough code of ethical practice for early physicians. This included a duty to:

With regards to confidentiality, the Oath states:

‘All that may come to my knowledge in the exercise of my profession or outside of my profession or in daily commerce with men, which ought not to be spread abroad, I will keep secret and will never reveal’ (Association of American Physicians and Surgeons (AAPC), 2016).

It is interesting that the Oath deals with privacy, as the modern paramedic is well-versed in the need to protect patient privacy, and subsequently protect themselves. The Health and Care Professions Council (HCPC) (2012) gives clear directions on the standards expected. It would seem that there is an affinity between the Oath and modern guidance on confidentiality: both seek to maintain privacy on the basis that this protects patient welfare. However, the Oath came before modern confidentiality guidance; therefore, it must be the foundation for its existence.

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