There are a number of reasons why a person may not disclose significant risk factors or even lie about them. An important reason for keeping information confidential is to encourage people to disclose sensitive information that could impact their care.
A person may not want to disclose:
(1) smoking history
(2) alcohol use
(3) drug abuse
(4) criminal behavior
(5) past criminal record
(6) sexually-transmitted disease
(7) other infections associated with stigma
(8) non-compliance
(9) drug diversion
(10) deviant behaviors
(11) an abortion
(12) any behavior forbidden in society
A number of problems can arise by failing to disclose this information. For example, a person may go into withdrawal following surgery. Or non-compliance may be interpreted as drug-resistance. Or other people at risk may not be detected early.
An important skill for a clinician is to be able to suspect that something is being withheld and to be able to elicit the information. This may require a degree of trust and respect from the patient.
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