Whatever Ought Not To Be Spoken Of Abroad: Formation (of Medical Students) and Information (of Patients)

Confidentiality has a pre-eminent status in the medical curriculum for ethics, law, and professionalism because it does not depend on prior clinical learning or scientific knowledge, and it provides students with the opportunity to engage in the work of self-formation in professional practice from the very beginning. The historical tendency to romanticise medical professionalism, and confidentiality in particular as a symbol for this, was able to thrive in previous eras as a result of uncertainty around the boundaries of disclosure. To some extent echoes of this romanticism can still be heard today in rhetorical appeals to the Hippocratic tradition despite the development of detailed clarification in frameworks of law, standards, codes, professional regulation, and guidance from the second half of the 20th century. This paper considers two iconic portrayals of medical professionalism from the romantic period of the Victorian past, contrasting that era with the present-day environment of normative codifications. While ethics is commonly approached in an intellectual mode as a discussion of theory, a purely cognitive understanding is deficient on its own since learning in professional ethics must by definition be reified as sets of practices. The shift to the clinical accountability of today means that practices are of central importance to the undergraduate medical curriculum, not least in the area of confidentiality, for which the General Medical Council guidance sets the UK agenda for medical educational approaches to teaching, learning, and assessment, before students repeat the Hippocratic Oath at graduation as they embark on their future careers as doctors.