Confidentiality: whose consent governs disclosure when the guarantor is not the client?

• A. The client's consent governs disclosure, even if the guarantor is not the client.
• B. The guarantor's consent governs disclosure.
• C. No disclosure is allowed to anyone.
• D. Disclosure is governed by the advocate's discretion.

Answer: (A)

The important idea is that patient confidentiality rests with the patient. Disclosure of medical information to a third party, such as a guarantor, requires the patient’s explicit consent or a legally authorized surrogate to consent on the patient’s behalf. If the patient is not the guarantor, the guarantor’s own consent does not authorize disclosure. The patient can choose to share information with the guarantor, or, if the patient lacks capacity, a legally recognized representative can consent instead. Absent patient consent or a legal exception (such as a required disclosure by law or imminent safety concerns), disclosure should not occur. This is why the patient’s consent governs disclosure in this scenario, rather than the guarantor’s consent, lack of disclosure, or the advocate’s discretion.