The lasting legacy of a bigamous Duchess: the benchmark precedent for medical confidentiality.

For all that is currently written on the subject of medical ethics, comparatively little comes from a historical perspective. This article provides socio-historical background on the case that set the boundaries of modern-day definitions of medical confidentiality: the trial of the Duchess of Kingston in 1776. By looking beyond Lord Mansfield's key ruling on confidentiality to the context in which it was made, the paper claims that the precedent did not rest on a debate of the central principles involved. Rather, professional privilege was used by a high-ranking surgeon as a means of maintaining reputation and status when forced to make a public breach of confidentiality.