Abstract
A survey of pharmacists in Nebraska (N = 70) examined the nature and frequency of ethical problems with patient confidentiality. Respondents reported on the importance of specific contextual features of pharmacy practice and community life that made it difficult to maintain confidentiality. Elements of pharmacy practice that influenced confidentiality included: requests from third party payers and the lack of space for confidential patient consultations, Differences between rural and urban pharmacists were noted where the impact on confidentiality of two community patterns, gossip and the presence of extended family members, were compared. Implications for teaching moral and practical issues involved in confidentiality are discussed.