Confidentiality is understood in many professions as maintaining absolute privacy of privileged information. Realistically, in our circles, it is somewhere between the seal of the confessional and what prisoners jokingly call confidence that you will not use what you know against me. Beware of assurances of confidentiality, whether from colleagues or committees, as all too often privileged information finds its way into the public arena. Many women have found their reputations ruined, their trust broken in such situations. There may also be times when the demands of confidentiality serve the needs of the institution and not the greater good, creating a situation of extreme dissonance and ethical dilemma.