The doctrine of confidentiality, which applies to the information exchanged between doctor and patient, is an ethical duty which has been cited in court as an expression of the physician's legal duty to his patients. In addition, 47 States have enacted statutes providing for a physician-patient privilege, in which the patient has the right to prevent his physician from testifying to confidential information in court. These principles apply equally to medical information within prisons because correctional officials have a duty to provide inmates with medical care. The first duty of a physician employed by a correctional institution is to his patients, not to his employer, although there are certain circumstances under which prison personnel should be given access to inmates' medical records. It is another well-established principle of law that any competent adult may refuse medical treatment; this includes inmates, except in situations where there exists an overriding interest of the State. In general, the courts have supported an inmate's right to refuse treatment; some exceptions include communicable disease, security concerns, self-inflicted injury, and emergencies. In the case of a juvenile offender, a physician may treat the patient with the consent of the corrections officer responsible for his care. 15 notes and 2 appendixes