An ethical foundation for confidentiality is found in the AAOHN Code, grounded in a respect for autonomy. Confidentiality is a phenomenon involving a trust relationship between at least two people. An undesirable outcome could result if the confidential information or observation is revealed. Although confidentiality has an impact regardless of the individual's gender, women can be at higher risk for compromises to confidentiality. The implications for women include but are not limited to the inherent inequality in client/professional relationships, paternalistic practices in health care delivery, and the importance of autonomy as an ethical principle. The nurse's sensitivity to the possible vulnerability of women, the recognition of the importance of trust and communication in professional relationships, and an effort to ask the gender question contribute to an ethical practice in occupational health care related to the issue of confidentiality.