 Paternalistically withholding medical knowledge from patients as the secrets of doctors, healthy spouses and adult children pits ideals of beneficence in caregiving against the patient’s right to know. Paternalistic secrecy is a major feature of medical practice, more prevalent in some countries, communities and families than others. Moral ideals of autonomy and agency argue for informing patients of their medical conditions, truthfully and fully. Yet, medical news is sometimes deliberately kept from patients. The adult children of a 95 year old woman might think it unduly cruel to reveal the diagnosis of operable bowel cancer when she would be better able to cope with the fib that she has benign diverticulitis. The parents of a young child might think it kind-hearted to conceal his terminal leukemia from him, on the ground that he is too young to understand death. Some moralists would agree. Yet if deception is categorically wrong, then secrecy about medical adversity would surely be unethical. A related issue is how medical clinicians and researchers should deal with “incidental and secondary findings”: disclose to the subject, or keep confidential within the research team? The return of incidental findings may create undue worry and increase medical costs by prompting unnecessary medical visits and testing, but the overriding obligation may be to anticipate incidental and secondary findings and communicate them with care (Presidential Commission 2013).