and their applications among the daily work activities of mental health case managers. The

philosophical concepts of Utilitarianism and Deontology were also examined as justifications for

the case managers’ applications of treatment. For the purpose of this study, a qualitative

interview was conducted with three, mental health, intensive case managers to ascertain their

individual perceptions and applications of autonomy and confidentiality. Observations of case

manager team meetings and reviews of several agency policies were also conducted. All data

were then analyzed for thematic content. The emerging themes consisted of: daily havoc,

confidentiality is contextual, autonomy is relative and is manipulated, and protection. These

themes suggest that the application of autonomy and confidentiality are directly influenced by

contexts, policies, values, and behaviors. This study should be beneficial to health care

practitioners for the purpose of recognizing the dynamic role of context and its’ influence on client