To opt in or opt out of electronic patient records?: Analogy for soft paternalism in shared electronic records is flawed

doi:10.1136/bmj.333.7559.147-a

BMJ 2006;333:147 (15 July), doi:10.1136/bmj.333.7559.147-a

Letter

To opt in or opt out of electronic patient records?

Analogy for soft paternalism in shared electronic records is flawed

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EDITOR—There is a flaw in Norheim's argument using theanalogy of managing a hospital cafeteria for soft paternalismin shared electronic patient records.¹ If the manager of thehospital cafeteria decides to put healthy food at the beginningof the counter the worst that can happen is that customers eatmore healthily without consciously deciding to do so. If patients'health records are made universally available confidentialityis put at risk and the potential consequences are serious.

When serious harm can result from a course of action explicitconsent is required. The Royal College of General Practitionersis right to insist on opting in.

Anthony P Winston, consultant in eating disorders

Woodleigh Beeches Centre, Warwick Hospital, Warwick CV34 5BW AnthonyPWinston@aol.com

Competing interests: None declared.