Education And Debate

Use of personal medical records for research purposes

BMJ 1994; 309 doi: https://doi.org/10.1136/bmj.309.6966.1422 (Published 26 November 1994) Cite this as: BMJ 1994;309:1422
  1. Nicholas Wald, professora,
  2. Malcolm Law, readera,
  3. Tom Meade, professora,
  4. George Miller, senior clinical scientista,
  5. Eva Alberman, professor emeritusa,
  6. John Dickinson, professor emeritusa
  1. a Wolfson Institute of Preventive Medicine, Medical College of St Bartholomew's Hospital, London EC1M 6BQ
  1. Correspondence to: Professor Wald.
  • Accepted 15 November 1994

The established practice of doctors using medical records for research purposes is threatened by the recent proposed guidelines from the Department of Health, the BMA, and the European Commission. The European Commission has proposed that explicit consent should be obtained from each patient before his or her medical records can be used; the proposals from the Department of Health and the BMA would require all research that needs access to personal medical records to be submitted to an ethics committee. We believe that these proposals would seriously impair an entire category of research and suggest therefore that another set of guidelines, proposed by a Royal College of Physicians' working group, should be used to modify the proposals. The guidelines of the working group encourage the use of medical records for research and ensure that such use can be made in a confidential manner without causing harm.

The use of medical records for research purposes is a longstanding practice by doctors of virtually all specialties. The value of such a practice has been immense. It is now under threat from proposed guidelines issued by the Department of Health,1 from a draft bill governing use and disclosure of personal health information produced by the BMA's Multidisciplinary Professional Working Group,2 and a draft data protection directive (SYN 287) from the European Commission. Safeguards to protect the confidentiality of financial and other personal details from unauthorised access by public authorities are being uncritically extended to cover medical records held by doctors.1 2 An entire category of research, which can identify, for example, the side effects of drugs, the effects of toxic substances in the environment, or the safety of medical procedures, would be seriously impaired.

Background

The use of medical records for research purposes has usually taken two forms: …

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