Intended for healthcare professionals


Keeping joint medical and nursing notes at foot of bed

BMJ 2000; 320 doi: (Published 04 March 2000) Cite this as: BMJ 2000;320:646

What about confidentiality if notes can be accessed by anybody?

  1. Jose Catalan (, reader in psychiatry
  1. Imperial College, Psychological Medicine, Chelsea and Westminster Hospital, London SW10 9NG
  2. Redbridge Health Care Trust, King George Hospital, Ilford, Essex IG3 8YB
  3. North Middlesex Hospital, London N18 1QX
  4. Royal Free Hospital Hampstead NHS Trust, London NW3 2QG

    EDITOR—Luke et al's report on the views of patients' families and staff on the placing of notes at the foot of the bed shows some advantages of promoting partnerships in health care.1 The authors hint at but unfortunately do not address some difficulties with patients' autonomy, confidentiality, and the content of records, all of which require further consideration.

    There are substantial differences between patients and within the same patient at different times in terms of attitudes to patient autonomy.2 3 A blanket policy of making records available to patients without first inquiring about their wishes or explaining the significance of the options listed in a differential diagnosis or test results would be the opposite of a patient centred approach. Staff often misjudge patients' wishes for information and involvement in decisions, 2 3 and direct communication between the parties seems the simplest route to reaching agreement.

    The question of who …

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