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Wanted: social contract for practice of medicine

BMJ 2001; 323 doi: (Published 20 October 2001) Cite this as: BMJ 2001;323:930

Ethical framework for using medical records is needed

  1. D M Fleming, director
  1. Royal College of General Practitioners, London SW7 1PU
  2. Addenbrookes Hospital, Cambridge CB2 2QQ
  3. Patient Concern, PO Box 23732, London SW5 9FY

    EDITOR—I support the idea of a social contract for the practice of medicine, as outlined by Gillon et al in their editorial.1 I write particularly from the perspective of surveillance of diseases.

    Effective surveillance leaves no option for patients to opt out. That does not mean that patients have to be identified. Equally, no one can be forced to undergo a specific investigation procedure, but in the interests of public health we do need to identify the cause of epidemic diseases and patients are investigated quite specifically for protecting the health of the community rather than for individual patient management. By the system of legally required official notification there is a recognised mechanism for the notification of disease for which …

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