Ethicist says medical records now open for patient requests.(Practice Trends)

The long-held perception that medical records should never be altered at a patient's request is quickly becoming erroneous, according to health lawyer and ethicist George Annas.

"We can delete (items from the record), as long as we note that something has been deleted and who did it," said Mr. Annas, chairman of the department of health law, bioethics, and human rights at Boston University.

In a Webcast sponsored by the National Institutes of Health, he braced physicians for a future in which patients will increasingly ask to have items corrected, deleted, or changed that are errors or that they are concerned may pose harm to them.

"The real reason patients don't ask to make deletions [now] is because most people don't look at their records," he said. But with the advent of the Health Insurance Portability and Accountability Act (HIPAA), "there's a federal right of access" to records.

Moreover, President Bush's emphasis on electronic medical records (EMRs) embraces "the idea that patients should be in control," and patients are generally more concerned about the content of electronic records than paper records, said Mr. Annas, who is professor of sociomedical sciences and community medicine at Boston University.

The Bush administration has not addressed, in the context of its EMR proposals, whether "a patient [should] be able to delete accurate, factual information [from medical records]," he said.

There are "lots of mistakes in medical records," making it likely that in the future, many changes will address errors. Debate about other types of alterations will ensue, but under this new climate "you could argue that patients should be able to change anything," he told the physicians.