Keeping joint medical and nursing notes at foot of bed

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.