The development of disclosure of medical records in Japan and its comparison among some nations

自1997年以来，日本关于医疗记录公开的争论越来越多。第二年，福利和劳工部在医疗记录披露委员会的报告之后提出了《医疗记录披露法》。但是，该法案遭到日本医学会的拒绝。2003年颁布的《个人信息保护法》使患者的病历获取权得到了实质性的实现。根据我们的社会调查，公民们认识到，尽管他们有权利去获取自己的病历，但他们不敢去尝试。另一方面，虽然许多医疗机构实行了“知情同意”，但很少有医生向病人解释身体状况，向他们出示医疗卡。根据我们的社会调查，很多医生和护士都不愿意主动向病人披露病历，相反，在英国，有关病历的法例已于九十年代初通过，现时有关NHS的问题已集中在病人的责任上。由于我们访问的第二个国家澳大利亚是由多个民族组成的，在执行知情同意时考虑到了他们的文化因素。在台湾，虽然医疗卡已经实现电子化订阅和管理，患者可以通过监护仪观看自己的医疗卡，但有时对患者家属的医疗解释优先于对患者的解释，只要医疗卡实现电子化，我国医疗卡的公开将逐步实现。我们认为最重要的是病人与医生之间会建立一种怎样的关系。

The argument about the disclosure of medical records has bees increased since 1997 in Japan. In the next year 'The Act of the Disclosure of Medical Records' was brought by D.of Welfare and Labor, following the Reports of the committee on the disclosure of medical records. The Act was, however, rejected by the Japan Medical Association. After that, patient's right to obtain his medical records was substantially realized by 'The Act of Protect of Persona Information' in 2003.According to our social survey, citizens recognize that they don't dare to try to get their medical records, although they are entitled to do so. On the other side, though 'Informed Consent` has been executed in many medical institutions, there are few doctors who explain physical conditions to patients, showing them their medical cards. According to our social survey, many doctors and nurses feel reluctant actively to disclose medical records to patients.On the contrary, in England, acts on medical records were passed in early '90s and the issue on NHS is now focused on responsibility of patients. As Australia the second country we visited is composed of multiple ethnic groups, informed consent is executed, taking cultural factors of them into consideration. In Taiwan though medical cards have already subscribed and managed electronically and patients are able to watch their own medical cards through monitor, a medical explanation to a patient' family member is sometimes given priority over that to the patient.The disclosure of medical cards in our country will be gradually realized as long as they will be written electronically. We think that it is the most crucial point that what sort of relationship will be established between patients and doctors.