o the Editor:

Far from taking a reasonable approach to protecting the privacy of people's medical information, the Bush administration is proposing to gut the first-ever federal medical privacy rule ("Modifying Medical Privacy," Topics of The Times, May 20).

Under pressure from the health care industry, the administration is proposing to eliminate the new rule's core consent requirement and authorize the use of people's medical records for far more than just "health professionals' communicating among themselves." The administration is also proposing to open up medical records without patient consent for marketing, legalizing the growing practice of pharmacies' being paid by drug companies to contact patients to urge them to switch to a new or different drug.

None of these changes will improve patient care or lower barriers to care; in fact, they will do just the opposite. Consent is central to fostering trust and confidence in the health care system.  
JANLORI GOLDMAN
Director, Health Privacy Project
Georgetown University
Washington, May 20, 2002