1. The patient has the right to a medical record, carefully updated and safely stored by the health professional. The law does not provide a definition of a medical record. It is a factual notion: the medical records are the set of all facts related to health, documents, attachments, etc., that relate to a single patient, maintained and stored by a health professional, sometimes in various places and on various media (paper, electronic, etc.). The law does not provide any norms to which the medical record must adhere.
2. At the request of the patient, the health professional adds any documents supplied by the patient to the medical records, for instance an advance directive drafted by the patient.
3. Patients have the right to access their own medical records. The explanatory report thoroughly discusses the reasons for having a right to access. It is not primarily intended to satisfy the patient’s information needs: these needs are addressed by the right to information about one’s state of health and to information preceding consent or refusal. The decision to provide this information lies with the health professional, and this should be done anytime there is a need for it, if necessary several times per day (e.g. an acute hospitalization). The right of access is not a substitute for poor information delivery. If the patient needs to exercise his right of access in order to obtain information that he should already have been given, then there is something wrong with the initial information delivery. The main reason for having a right of access is to protect the patient’s privacy. On the basis of this right, the patient can exercise control over personal data included in a medical record, thus protecting his privacy.
   A patient’s request to access his medical record shall be granted as soon as possible and not later than 15 days following the request. The health professional’s personal notes and information relating to third parties are excluded from the right of access to medical records. According to the explanatory report, personal notes are the annotations made by the health professional which are kept separately and which are never accessible to others, not even to the other members of the medical care team. The moment a health professional shows these notes spontaneously to a colleague, they lose their qualification as ‘personal notes’ and can therefore no longer be excluded from the right to access.
   Patients may request to be assisted by, or to exercise their right of access through a close confidant designated by them. If the latter is a health professional, he or she shall also have the right to access the personal notes referred to above.
4. Patients have a right to obtain a copy of their medical records, in whole or in part, at cost price, in accordance with the legally prescribed provisions (i.e. by request, as soon as possible and not later than 15 days following the request, excluding personal notes and data concerning third parties, with the assistance of a confidant by request). Each copy shall clearly indicate that it is strictly personal and confidential. The health professional refuses to supply such a copy if there are clear signs that the patient has been pressured to ask a copy of his medical record at the instigation of a third party.

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