The Aug. 23 front-page story "Long Reach Into Patients' Privacy" chronicles some astonishing lapses of privacy around medical records and alludes briefly to a controversy in Maine about hospitals' release of medical information. It describes a short-lived law that prohibited hospitals from releasing information about patients without their written permission and notes that "newspaper reporters complained that they could no longer write about accident victims." (Other groups -- such as patients' relatives, priests and florists -- objected as well.) Developing standards for the public release of names and other personal details of accident victims is a crucial part of the continuing debate about medical privacy and one that news organizations bear some responsibility for changing.

As a physician, I applaud the goals of a law such as the one in Maine because I wonder if the news value of knowing the names of accident victims outweighs the demands of privacy. Soon after the Columbine High School shootings in Littleton, Colo., anyone from a casual newspaper reader to an avid Internet surfer easily could have found the names, ages, injuries and medical conditions of multiple hospitalized victims, including those under 18 years old. Two of the victims had their yearbook pictures displayed on the CNN Web site.

A law such as the one in Maine would have ensured that patients and their families had consented to this information being released. Newspaper reporters could still (and should) write about accident victims in the wake of a law such as the one in Maine. What changed was that instead of presuming patients' consent for information to be released, they had to obtain it from the patients or families themselves.

This is how it is in medicine: As physicians, we presume privacy and we ask consent. We do not always do this perfectly, but many of us try to do it scrupulously. We do this because we believe that it is not up to us what information should be passed on to others; it is up to the person whom that information describes.

Consent to release information is a strong ethical precept for physicians and other health care providers. Privacy and the dignity of the victims demand that we consider stronger standards of consent in the media when reporting on stories involving private and personal medical records.

JOSHUA HAUSER

Chicago