The nursing home nurses were faced with a troubling problem. An 87 year old woman, who had been a resident of the home for several years, had gradually become disoriented, confused, and nearly unable to communicate. Nursing care for this otherwise healthy woman continued as always — monitoring and maintaining her medical status with a necessary increase in physical care as her own self-care ability diminished. The problem was the woman's son: he was demanding to see his mother's chart because he believed that she had cancer and that this was being concealed from him. What should the nurses do?

The issue is complex and can best be examined in stages. The first question is: does the son have a legal right to see his mother's records? The answer is that in no state does a patient's son or other relative have an automatic legal right, by virtue of his relationship to the patient, to see an adult patient's medical record. Often, particularly with nursing home patients, a relative signs an agreement to assume financial responsibility for expenses incurred by a patient.