Although confidentiality with regard to medical records is supposedly protected by the American Medical Associaton's principles of Ethics and the physician-patient privilege, there are a number of laws that require a physician to release patient information to public authorities without the patient's consent. These exceptions include birth and death certificates, reports of wounds caused by firearms or weapons, suspected child abuse, infectious diseases, and medical information that affects performance or status in the military. In addition, medical record releases are required for insurance companies and employment. Health care reviewers, state and federal computerized "human services" data banks, and groups of professionals organized to monitor government-funded health care pose further risks to confidentiality in that they often disseminate health information to credit bureaus, employers, and educational institutions. Ironically, individuals often have difficulty in obtaining their own personal health records. In states with access statutes, individuals must sue to obtain medical records, and in states without access statutes, hospitals can legally deny an individual access. (MAI)