ABSTRACT
The idea that patients have rights sits ill with the general shape of English health care law.1 Issues of informed consent are governed by ordinary malpractice principles, not by the right of self-determination.2 Confidentiality is justified by reference to the public good, not individual privacy rights.3 For practical purposes, rights to health care under the National Health Service Act 1977 are unenforceable.4 Some progress towards a rights-based model can be seen in legislation giving access to health reports and records.5 Even here, however, the rights created are subject to being overridden by a professional judgment that patients would be better off not being able to exercise them.6
