Physicians in this country seem so confident of their group strength that they can afford to ignore public opinion. So, at least, say critics of the powerful medical establishment in the wake of this week's failure by a subcommittee of the government's medical reform council to agree on a proposal to seek new legislation to require the disclosure of a patient's medical records upon request. Exactly one year ago, a private advisory group to the Health and Welfare Ministry proposed that such disclosure should be made obligatory, but the council then failed to come up with any recommendations, mainly due to the disapproval of the Japan Medical Association.

Now, a special subcommittee of the Council on Medical Service Facilities has issued a draft report reflecting this continuing deep division among its members on the controversial issue. The question that occurs to many observers, in particular to patients and their families, is why something they feel should be a matter of medical routine is still the subject of so much professional dispute. Why should specific details about their illness and its treatment be kept from them? At a time when serious cases of medical malpractice and hospital error are much in the news, the public's image of the medical profession would seem badly in need of improvement.

Yet, the influential JAMA remains adamantly opposed to any revision in the Medical Service Law that would require its members to provide patients with copies of their medical charts and other records on demand. Despite this opposition, the prospect for a heightened awareness of patients' rights by the medical profession is not as bleak as some commentary on the council's report would suggest. Although the report failed to produce any firm recommendations on the disclosure question, it did indicate that some of the council's 14 members supported the proposal for new legislation. Others, mainly those representing the JAMA, insisted that disclosure should be voluntary on the part of individual physicians.