We were interested to see that the study by Hilary Arksey and colleagues ('Tell it like it is', pages 32-33, 22 January) bears out the findings of a similar study we undertook into the needs of cancer patients' carers in Hillingdon in 1993.1 Their information needs were again identified as different from those of patients, and as sometimes in conflict with the duty of professional confidentiality.

At that time we contacted the British Medical Association to see whether there were any guidelines for doctors about circumstances in which it was permissible to give such information to carers, but were informed there was no guidance on the matter. While we fully appreciate it is normally best for such things to be decided in discussion with patients, there are occasions when carers need to know things which patients do not wish to hear about.

The increasing emphasis on care in the community means that more carers are being expected to work as unpaid professionals. They deserve to be given the information needed to carry out this work, without which the resources of public services would soon be as exhausted as many of them are.

Gay Walker, Jane Bradburn, Jane Maher,

Lynda Jackson Macmillan Centre for Cancer Support and Information,

Mount Vernon Hospital,



1 Walker G. Hillingdon cancer patient carers project. Carers World. July 1994: 47.