Published 8 September 2008, doi:10.1136/bmj.a1232
Cite this as: BMJ 2008;337:a1232

Analysis

Commentary: Consent and confidentiality in publishing—the view of the BMJ’s ethics committee

¹ Centre for Ethics in Medicine, University of Bristol, Bristol BS6 6AU, ² British Medical Association, BMA House, London

Two years ago four paediatricians and an ethicist submitted to the BMJ a case study as an ethical debate which the BMJ decided not to publish because the authors had not obtained the consent of the patient’s parents for publication. The authors submitted it elsewhere, and the article was published last year.

Here the authors explain why they think the BMJ should have published despite the lack of consent (doi 10.1136/bmj.a1231); the editor of the journal that did publish the case study explains why he did so (doi: 10.1136/bmj.a1233); and two members of the BMJ’s ethics committee explain why they recommended not to publish it. An accompanying editorial explains why English law would now not allow the BMJ to publish it without consent, even if we thought it reasonable to do so.

The first 150 words of the full text of this article appear below.

We explain here the response of the BMJ’s ethics committee to the case study submitted by Isaacs and colleagues and make some broader points about the need for patient consent to publish case studies. We conclude that the "public interest" criterion for publication justifiably has a high threshold, which was not met by this paper. Yet we recognise that policy formation in this contested area can be difficult and that further debate is required.

The publication of case studies in medical journals provides a rich narrative of clinical practice with valuable lessons for other practitioners and has extended ethical debates, suggested policy changes, and led to changes in clinical practice.¹ Yet consideration must be given to the way in which clinical case studies are used, particularly in relation to respecting patient confidentiality.²

In the case described by Isaacs and colleagues³ the authors believed the case would make a valuable . . . [Full text of this article]

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