Published 8 September 2008, doi:10.1136/bmj.a1233
Cite this as: BMJ 2008;337:a1233

Analysis

Ethical debate

Commentary: Consent to publication—no absolutes

¹ Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Victoria 3052, Australia, ² Journal of Paediatrics and Child Health

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; and two members of the BMJ’s ethics committee explain why they recommended not to publish it (doi: 10.1136/bmj.a1232). 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.

Privacy and confidentiality are central and longstanding tenets of the relationship between patient and doctor. It follows then that specific informed consent should be obtained before any patient information is divulged, including publication in medical journals. Most journals thus have a policy of requiring written informed consent from the patient, or in the case of a child, from the parents or legal guardians.

However, just as "in clinical practice confidentiality is not an absolute principle but admits of exceptions ... confidentiality is not absolute in editorial practice either."¹ Although the norm is always to obtain informed consent, in some instances editors may decide that publication is in the public interest and that the benefits in publishing a case outweigh any risks that privacy and confidentiality may have been breached.² Sometimes when consent is not obtained key clinical and patient information is changed in an attempt to hide the patient’s identity. . . . [Full text of this article]

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