Time to change from guarding anonymity to getting consent

Last week three doctors appeared before the General Medical Council, the body that regulates British doctors, charged with serious professional misconduct because they had published a report on a patient without, it was claimed, gaining adequate consent from the patient (p 1245).1 The report, published in the British Journal of Psychiatry in 1993,2 concerned three patients with bulimia nervosa who had bled themselves. The paper came from Aberdeen, and the local newspaper picked up the story. It published only details that were in the case report (which included, for instance, “Ms C is a 26 year old preregistration doctor”), but a friend of one of the patients was able to identify her from the newspaper report. The patient made a complaint to the General Medical Council, saying that, although she had consented to the use of her case for teaching and research, she had not consented to its being published in a journal.

Despite the fact that the General Medical Council did not find the doctors guilty of serious professional misconduct, this case illustrates radical changes in expectations on guarding patient confidentiality in published reports; and these changing expectations reflect broader changes in the relationship between doctors and patients. Medical journals and textbooks have …