A video showing real surgical operations was about to be sold through high street shops during the closing months of 1996. The BMA, GMC (General Medical Council), and the Institute of Medical Illustrators were quick to condemn this commercial exploitation of sensitive and confidential material. Media coverage was generally critical.1 A temporary injunction stopped any sales of the video, and a subsequent court order permanently prevented its distribution. Although the film's producer claimed that the surgeons concerned had given their permission for the video footage to be used, it emerged that many of the patients had not.

It is common practice to illustrate medical books with photographs of patients. In how many such cases have the patients given valid consent for publication? The advent of digital imaging has allowed photographs and video recordings to be stored, accessed, and distributed around the world with ease. Consequently, there is an increasing demand for medical images. Does valid consent for the use of a photograph in book publication cover the use of the same picture in electronic publishing? In most cases we doubt whether there is sufficient documentation to find out for what uses the patients originally gave consent.