Education And Debate

Videos, photographs, and patient consent

BMJ 1998; 316 doi: http://dx.doi.org/10.1136/bmj.316.7136.1009 (Published 28 March 1998) Cite this as: BMJ 1998;316:1009
  1. Catherine A Hooda,
  2. Tony Hope, reader in medicinea,
  3. Phillip Dove, directorb
  1. a Ethox, Division of Public Health and Primary Care, Institute of Health Care Sciences, Headington, Oxford OX3 7LF
  2. b Oxford Medical Illustration, John Radcliffe Hospital, Oxford
  1. Correspondence to: Dr Hood
  • Accepted 16 February 1998

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.

Summary points

• The internet and electronic publishing are powerful tools for the dissemination of medical information and have created a demand for medical images

• Consent should be requested from patients for all medical photography and for the subsequent use of their images whether or not they can be identified by the picture

• Specific consent should be obtained if an image will be used in electronic publishing and we describe a new consent procedure that covers such use of pictures

• Review of this procedure after 4 months shows that 85% of patients continue to give consent for publication of their image despite …

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