Publication of pictures of patient on BMJ's website was mistakeBMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7136.1022a (Published 28 March 1998) Cite this as: BMJ 1998;316:1022
Editorial by Smith
EDITOR—Abbasi recently wrote a news article on the widespread distribution of a picture of a radiograph of a knife embedded in Alison Kennedy's skull.1 The man who attacked Alison Kennedy was subsequently convicted of attempted murder. Reading Abbasi's article, I found it difficult to know whether to be taken aback more by its hypocrisy or its (purported) naivety. The radiograph was always going to be linked with a named person even when limited to the BMJ as this unique case was bound to get massive media coverage. It was never going to be anonymous.
Alison Kennedy gave permission for the picture “to be published only in the BMJ,” doubtless understanding that this was a journal largely limited to a professional medical readership. The journal broke that trust by putting the picture on a public website and apparently leaving it there throughout the trial. Richard Smith, the journal's editor, claims that others made links to the journal's web page “without seeking permission.” Who is he trying to fool? The journal must know that the internet is about connectivity of information resources. Does it seek permission from the owners of a web page each time it publishes a web page address? Does the editor believe that the owners of search engines have sought specific permission from the owners of all the web pages that might be used that their address may be identified? Abbasi notes that the journal was aware that “copyright consideration are regularly ignored by Internet users.” Knowing this, and that use of the photograph by others was likely to cause Alison Kennedy distress, why did the journal put the picture on its website?
Smith is correct when he says that Alison Kennedy's rights have been abused and that this was also an abuse of the doctor-patient relationship. The abuse was started by the BMJ going beyond its remit by using pictures in circumstances and a manner that were clearly likely to lead to identification of the individual and distress to that individual and her family.
Rather than have its solicitors threaten others with legal action, the BMJ should put its own house in order. There is not a single indication in Abbasi's article that the BMJ believes other than that it acted with total responsibility throughout. It should use its solicitors to negotiate a suitable financial settlement with Alison Kennedy and her family for the distress its action caused.
*We do not accept that the BMJ behaved irresponsibly, although we can undoubtedly do better. We have now—partly as a result of this episode—produced a standard consent form. It can be seen on our website (www. bmj.com), and we welcome comments. We had signed permission from Alison Kennedy to reproduce the pictures, but nowhere did we reveal her name. The BMJ's website is visited mainly by doctors, and the paper version is seen by many non-doctors, including journalists. Material on our website is copyright in just the same way as material in the paper version. In these senses the paper version and the website are not appreciably different. Of course people do not need permission to link to our website, but they need permission from a patient if they are going to reveal information about that patient. We hope that the bodies that regulate the press and broadcast media will uphold the need to seek permission—otherwise, we all lose.—DITOR
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