Patient confidentiality and consent to publication

The main points of this policy are:

1. Publication of any personal information about a patient will normally require the signed consent of the patient. We expect authors to use the LJPC's consent form. You may remove a patient’s identifying details from a LJPC article, although consent will still be required. Do not change the personal details of patients to try to disguise them: this is bad scientific practice. In addition, black bands across the eyes are wholly ineffective in disguising a patient’s identity in a photograph: we will not publish these.
2. Personal information about a patient will not be published over the patient’s refusal, except in the most exceptional circumstance of overriding importance to public health.
3. Publication without the consent of the patient will be permitted if all of the following conditions are met:
1. The patient who is the focus of the article is untraceable without an unduly burdensome effort or it is impossible or unreasonable to expect consent to be obtained from the patient or the patient’s next-of-kin.
2. The article contains a worthwhile clinical lesson or public health point which could not be as effectively made in any other way. ("Worthwhile" is intended to sit on a spectrum between "interesting" which is the publication threshold with patient consent, and "overriding public health importance", which is the publication threshold over patient refusal.
3. A reasonable person in the patient’s position would not be expected to object to the publication of the case. (This requires an assessment of the intrusiveness of the disclosure and the potential that it has for causing the patient, or the patient’s family, embarrassment or distress. Particular attention must be paid here to differences of cultural and social attitudes. It must not be assumed that what is a matter of indifference in one society will have the same status in another.)
4. The risk of identification of the patient is minimised by measures designed to prevent the identity of the patient being revealed either to others or to the patient himself or herself. (These measures will include anonymisation of the case and/or the author. The publication without consent of photographs will require particular scrupulous attention to anonymisation.)
4. The LJPC ethics committee will review all instances of publication without consent under these guidelines on an annual basis to audit compliance with the guidelines and also provide data for continuous improvement of the guidelines.

Given this policy on consent for images of patients mentioned in LJPC articles, is it inconsistent of us to publish pictures provided by agencies in news items and other articles? We believe that the LJPC would be at a disadvantage among other media if we didn't use such images, and pictures can often tell a story more powerfully than words. But we cannot take responsibility for the consent of people who are shown in pictures that we have obtained from agencies, libraries, other publications, and other commercial sources. We state clearly where pictures have come from, and we assume that they and their photographers have obtained relevant permission from models in any images showing people. Reputable picture agencies and other sources are unlikely to take the legal and financial risk of selling sensitive images without appropriate consent. If we doubt that someone photographed could have given consent—owing to severe mental illness, dementia, or learning disability, for example—we use our discretion and try to avoid images that might allow that person to be identified.

Reporting clinical trials conducted by pharmaceutical companies

Please ensure that clinical trials sponsored by pharmaceutical companies follow the guidelines on good publication practice at www.gpp-guidelines.org

These guidelines aim to ensure that such trials are published in a responsible and ethical manner. The guidelines cover companies’ responsibility to endeavour to publish results of all studies, companies’ relations with investigators, measures to prevent redundant or premature publication, methods to improve trial identification and the role of professional medical writers.