The use of images of personal information of patients or other individuals
Formal consents are not required for the use of entirely anonymised images from which the individual
cannot be identified- for example, xrays, ultrasound images, pathology slides or laparoscopic imagesprovided
that these do not contain any identifying marks and are not accompanied by text that might
identify the individual concerned.
If consent has not been obtained, it is generally not sufficient to anonymise a photograph simply by using
eye bars or blurring the face of the individual concerned.
Special considerations for patient and research subject permissions
Patients' and research subjects' names, initials, hospital or social security numbers, dates of birth or other
personal or identifying information should not be used.
Images of patients or research subjects should not be used unless the information is essential for scientific
purposes and explicit permission has been given as part of the consent. Even where consent has been
given, identifying details should be omitted if they are not essential.
If identifying characteristics are altered to protect anonymity, authors should provide assurances that such
alterations do not distort scientific meaning.
Requirement for consent
Requirement for consent
Appropriate consents, permissions and releases must be obtained where we wish to include case details or
other personal information or images of patients and any other individuals in an Elsevier publication in
order to comply with all applicable laws and regulations concerning the privacy and/or security of personal
information, including, but not limited to, the Health Insurance Portability and Accountability Act of 1996
("HIPAA") and other U.S. federal and state laws relating to privacy and security of personally identifiable
information, the European Union Directive 95/46/EC and member state implementing directives, Canada's
Personal Information Protection and Electronic Documents Act, India's Information Technology Act and
related Privacy Rules, (together "Data Protection and Privacy Laws").
It is the responsibility of the author to ensure that each individual, or the individual's legal guardian or
other person with legal authority to act on the individual's behalf who appears in any video, recording,
photograph, image, illustration or case report (or in any other identifiable form) is made aware in advance
of the fact that such photographs are being taken or such video, recording, photograph, image, illustration
or report is being made, and of all the purposes for which they might be used, including disclosure to
Elsevier and use by Elsevier or its licensees in any work or product. That individual, legal guardian or
person with legal authority must give his/her explicit written consent. If such consent is made subject to
any conditions (for example, adopting measures to prevent personal identification of the person concerned),
Elsevier must be made aware in writing of all such conditions. Written consents must be retained by the
author and copies of the consents or evidence that such consents have been obtained must be provided to
Elsevier on request.
It is the responsibility of the author to ensure that the form of written consent complies with each
requirement of all applicable Data Protection and Privacy Laws.
Particular care should be taken with obtaining consent where children are concerned (in particular where a
child has special needs or learning disabilities), where an individual's head or face appears, or where
reference is made to an individual's name or other personal details.
In the case of a child, if parents or guardians disagree on the use of the images of that child, then consent
should be deemed not to have been given and those images should not be used. It is also important to
ensure that only images of children in suitable dress are used to reduce the risk of images being used
Even if consent has been obtained, care must be taken to ensure that the portrayal and captioning of the
individual concerned are respectful and could not be seen as denigrating that individual.