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    • Copyright

    • Data Protection and privacy

    • Medical ethics and the requirement for informed patient consent

      • 3.5.2

        Guidance to creators and users

Patient consent, preferably written, is generally required. The patient’s consent, however, is not required to use:

  • images of pathology slides

  • X-rays

  • laparoscopic images

  • images of internal organs

  • ultrasound images

for teaching purposes provided they are anonymised before use, that is by removing any identifying marks e.g. marginal notes such as date of birth, name, name of hospital. If it is certain the patient cannot be identified and the record has any or all identifying marks removed then the record can be used for teaching purposes.

Patient consent is required for other types of images. When giving consent the patient must understand the purpose of the recording and precisely how it will be used, whether copies will be made, arrangements for storage and the length of time the recording will be kept, and all potential uses of the recording. There must be no suggestion that permission is expected and patients should be asked after the recording has been made if they wish to vary or withdraw their consent. If the patient cannot give consent it may be sought from close relative or carer. It is essential to get consent if recordings cannot be anonymised.

There are cases where medical images cannot be anonymised but their use would be in the interests of medical science. These cases must be thoroughly discussed with medical practitioners before this step is taken and be justifiable to the patient.

For teaching purposes both GMC and BMA Guidance indicates it is permissible to continue to use recordings made before 1997, provided the patient is not identifiable. Every effort should be made to replace these images and recordings with similar ones where the patient has given consent.

If the image is to be used beyond the institution then is may be prudent to use a more restrictive agreement.

3.5.3 Ownership of copyright

Recordings of patients are likely to be the copyright since 1 April 1991 (England and Wales) or 24 July 1990 (Scotland) of the employing National Health Service body

  • e.

    g. health authorities or NHS trusts.

      • 3.5.4

        Including in a multimedia repository

The principal concerns are with patient confidentiality, medical ethics and data protection in addition to copyright. The patient consent should cover all uses of

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