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May 22, 1991

Patients Have a Right to Privacy and Anonymity in Medical Publication

JAMA. 1991;265(20):2720. doi:10.1001/jama.1991.03460200100043

The classical ideal of the good patient-doctor relationship implicity accepts the doctor's access to the patient's physical, social, and mental "nudity," as long as this intrusion serves the patient's best interests. Without such an implicit confidence, most clinical work would be impossible. Yet breaches of confidence do occur, sometimes deliberately, sometimes by accident or simply by lack of consideration. Examples may include release of sensitive patient information to the press, gossip in the local medical community, and public disclosures through administrative or legal statements.

A relatively new ethical transgression is intrusion into a patient's bodily or social integrity by clinical descriptions and photographs printed in textbooks or medical journals. The phenomenon itself is not new. A quick glance into many old and new textbooks will demonstrate patients portrayed in the nude without any masking or any statement on the patients' informed consent. What is new, however, is that public and