Patient consent form
OUP GUIDELINES FOR THE USE OF THE CONSENT FORM
THE APPROACH
 Approach the patient in a neutral way. Do not apologise for wanting to photograph them, but don’t
assume they will complain, either. But, remember that the patient is under no obligation to sign, and
take care not to pressurise them in any way.
 Make sure that the patient knows why you are photographing them. Hopefully they will - but that won’t
always be the case!
 Make sure the patient knows what image is being taken and whether it is a photograph, video or sound
recording.
 If an image is only for the library or publication (i.e. that the photograph is not directly related to their
on-going medical care), then the patient must be made aware of this
 Use the consent form for all photographs, videos and sound recordings, even if the request is for routine
photography.
GAINING CONSENT
 Give the patient time to read the form.
 Be guided by the patient. You should give the patient general information and make sure they
understand the main purpose for taking the photographs and what you, and others, may be using their
image for. Give clear and simple explanations of parts of the form if the patient asks. Be honest but
don’t go into too much technical detail unless they wish you to. Too much information can actually
reduce a person’s ability to understand, and therefore, to give informed consent.
 Make clear the importance of medical images in teaching medical students, nursing students, qualified
doctors, nurses and other health professionals. Explain that:
 the photograph (video/sound file) is to be used primarily for teaching and educational publication;
the publications will be targeted at health care workers but the possibility of the general public
seeing these pictures (e.g. in a book on sale in a bookshop) cannot be eliminated. Please also assure
the patient that, where possible, all identifying features will be removed.
 Electronic publication refers to material that is now available on computer disks, CD-Roms, handhelds, or via the Internet.
 It is possible that only part of the image may be used in publications, and it may also be combined
with other photographs or graphical material. The basic subject matter will not be changed.
 The image will be stored by the Publisher indefinitely unless a request is made for its removal from
the database. Removal will not affect uses that have already been made.
 Images that form part of on-going legal cases may not be used. The patient should be told that he/she
has a duty to make known any ongoing and/or proposed litigation.
CONFIDENTIALITY
 Anonymity will be preserved wherever possible and the majority of pictures need not reveal identifiable
features. For example, with new techniques, photos and images can be digitised and tattoos removed in
an effort to achieve maximum confidentiality.
SENSITIVE IMAGES
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 For some images, anonymity cannot always be preserved (e.g. facial images). Once such photographs
or videos have been taken, tell the patient that there is an allotted cooling-off period of fourteen days
during which the image will not be shown outside the department. If during this time the patient
changes his/her mind the photograph or video will not be used.
REFUSAL
 Always make it very clear that patients have the right to refuse with no effect on medical care.
 Some patients will be referred for clinical purposes and some as part of projects to build up a ‘library of
pictures’ for teaching and educational publication. Patients may refuse consent for their photograph,
video or sound files to be placed in the library whilst still giving consent for their image to be part of
their confidential medical notes. If they refuse consent for the photographs, videos or sound files to be
taken at all the referring doctor should be informed.
 Tell the patient that they can view their image at any time and/or withdraw consent for its use in the
‘library of pictures’ for teaching and for new educational publications (but obviously not for past or
current uses).
 Make it clear that if consent is withdrawn the image will be removed from the ‘library of pictures’. If
however, fourteen days have passed since taking the photos, video or recording, the photos, video or
sound files may already have been used for teaching or publication.
SPECIAL CASES
 If the patient is under 16 years of age then the consent of the parent or guardian must be obtained in all
cases. However, the views of the child must not be ignored and if they object, even if parental consent
has been given, then the image or sound file should not be taken. Children have the right to review, and
withdraw, their consent at any time.
 Where it is deemed that a patient is unfit to give consent e.g. dementia, confusion, it must be gained
from a close relative or carer. In Scotland, you must seek agreement from any person, appointed under
the Adults with Incapacity (Scotland) Act 2000, having an interest in the welfare of the patient. If the
patient subsequently recovers to a state where they are capable of giving consent, then consent must be
re-obtained at that time.
These guidelines are based on those of Oxford Medical Illustration, John Radcliffe Hospital, Oxford, and
their kind permission in making their guidelines available for our use is gratefully acknowledged.
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CONSENT TO PUBLICATION OF MATERIAL ABOUT THE PATIENT
PLEASE USE BLOCK CAPITALS
Patient name...................................................................................................
PATIENT CONSENT
I hereby confirm that I give consent for the material set out on the attached request form to be
published.
It has been explained to me that the material has educational value. I therefore consent to the
material being shown to appropriate professional staff (i.e. health care professionals, including
students) and published in educational publications, journals, textbooks in any form or medium
(including all forms of electronic publication or distribution) anywhere in the world without time
limit. I also understand that it is possible that the material may be seen by the general public. All
or any part of the material may be used in conjunction with other photographs, drawings,
videotape images, sound recordings or other forms of illustration. I understand that efforts will be
made to conceal my identity, but that full anonymity cannot be guaranteed.
I understand that I may view the material by arrangement with ………………………. .
However, once the material is made available for research or teaching purposes (which shall
include publication), I realise that recovery of the material may not be possible. I understand that
no fee is payable by ………………………. or any other person for use of the material either
now, or at any time in the future.
I confirm that the purpose for which the material may be used has been explained to me in terms
which I have understood. It has been made clear to me that refusal to consent will in no way
affect my medical care. I confirm that I am over 16 years old, of sound mind and that I am not
signing under any form of duress.
To be completed by the patient or parent/guardian, or next of kin if the patient is under 16
years of age, or deemed unfit to give legal consent.
Full name:.......................................................................................................................
Address:.....................................................................................................................
Signature ..............................................................................Date:..............................
(Patient, parent/guardian or next of kin)
Signature……………………………………………. Date………………………………..
Hospital details
.................................................................................…………………………………………………………
…………………………………………………………………………………………………………….
Date:.........................................
This form is largely based on the consent form of Oxford Medical Illustration, John Radcliffe Hospital,
Oxford and their kind permission in making their consent form available is gratefully acknowledged.
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