During the submission please upload the Consent form as a supplemental form and label it 'patient consent form'.

Patients have a right to expect that identifiable information about themselves provided or discovered in the course of their health care will not be shared with other people without their knowledge. The disclosure of identifiable information without the patient's consent to someone who did not previously know it breaches confidentiality. The duty of confidentiality is owed to all patients, including mature and immature minors, and adults who lack the capacity to take decisions for themselves. The duty endures beyond the individual's death.

BMA. Confidentiality & disclosure of health information (London, BMA: 14 October 1999.)

For all articles reporting patient information, for example, case reports consent forms must be uploaded with your manuscript at the time of submission; please upload a consent form for each patient as a supplemental file and label them 'patient consent form'. Your article will NOT enter the review process until written consent has been received.

Larger studies on patients or volunteers require ethics committee approval which typically includes informed consent. As author, you should have obtained ethics committee approval and informed consent and this should be stated in your covering letter and in your manuscript.

Pedigrees, particularly those containing information on people who may be presymptomatic carriers of later onset disease, should, as far as possible, be anonymised.

The multimedia environment poses different challenges in relation to anonymisation. This may be easiest with text, and more difficult with photos and video. Data relating to aggregate anonymised tissue and other samples will not normally be considered personal information relating to a particular patient and publication of research findings connected with such samples does not require patient consent.

1. The patient who is the focus of the article is dead, and his or her family is untraceable to seek consent.

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 of photographs without consent will require particular scrupulous attention to anonymisation.)