Commons talk:Patient images

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Related discussions elsewhere:

Related policies:

Precedents on Commons[edit]

Images with questionable provenance, challenged and deleted:

Images with questionable provenance, challenged and kept:

Images from patients deleted:

Gallery: Parental consent[edit]

Gallery: Patient consent / model release unclear[edit]

Uploader does not attest patient permission

Gallery: Government image library public domain[edit]

None of these image pages mention patient consent or model release

Gallery: If not copyright then patient consent?[edit]

Reliable sources[edit]

Trying to find some authorative (vs. single doctor's perspectives in journal commentary sections is hard). But here are some links that I think are helpful re privacy and consent. I'll not address copyright issues here which should be easily addressed as per any other material in Wikipedia, provided (and this is the big proviso) one can work out who holds copyright on medical images.

  • International Committee of Medical Journal Editors (November 1995). "Protection of patients' rights to privacy". BMJ 311 (7015): 1272. PMID 11644736.
    This seems a useful piece not least because of international nature of the opinion, from: Annals of Internal Medicine, BMJ, Canadian Medical Association Journal, JAMA, Lancet, Medical Journal of Australia, New England Journal of Medicine, New Zealand Medical Journal, Tidsskrift for den Norske Laegeforening, Western Medical Journal, and National Library of Medicine ! Furthermore there are three classes of editors who might seek to upload an image:
    1. Medical staff - this reference though sets out guidelines that would seem normally to apply to Australian, Canadian, NZ, UK, US (apologies to wherever Tidsskrift comes from) and such people professionally should be no less ethical in their approach when acting as wikipedians.
    2. Patients themselves - presumably entirely free to disclose and self identify themselves in image if they so choose to (notwithstanding the separate copyright issues).
    3. Neither of the previous two groups - but presumably then question of circumstances by which they come to hold the images - is this with consent, and if so what were the terms of that consent (i.e. consent for storage in the patient's record, use as training aid for other doctors, copyrighted restricted-rights of a book, or the free-for-all of open license on the internet), otherwise a breach of data privacy/medical records ?
    Noted is "Complete anonymity is difficult to achieve, and informed consent should be obtained if there is any doubt. For example, masking of the eye region in photographs of patients is inadequate protection of anonymity"
  • Smith R (November 1995). "Publishing information about patients". BMJ 311 (7015): 1240–1. PMID 7496217.
    Observes "Medical journals and textbooks have been published on the assumption that they will be read largely by doctors. This may explain why editors have been lax in allowing the publication, without gaining consent from patients, of material from which it is likely that some people will be able to identify the patient. In particular, patients are upset when they find out that their cases have been presented without their consent." - and Wikipedia is most definitely not largely read by doctors.
    Some discussion has also been had whether non-identifiable material should be similarly considered (eg x-rays or endoscopy images), for wikipedian doctors (at least in UK) the guidance at the BMJ states "The BMJ now gets written consent from patients or their guardians for all the pictures published on the Minerva page, even when they show only radiographs or pathological specimens. Very few patients refuse. We also try (although we don't always manage this yet) to mention on the page that we have obtained the patient's permission."
  • (6 January 1996). "Advice to authors". BMJ 312: 41-3.
    This BMJ advice states on the subject "Patient confidentiality: If there is any chance that a patient may be identified from a case report, illustration, or paper we ask for the written consent of the patient for publication. Patients are almost always willing to give such consent. Black bands across the eyes are wholly ineffective in disguising the patient, and changing details of patients to try to disguise them is bad scientific practice."
  • Hood CA, Hope T, Dove P (March 1998). "Videos, photographs, and patient consent". BMJ 316 (7136): 1009–11. PMID 9550967. PMC: 1112855.
    A sobering article reporting on the professional disciplinary enquiry into 3 doctors. Of particular relevance is the very detailed and careful steps set out for publishing on the internet - see "New procedure for obtaining patients' consent for publication of medical images" box.
    But even if such "best practice" is done by a doctor:
    1. How does Wikipedia receive or keep such consent documentation ?
    2. If done on basis of the editor's "honour", how can we verify the editor's identity - do editors submitting medical images need to fully disclose their identity, or at least give permission to the Foundation to disclose it on their behalf if a valid formal request in writing received over a particular image (I don't mean a court order, but rather a hardcopy signed request by a patient) ? Whilst my entry on the GMC Medical Register is easily locatable and gives some very sparse information, would I agree to disclose much more information on the internet ? I think not.
  • Geiderman JM, Larkin GL (July 2002). "Commercial filming of patient care activities in hospitals". JAMA 288 (3): 373–9. PMID 12117405.
    Whilst there is no commercial gain issue at Wikipedia itself, material may be used by others in a commercial manner. The "Legal Considerations " section is interesting reading (for a non-US) and sets out good practice points that seem more generally applicable (and to our discussion here).
  • Mallardi V (October 2005). "[The origin of informed consent]". Acta Otorhinolaryngol Ital 25 (5): 312–27. PMID 16602332.
    This sets out historical development of concepts of consent.

Davidruben (talk) 02:42, 29 June 2008 (UTC)

Verification of consent[edit]

Wikimedia Commons already has a procedure for verifying licensing when an image is uploaded by someone other than the copyright holder. Perhaps a similar procedure could work for verifying patient consent and model releases more generally. --Una Smith (talk) 03:27, 29 June 2008 (UTC)

(I clearly do not known enough of the details of Commons) if so might sort out the problem, so can you please point me to that specific current proceedure :-) Davidruben (talk) 14:34, 29 June 2008 (UTC)
See Commons:Email templates and Commons:OTRS. This procedure enables copyright holders to license images in a relatively private and confidential manner. In the United States publishing industry, it is not necessary for the publisher to show the viewer proof of permission to publish. The publisher merely needs to obtain permission from the copyright holder and/or creator and/or model (subject, patient). (See w:Copyright and w:Model release). It is a point of good marketing for the publisher to attest to the viewer that the appropriate permissions have been obtained. Note that this Wikimedia Commons procedure relies on private attestation. --Una Smith (talk) 15:32, 29 June 2008 (UTC)

Work for hire[edit]

w:Work for hire needs cleanup, and expansion to include medical images, but gives the basic idea of the difference between copyright and moral right. --Una Smith (talk) 15:53, 29 June 2008 (UTC)

Creation of patient images[edit]

With respect to Commons and Wikipedia, the issue of greatest concern is publishing of patient images. But there are additional issues surrounding the creation of patient images. Some refs follow. --Una Smith (talk) 23:42, 29 June 2008 (UTC)

Journal "model release" forms for patient images[edit]

Started section with 2 forms. --Una Smith (talk) 04:08, 30 June 2008 (UTC)

The question is of course: can we use consent forms, and who veries them? I don't think we could send them to OTRS... --Steven Fruitsmaak (Reply) 12:22, 3 July 2008 (UTC)
Another question: do we need consent forms? Model releases are needed only when the use is not editorial. Photo journalists do not need to obtain model releases. Patients merit more protection, but how much more? Publishers normally do not see the model release; instead, the photographer merely attests that there is or is not a model release. --Una Smith (talk) 03:53, 4 July 2008 (UTC)
You would be foolish to take images of identifiable patients without getting sign consent for release on Wikipedia. As the healthcare provider you need to keep a copy of all these forms. If a subject of the photo approaches your licensing body than you have documented proof that you obtained consent. Wikipedia does not need to get involved. James Heilman, MD (talk) 04:32, 18 September 2013 (UTC)

Copyright/author[edit]

We currently list four possible "authors" under the ==Copyright== section: patient, ordering physician, technician, and radiologist. I don't think that it's going to be the patient, who neither takes the image nor meets the work for hire rules (there's no employer/employee agency here, as the patient has essentially no control over the pay, working conditions, etc.) It's also not going to be the radiology tech, who is definitely an employee making an image in the course of his/her normal employment. That option should probably be replaced by the hospital/clinic/entity that employs the RT.

At the moment, I'm leaning a little towards the hospital/clinic/entity that employs the RT as being the legal author. I've actually sent a note to the U.S. Copyright Office, and will let you know whether I get a response. If we don't get a response (they provide "information" but not "legal advice"), then it might be worth asking the Wikimedia Foundation to hire a lawyer to issue an official opinion on at least the simplest case of an image taken in the U.S. as part of medically necessary treatment (e.g., X-ray for a broken arm). Relative to screwing up, the attorney's fee will be cheap. WhatamIdoing (talk) 18:11, 30 June 2008 (UTC)

w:Work for hire can occur under conditions other than employment. In any case, it is not for us to determine who is the author. The person who uploads the image has the obligation to determine and reveal (or not reveal) the identity of the author. --Una Smith (talk) 19:32, 30 June 2008 (UTC)
It is true, but not immediately relevant under US law, that works for hire can be created outside of employment. Note that this is an "agency" rule for what constitutes an employer/employee relationship, which is not what most of us are used to calling employment. Employment agency is broader than just "plain" employment, although every person who is employed in the normal sense is included in that group. If there is no employer/employee agency, then there are nine other categories of work which can be explicitly created as works for hire -- and the creation of medical images isn't in the list.
The reason that the author matters is that it tells us who naturally holds the copyright for an unregistered work, and that clearly does matter to us. (I assume, of course, that we want this essay to actually be useful to the person who is trying to do the right thing.) WhatamIdoing (talk) 20:37, 30 June 2008 (UTC)
Unfortunately, (knowing) the author does not tell us who naturally holds the copyright. Author and copyright holder often are one and the same, but not always. Also, not every person employed in the normal sense is in "that group". University faculty are a case in point; their photographs and other images generally are not work for hire; they are the authors of the images they create, and they hold the copyright (unless they transfer it to, eg, a publisher). However, a university staff photographer or artist who creates photographs for the faculty to use in their books and other publications generally is doing "work for hire" and gets no credit, only a fee: the faculty member who requests the image is the author and the copyright holder. --Una Smith (talk) 02:36, 1 July 2008 (UTC)

All that Commons can do is ask who is the author, who is the copyright holder, and who is the patient? ...oops. (See the problem?) Commons can also ask: is the image licensed with the author's permission, with the copyright holder's permission, and with the patient's permission? Ultimately, with respect to all images Commons relies on attestation; eg, that the uploader made the image, or that X made the image, in which case behind the scenes a volunteer receives an e-mail purportedly from X, seconding the uploader's attestation. --Una Smith (talk) 02:41, 1 July 2008 (UTC)

Faculty members technically do not write books or create artwork during the normal course of their employment, but never mind: my stated assumption that the goal behind this essay was to be useful to the person who does not know anything about copyright law and is trying to do the right thing is invalid. Therefore, I see no point in continuing this conversation. I'll take it off my watchlist. WhatamIdoing (talk) 04:49, 1 July 2008 (UTC)
At this point, we're still trying to figure out what is the right thing to do. --Una Smith (talk) 03:47, 4 July 2008 (UTC)
We certainly do not rely solely on attestation. If someone says, "I swear it's all public domain" they're going to have to prove it if they want it to stay here. Similarly, if they say "I own the copyright on this medical image", they will have to make a convincing argument. The page currently suggests that "The patient, who in several countries owns the copyright to material in his medical records", but it does not list the alleged countries or any evidence. Superm401 - Talk 01:08, 3 July 2008 (UTC)
"I swear ... public domain" is an attestation about license. If it is made by the copyright holder then it is so. If someone who uploads an image attests that they are the copyright holder because it is self-made, normally that is sufficient. Why set the copyright bar higher for patient images than for other images? --Una Smith (talk) 03:47, 4 July 2008 (UTC)
Public domain is not a license. Nor is it possible for a copyright holder to say something is public domain. That is a contradiction. It may be possible to dedicate to the public domain, but this is not well-established. Superm401 - Talk 18:53, 5 July 2008 (UTC)
There is no contradiction. The copyright holder puts a work in the public by saying that it is in the public domain. People who upload images to Commons do it all the time. --Una Smith (talk) 20:32, 5 July 2008 (UTC)
A simple attestation ("I swear it's public domain") is different from an explanation of why an image is free. There are many possible explanations (e.g. made 200 years ago, I took the photograph), but some explanation is vital. The bar is not being set higher here. There is no copyright problem (there may be a privacy one) with self-made patient images being uploaded. Superm401 - Talk 18:53, 5 July 2008 (UTC)
"I took the photo" is not an explanation of why an image is public domain (or under a free license); it is an attestation, indirectly, that the uploader is the copyright holder. The problem with patient images created in the context of medical care is that the person who took the photo (the author) is not necessarily the copyright holder. The problem is not self portraits but rather radiographs, photos of surgery in progress, and photos of pathology specimens. --Una Smith (talk) 20:24, 5 July 2008 (UTC)
"I took the photo" would not be the whole explanation, but a necessary part. Similarly, for a radiograph the page might say, e.g. a nurse employed by Veteran's Affairs took this image, so it is P.D.". Note that just saying it's free or PD (an attestation) is never enough. Superm401 - Talk 22:07, 8 July 2008 (UTC)
People who have not worked for a US federal government agency often think it works that way, but the rule applies only to official publications of the US federal government. It does not apply to works that are not official publications. Thus, a radiograph taken by a nurse employed by the VA is not automatically in the public domain. --Una Smith (talk) 02:28, 9 July 2008 (UTC)
It has nothing to do with "official publications". The rule is that "A “work of the United States Government” is a work prepared by an officer or employee of the United States Government as part of that person’s official duties."[1] The work doesn't even have to be published. Superm401 - Talk 18:48, 9 July 2008 (UTC)
So, Superm401, are you arguing the above VA radiograph is PD? --Una Smith (talk) 05:29, 10 July 2008 (UTC)
If it's made by a U.S. government employee during their official duties, yes. Superm401 - Talk 11:48, 10 July 2008 (UTC)
Just saying it is PD is enough, if that attestation is made by the copyright holder. --Una Smith (talk) 02:28, 9 July 2008 (UTC)

Work of the U.S. government[edit]

I'm moving his down to avoid indenting: Superm401 - Talk 02:08, 18 July 2008 (UTC)

It's more complex than that. See Frequently Asked Questions About Copyright: Issues Affecting the U.S. Government. --Una Smith (talk) 14:06, 10 July 2008 (UTC)

Please explain the alleged complexities for me. The page you link to repeats, "A "work of the United States Government," referred to in this document as a U.S. Government work, is a work prepared by an officer or employee of the United States Government as part of that person's official duties. (See 17 USC § 101, Definitions.56)", which is exactly what I said. None of the clarifying remarks in any way contradict that. Superm401 - Talk 22:22, 14 July 2008 (UTC)
As alluded to in the link, "official" has special meaning. Most employees are not officials, and do not speak for the US government. Their work is not automatically in the public domain. --Una Smith (talk) 03:01, 16 July 2008 (UTC)
It doesn't matter whether the employee is an official (whatever that even means), nor "whether they speak for the US government". Neither of those are mentioned in the law. "Official duties" just means they're doing what they're hired to do. Note that the page you've linked says, "An officer's or employee's official duties are the duties assigned to the individual as a result of employment." Such duties do not need to involve speaking in any context. Superm401 - Talk 01:59, 18 July 2008 (UTC)
Please read Frequently Asked Questions About Copyright: Issues Affecting the U.S. Government again. It explains how the letter of the law is interpreted by the US Government. There are key qualifications. So, for example, patient images in VA patient records are not public domain. Similarly, publications authored by government employees that are not official publications may be released into the public domain but are not necessarily public domain per this law. This wrinkle applies particularly to articles by government employees that are published in scholarly journals. There is yet another wrinkle: many images in US government public domain publications are not in the public domain. This happens when the document includes a copyrighted image, used with permission. --Una Smith (talk) 07:53, 27 August 2008 (UTC)
I see no mention of the VA in that document. Nor do I see what external used with permission images have anything to do with this discussion. Superm401 - Talk 19:18, 27 August 2008 (UTC)
Indeed, it seems Una Smith has misread on this point.  — Mike.lifeguard | @en.wb 16:17, 5 December 2008 (UTC)

"Patient experience" marketing videos[edit]

Take a look at this. --Una Smith (talk) 20:58, 4 July 2008 (UTC)

Running loose with Meshworks v. Toyota Motor Sales[edit]

An addition was made that suggests that medical images are in the public domain; it cites this, which in turn cites Meshworks v. Toyota Motor Sales to argue that, unless there is an expressed artistic element in radiographs, micrographs, and a range of other technical works, they are ineligible for copyright protection. IMO (and IANAL), this is an extreme stretch of the court case, which seems rather specific. Copyright law doesn't require art, it requires originality. The choice of placement, angle, and exposure on a radiograph, and of field, lighting, and aperture on a micrograph is an informed decision; different technicians will make different decisions to achieve different results. This is an area where hand-waving is not likely to be useful without actual case law to back it up.--Curtis Clark (talk) 03:10, 20 August 2012 (UTC)

It also fails the "if this were so then..." test. If this were so, we could upload all such images from all online medical journals onto commons and have the biggest radiographic image library in the world. Colin (talk) 10:03, 20 August 2012 (UTC)
Besides, it would only be valid for images generated in the US. In Germany, x-rays are copyright-protected, though to a slightly lower grade than artistic works. --Túrelio (talk) 12:00, 20 August 2012 (UTC)
Not at all. If someone builds a house they go not get copyright on it.
We might be able to upload every Xray image in the world and have the biggest library but that would be cowboyish. It would likely result in clarification of the law though. James Heilman, MD (talk) 04:36, 18 September 2013 (UTC)

UK copyright of X rays[edit]

Per here [2] X rays do not seem to fall under UK copyright protection. They are not really a picture but are representations taken with the exact same technique each time. Creativity in taking X rays is not allowed. If the tech came back and said he or she adjusted the angle / strength as they though it looked more artistic they would be shown the door. James Heilman, MD (talk) 13:39, 20 August 2012 (UTC)

Perhaps in the UK, "original" = "artistic". In the US, "original" can also mean "more diagnostic". I have absolutely no familiarity with medical standards other than as an informed consumer, and sometimes I suspect that my HMO standardizes care rather than optimizing it ("If I rotated that a bit more, we might be able to see the problem, but I'm not allowed to do so."), but I have a lot of experience with scientific imaging, and I know that a lot of work goes into showing the areas of interest and not letting them get overwhelmed by the uninteresting stuff. And given that medical imagery is used for things other than medical practice (research comes to mind), even if diagnostic X-rays were copyright-ineligible, we'd still have to determine on a case by case basis whether a given X-ray was diagnostic or for other purposes.--Curtis Clark (talk) 15:27, 20 August 2012 (UTC)
Sure nearly all X rays are for diagnostic purposes especially as there is potential harm to imaging. James Heilman, MD (talk) 15:31, 20 August 2012 (UTC)

Encephaly image [3][edit]

There is a discussion about deleting a particular image.

More about this discussion is on the en.wiki's WikiProject Medicine page.

A user suggested that the Human Tissue Act 2004 which resulted from the Alder Hey organs scandal might contain information about using media. Anyone who can cite a source explaining best practices would be especially welcome to share the policies in place of existing organizations, journals, or governments. Blue Rasberry (talk) 14:33, 13 December 2012 (UTC)

The act doesn't cover photographs themselves as it is only concerned with human tissue. However, the Royal College of Pathologists were concerned that taking photographs would be considered a "use" of the tissue without consent. The Act is important in that it enshrines in law the desire that "human bodies, body parts and tissue be treated with appropriate respect and dignity". -- Colin (talk) 15:18, 13 December 2012 (UTC)

Hi. I am the en.wiki user that began the discussion mentioned above. There was a substantial conversation that has now concluded, but it has not been closed.

Now there is a new development. Despite the concerns expressed on en.wiki, the same user has now uploaded the file to Commons. I am somewhat at a loss regarding what to do now, as I am not very familiar with the norms at Commons. I did find this policy page helpful, and I think it tends to support my original argument that the image should be deleted, though I note that it says nothing about two issues relevant to the current discussion:

  • What if the image is composed in such a way as to arguably be demeaning to the subject? Does that strengthen the argument that consent is required, even if the image arguably advances medical education?
  • What if the subject of the image is a minor? Who can give consent?

I think those questions would be useful additions to this policy page. Additionally, is there any policy about images being uploaded to Commons despite being the subject of unresolved contention on a language wiki? Finally, I would be grateful for any advice as to how to proceed with challenging the presence of this image on Commons. Thanks, --BlueMoonlet (talk) 19:18, 27 December 2012 (UTC)

This isn't a policy.
Commons generally accepts any image that meets its requirements, no matter what else is going on elsewhere.
You might want to read the actual requirements at Commons:Photographs of identifiable people and Foundation:Resolution:Images of identifiable people. WhatamIdoing (talk) 01:28, 28 December 2012 (UTC)
I'm afraid that Commons isn't concerned with image issues beyond copyright law and other laws as it affects their hosting servers. I believe trying to provoke any discussion on ethics here is just pissing in the wind. IMO the WMF should consult with professionals wrt ethics and establish a position from above -- this is no subject for "the wisdom of the crowd", especially given the demographics here.
Without appropriate consent from the parents, it is quite likely that in some countries any doctor who took and uploaded an image such as this broke their employment contract, the guidelines of their professional body, the doctor-patient contract with the mother. But because it has a CC BY-SA 3.0 licence, Commons, quite frankly couldn't give a damn. Colin (talk) 14:08, 28 December 2012 (UTC)
I believe that Colin is right. Commons is somewhat single-minded in its approach. WhatamIdoing (talk) 03:14, 29 December 2012 (UTC)
Thank you for your advice. It sure seems to me that the policies you quoted are favorable to my case. The image 1) was taken in a private place, 2) is demeaning to the subject, and 3) intrudes into a tragic family situation. Are you saying that the users who frequent Commons are not actually interested in applying these policies as written? When you say Commons is "single-minded," on what single purpose is its mind focused? Inclusion of images across the board?
Furthermore, moving this file from en.wiki to Commons is blatant forum shopping. Does anyone here care about such things?
Finally, none of these policies or guidelines say anything about the procedure by which they are enforced. How does one go about challenging an image that does not meet the guideline? After looking around a tiny bit, perhaps I should initiate a deletion request with a citation of the privacy policy as the reason. I might also be inclined to alert all the en.wiki users who previously commented on this image (regardless of whether they agreed with me, so as to avoid canvassing). However, if you think these are bad ideas, I would value your input as more experienced Commons users. Thanks, --BlueMoonlet (talk) 01:11, 30 December 2012 (UTC)
There are some reasonable people on Commons but they are often overwhelmed by, well by juvenile boys basically. The reaction of a typical Commons user to this image is likely to be "Excellent! That's gross. Hey guys come look at this..." rather than "I hope that doctor got permission before taking snaps with his mobile phone". Internet culture regards any form of editorial restraint as censorship and something to be opposed with the fervour of a human rights campaign. Trying to "do the right thing" is not a priority. Commons delights in finding reasons to host an image and unless concerns have the force of law, they are often disregarded.
Our guideline on photographs of identifiable people (as currently written) doesn't strictly apply as the subject is dead and some legal authorities might have considered it never alive. You seem to have a problem with this image itself rather than whether consent was given (by the parents). Correct me if I'm wrong. My position is that this is a low-quality image but definitely in-scope for Commons and useful for Wikipedia provided parental consent was given (and affirmed by the uploader).
Btw, the moving of the image from Wikipedia to Commons is not "forum shopping" but a quite normal thing that occurs whenever an image uploaded to Wikipedia is also appropriate for Commons (some images aren't).
I will ask around to see if someone else can help with this. Colin (talk) 17:39, 30 December 2012 (UTC)
Thanks. I'll think on this.
Since you ask, my objection to the image is intimately connected with the issue of consent. As I have repeatedly explained in conversations linked in this thread, I have no problem with the image being graphic or "gross", but I do object to the disrespectful way in which the subject is portrayed. An interesting comparison might be an unflattering image of a public person in a public place; just out of curiosity, would Commons have any problem hosting an image like this if it were copyright-free etc.? In general, an image subject (or people who care about him/her) would generally refuse consent to publish such images if they were asked, which is why I think it is important to at least ask whether the image in question was obtained under consent.
Your point about the subject being dead is curious. To take a related hypothetical, would Commons have no scruples about hosting an image of a dead body that was surreptitiously taken in a private place above the objections of the deceased's family? --BlueMoonlet (talk) 21:07, 2 January 2013 (UTC)
Well despite my lack of hope wrt ethics on Commons, I have been trying to improve our guideline Commons:Photographs of identifiable people and have proposed a significant redraft at Commons talk:Photographs of identifiable people#Another redraft. Both the law and the ethical situation wrt photographs of people is more complex than the current guideline implies. I'd rather comment on specific photographs, where we know all the details, than on some hypothetical situation. I suspect it probably would host the Clinton photograph but slap a big {{personality rights}} template on it, and it couldn't be used on Wikipedia. -- Colin (talk) 22:14, 2 January 2013 (UTC)
The uploader may be from Pakistan as he or she uploaded some currency from their. I am not convinced that even without content uploaded this image would constitute "broke their employment contract, the guidelines of their professional body, the doctor-patient contract with the mother" and think it is inappropriate for us to speculate here. The image is not recognizable as an individual and we should not start making judgement's on aesthetic considerations. We still have no idea if this user received consent. They may have limited English ability limiting their desire to jump into this discussion. James Heilman, MD (talk) 03:44, 3 January 2013 (UTC)
Commons has pictures of people picking their noses. A picture of a politician with an odd smile or taken from a strange angle wouldn't bother the Commons community at all. WhatamIdoing (talk) 17:02, 3 January 2013 (UTC)

(outdent) I did clarify that the "break their various contracts" bit was only for some countries. Pakistan medical journals still think that "blackened out" eyes protect a patient's identity Journal of the College of Physicians and Surgeons Pakistan: Instructions to Authors but their medical council does state that permission is required before taking photographs of patient. In general, Pakistan is bottom of the table with regard to ethics of various kinds (Source: World Bank).

The actual ethical situation of this photograph is unknown. While in the absence of evidence it might be nice to consider that the medic behaved ethically (to our standards), we're not judging the person, but whether we can host/publish a picture. For those reasons, if Commons agrees that consent is required (and it is a big if), then we need the uploader to confirm that consent was received. -- Colin (talk) 09:38, 3 January 2013 (UTC)

Featured picture nominated for deletion for being technician-performed[edit]

There is a discussion at Commons:Deletion requests/File:Computed tomography of human brain - large.png about deleting the image because of copyright concerns. I told participants there to come there and talk. Blue Rasberry (talk) 15:05, 16 September 2013 (UTC)

The discussion could potentially result in the deletion of all radiological images. James Heilman, MD (talk) 21:16, 16 September 2013 (UTC)
In 2011 or 2012 I've deleted several x-rays, uploaded by patient himself, as source country was Germany, where the copyright situation is clear. --Túrelio (talk) 14:24, 18 September 2013 (UTC)
Except that the copyright situation is NOT clear and repeatedly stating it is so does not make it true. James Heilman, MD (talk) 01:07, 19 September 2013 (UTC)
Except it is (for Germany, §72 UrhG[4] and scholarly references in[5]) and repeatedly stating it is not so does not make your claim true. --Túrelio (talk) 06:14, 19 September 2013 (UTC)

Okay the ref is: (1) photographs and products that are manufactured similarly light images are protected by analogous application of the provisions applicable to photographic works of the part 1. (2) The right referred to in paragraph 1 is to the light generator. (3) The right referred to in paragraph 1 expire fifty years after the publication of the photograph or if its first allowed public took place earlier in public after this, however, fifty years after the making when the photograph within this period published or lawfully has been reproduced. The period shall be calculated in accordance with § 69th[6] And once again a wiki is not a reliable source.

Diagnostic X-rays are not manufactured similar to photographs. They are made following very strict protocols. Nowhere does it say diagnostic imaging is copyrightable. I am fairly sure that Germany has radiology journals. Have you tried asking them what they do? James Heilman, MD (talk) 10:09, 19 September 2013 (UTC)

Your habit of strawman-arguing (And once again a wiki is not a reliable source) is really disgusting, especially for an MD and :en-admin. In my above comment I expressed referred to the scholarly references[7][8]. How hard was that to be misunderstood? --Túrelio (talk) 10:15, 19 September 2013 (UTC)
You are free to attack me personally "is really disgusting, especially for an MD and :en-admin" Law is complicated which is why there are lawyers. A lay interpretation of bits and pieces of it is not the way forwards. This is a bit funny as it has been emphasized that their are 4 sources both here [9] and by yourself earlier. I pointed out the fact that wikis are not regarded as reliable sources but the number did not decreased to 3. Best James Heilman, MD (talk) 11:14, 19 September 2013 (UTC)