Need for greater consensus on protection of patient anonymity and rights in facial photographs: a survey of international and domestic oral surgery journals.

Although the International Committee of Medical Journal Editors has announced that masking the eye area in clinical photographs is inadequate for protection of patient anonymity, such examples can frequently be found in the field of oral surgery, indicating a large gap between the ideal and reality. In this study, two internationally and one domestically distributed journal published between 2009 and 2011 were analyzed. All articles containing clinical photographs of a patient's facial area were extracted and assessed based on 3 criteria: 1) extent of facial area visible, 2) necessity of showing eye area, and 3) presence or absence and form of eye masking. Showing the eye area was judged necessary in a total of 69.7% and 72.4% of photographs in the international journals, but in only 34.4% in the domestic journal. No eye masking was observed in 46.0% of photographs in one international journal and in only 4.7% in the domestic journal. Inappropriate masking occurred in 57.8% in the domestic journal. These results indicate that usage of eye masking reflects the editorial policy of a journal, influencing both author and reader consciousness. Although there may be problems in adhering to privacy regulations in a clinical setting, more needs to be done to ensure patient privacy in both journals and an educational setting.