The data and information of individuals (e.g., information obtained through a doctor–patient relationship) must be handled with the highest levels of confidence and discretion. It is therefore almost always necessary for authors to obtain written informed consent from any patients described in case reports and from those who are the subject of photographs. However, a report may be published without explicit consent if it meets all three of the following conditions: it is of great significance to public health (or is important in some other way); consent would be unusually difficult to obtain; and a reasonable individual would be unlikely to object to publication.