Pediatric Clinical Images Without Consent: A Governance Gap in the Long-Term Reuse of Health Data in Digital Health Ecosystems - Report - MDSpire

Pediatric Clinical Images Without Consent: A Governance Gap in the Long-Term Reuse of Health Data in Digital Health Ecosystems

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  • Iwona Bujek

  • June 1, 2026

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Clinical Report: Unconsented Use of Pediatric Clinical Images and Governance Challenges

Overview

This report examines the ethical and governance challenges surrounding the unconsented use of pediatric clinical images in digital health systems. A longitudinal case study highlights the persistence and downstream reuse of these images, raising significant concerns about privacy and consent.

Background

Expand on the evolution of digital health systems and their impact on governance frameworks.

Data Highlights

No identifiable evidence of informed consent for publication or long-term educational reuse was found across the analyzed materials.

Key Findings

  • Clinical images can persist for decades across various digital platforms without proper consent.
  • Partial anonymization techniques, such as masking the eye region, may not adequately protect patient identity.
  • Responsibility for consent verification is often fragmented among authors, publishers, and educational institutions.
  • Ethical considerations are heightened for pediatric images due to the subjects' vulnerability and limited autonomy.
  • Current governance frameworks inadequately address the long-term reuse of clinical images in educational materials.

Clinical Implications

Suggest specific actions healthcare professionals can take to ensure compliance.

Conclusion

Reiterate the urgency of addressing these governance gaps with specific recommendations.

Related Resources & Content

  1. ICMJE | Recommendations | Protection of Research Participants, ICMJE, 2024 -- Guidance on consent for publishing identifiable clinical images
  2. npj Digital Medicine — Toward governance of artificial intelligence in pediatric healthcare, npj Digital Medicine, 2025 -- Governance frameworks in pediatric AI
  3. European Radiology — Cybersecurity Challenges in Radiology Departments Utilizing Artificial Intelligence, European Radiology, 2023 -- Cybersecurity in AI healthcare
  4. Journal of Medical Internet Research (JMIR) — Rethinking Trust in Synthetic Health Data: Lessons From 7 European Research Initiatives
  5. npj Digital Medicine — A user-driven consent platform for health data sharing in digital health applications
  6. Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates, HHS.gov
  7. DICOM PS3.15 2024e2025a - Security and Sys, DICOM
  8. ICMJE | Recommendations | Protection of Research Participants
  9. Re-identification of patients from imaging features extracted by foundation models | npj Digital Medicine
  10. Informed Consent Practices for Publication of Patient Images in Dermatology Journals - PubMed
  11. Characteristics, licensing, and ethical considerations of openly accessible oral-maxillofacial imaging datasets: a systematic review | npj Digital Medicine

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