Legal and Ethical Considerations

Identifying Information

Identifying information (names, initials, or identifying numbers [ie, medical record numbers]) should not be published in written descriptions, photographs, and ancestry unless the information is essential for scientific purposes and the patient (or parent or guardian) gives written informed consent for publication, which must be copied to TPJ. Informed consent requires that the patient who is identifiable be shown the manuscript to be published. Authors should disclose to these patients whether any potential identifiable material will be available via the Internet as well as in print after publication. Complete anonymity is difficult to achieve and informed consent should be obtained if there is any doubt.

Conflict of Interest

Authors must make a statement of potential conflict of interest and complete the Disclosure Statement. The potential for conflict of interest can exist whether or not an individual believes that the relationship affects his or her scientific judgment. Financial relationships (such as employment, consultancies, stock ownership, honoraria, paid expert testimony, etc) are the most easily identifiable conflicts of interest and the most likely to undermine the credibility of TPJ, of the authors, and of science itself. However, conflicts can occur for other reasons, such as personal relationships, academic competition, and intellectual passion. It is the responsibility of authors to disclose all financial and personal relationships that might bias their work. Thus authors must state explicitly whether potential conflicts do or do not exist.

The Disclosure Statement must be submitted at the time of manuscript submission. As well as those potential conflicts listed above, the Disclosure Statement must include study funding and support.

Plagiarism and Other Misconduct

The Permanente Journal (TPJ) uses plagiarism detection software (CrossCheck/iThenticate) to limit the risks of research and publication misconduct. TPJ also discourages authors from duplicate publication and authors are required to disclose if a study is previously published and explain and detail the differences in the published article and the manuscript submitted for consideration.

Photographs and Other Images

Photographs depicting images of identifiable people must be accompanied by a Photographic Release Form. Subjects of images must be informed that their image will potentially be published in print and online.

Although beautification of an image is not misconduct, it should be avoided. Any change or alteration of an image or figure must be disclosed at time of submission. Change or alteration includes, but is not limited to, enhancement or removal of specific features; grouping of images that should have been presented separately; and adjustments that obscure, eliminate, or misrepresent any content information.

For images that are not of the author's own creation, reprint permission must be obtained and submitted to the Editorial Office. This includes images (graphs, charts, etc) created by the author but previously published elsewhere.

Protection of Human Subjects and Animals in Research

When reporting experiments on human subjects, authors should indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2013). If doubt exists whether the research was conducted in accordance with the Helsinki Declaration, the authors must explain the rationale for their approach and demonstrate that the institutional review body explicitly approved the doubtful aspects of the study.


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Author Resources

ICMJE – Recommendations for conduct and reporting of scholarly work are available from ICMJE at:

SQUIRE - Guidelines and resources for quality-improvement articles are available from SQUIRE at:

CONSORT – Guidelines and resources for reporting of randomized controlled trials are available from:

CARE Guidelines – Guidelines and resources for reporting case reports are available from:


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