Aims: The overall goal of this thesis was to explore the problem of consent for publication of clinical images, particularly identifying photographs of the face. The specific aims were 1) to assess journal policies on actual practices of publishing patient photographs and reporting on the obtaining of consent for publication; and 2) to explore the opinions of different stakeholders (patients, students, doctors) about the types of consent needed for publishing patient photographs, particularly in the digital form. Methods: The analysis of policies and practices was performed in a cross-sectional study. The opinions of doctors, patients and students were explored using two methodological approaches: 1) a cross-sectional questionnaire study including doctors and students of medicine and dental medicine at the Universities of Split and Zagreb, and patients attending dental and medical hospital and outpatient services in Split, and 2) a qualitative focus group study involving patients and doctors and students of medicine and dental medicine at the University of Split. Results: Current publishing practices in high-quality academic journals were not consistent and lacked a statement of obtained written informed consent for the publication of patient identifiable photographs. Only 52% of Dentistry and ORL journals included guidance about publishing clinical images of patients in their instructions to authors. From the total articles sample containing identifiable patient photographs, only 16% of articles (13/79) declared a statement regarding the obtained written consent for the publication. Relevant stakeholders' opinions, about the need for written consent in regards to the publishing of patient identifiable photographs, were not in line with current ethical guidelines. In the survey study, patients were most lenient regarding the need for obtaining written informed consent, followed by students and doctors. Only 33% of patients considered that written informed consent is required for the publication of the photograph of the face without any de-identification, mostly considering oral permission sufficient. Furthermore, doctors and students were more stringent requiring written informed consent for such publication (88-89%) but also more than half of the doctors (58%) considered that they are not obliged to provide the manuscript containing patient’s identifiable photographs that is going to be published. The focus group study explained these findings were due to the paternalistic patient-doctor relationship as a predominant model in the Croatian healthcare setting. Doctors considered that they were not obliged to ask patents to use their photographs. Patients and students considered health professionals in the Croatian healthcare system have a dominant role in the patient-doctor relationship and that patients were not informed properly in most situations. Conclusion: Current policies and practices of journals publishing research related to the face and neck region, in regard to obtaining and reporting of patients’ consent for publishing identifiable patient photographs are not harmonized with best practices. The opinions of stakeholders in the publication of patient photographs in academic journals (patients, students, doctors) do not have a sufficient level awareness of the processes and requirements for obtaining informed consent for publishing patient’s photographs, especially in the environment of open access publishing. There is a need for measures at different levels (information, education, professional policy-making) to implement adequate protocols for the protection of patient’s rights regarding publication of their photographs in academic journals.