How to use Internet graphics in your book – medical illustrations example

A publisher recently reached out asking about how to use Internet graphics in a yet-to-be released book on a specific medical condition. The author had found the images on a Google search, and wants to use them in the book. The problem that the publisher immediately identified: the images are copyrighted and therefore can’t be used in the book project without permission and/or paying licensing fees.

In addition to publishing Lean Media, my company publishes a line of guidebooks, the IN 30 MINUTES series. I have a few general guidelines for using existing medical diagrams in books based on my experience publishing C Diff In 30 Minutes and Acid Reflux and Heartburn In 30 Minutes.

Almost all of the graphics found on the Internet have three problems:

  1. They’re copyrighted and require permissions to use. The law is clear on this point – you cannot use copyrighted images scraped off the Web for your work (but there are some workarounds).
  2. The quality is rarely good enough for republishing. Internet images are usually resized downward to load quickly and look good on a computer screen or mobile device.
  3. Even if the quality is good enough, the colors and font sizes may not work for the format under consideration. For instance, IN 30 MINUTES guides are 6×9 inches and black and white, which means subtle color variations and small, detailed fonts are out of the question.

Recreating Internet graphics

It is possible to commission an artist to recreate a graphic of the human body, including adding annotations. Doing it from scratch is usually too expensive, though. For the most recent medical title we did, the author identified the graphics he wanted to use, and I found some low-cost vector graphics ($10 or less per image) that looked similar or covered the same body part, and often included basic annotations. I then had my regular book artist add annotations that not only were similar to the original, but in some cases were better than the original – clearer pointers, larger text, colors that translated well to greyscale, etc. Clear credit was given to the source of the vector graphics, but images created from scratch or wholly commissioned by my company were included in the copyright registration upon publication.

Upper Endoscopy based on licensed stock images. Credit: Depositphotos
Upper Endoscopy from Acid Reflux & Heartburn In 30 Minutes based on licensed stock images. Credit: Depositphotos

It’s also possible in some cases to use medical images published on public .gov websites, but you must make sure that they can be republished elsewhere. Sometimes the image release conditions are clear on the website, sometimes it’s not. For instance, the NIH website has this to say:

The NIH sponsors a centralized image service for the dissemination of primarily scientific, biomedical, and disease related imagery. Photos of NIH leadership, labs, buildings, and major historical events are also available. Images posted to the NIH Image Gallery are considered free-to-use with credit. This portal is provided for use by the science and health community, the press that covers health and science, teachers and other educators in health and scienceĀ  and non-profit organizations that produce health and science information. It is not intended for commercial use.

Book publishers in medical fields fall under educational use, although to be clear you could contact the NIH directly to confirm or ask your lawyer to review. “Commercial use” would be something like a pharmaceutical company or software company using an NIH image in an ad or promo brochure.

Additionally, you would be surprised at some of the good stuff that shows up on the stock photo websites. Shutterstock costs less than $10 per royalty-free image, but recently I have purchased bulk stock image credits from Depositphotos for something like $1 per image. What I often do is send the author the link to the stock photo website and have him search for suitable images to use or modify (based on the license offered by the company). It saves a ton of money and time, and protects your company from potential copyright notices and lawsuits down the road.

A few times I have asked for permission from companies to use images if there is no statement on the company website that allows use by publishers. They almost always give permission, although sometimes there are restrictions in the image release or photo release – you have to send the contextual information on the page containing the image for review, there is a time limit, or you can only use the image in the book but not in any publicity. I have also found some companies to be extremely slow in responding to image requests, too.

Finally, you can have an artist create something from scratch, commission a photographer to shoot photos, or license something from individual photographers and artists. I’ve done this in the past, and while it’s more expensive (typically a few hundred dollars per image, less for nonexclusive licenses) you get more control over the final product.

What about Creative Commons images?

A question that frequently pops up among publishers just getting started is whether images with creative commons licenses can be used in a book project. While some of the licenses allow commercial use and/or rights to modify the image, there are a few problems with creative commons licenses:

  • Most creative commons images are based on user-contributed content. You won’t know the provenance of the images, and if the user who uploaded it violated someone else’s copyright (for instance, stealing it from a stock photo website) the publisher will be liable if the victim decides to sue.
  • Some creative commons license types forbid commercial use or modification, and/or get changed or withdrawn at a later date.
  • While some quality creative commons images exist, oftentimes it’s not a great match with book publishing projects in terms of image quality or content.
  • If there is a problem with an image, there are a lot of very bad scenarios. Lawsuits are one, but even a cease & desist notice can cost a lot of money if it means withdrawing hundreds or thousands of print copies from circulation.

Bottom line: Understand the limitations of using Internet graphics on a book, know the workarounds, and consult your publishing lawyer if there are any questions or uncertainty.

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