The widespread availability of digital cameras (standalone, computer-based, in mobile phones) has made images broadly available for entertainment as well as for clinical teaching purposes. However, there are ethical and privacy issues that need to be carefully considered before whipping out the digital camera (or mobile phone) and taking a photo of an interesting skin lesion or post-operative result.
An article on the use of photography in clinical settings was recently highlighted by the CMPA and although the article was written in 2011, the points that are made are even more relevant in 2013 and should be reviewed by any physician who documents patient information using a digital camera.
- Always obtain express consent before taking photographs of patients for clinical or promotional purposes and clearly explain to patients how the images will be used;
- It is advisable to obtain written consent before proceeding. The CMPA article offers a number of useful criteria to include in a consent form;
- Maintain the privacy of your patient's personal health information. This includes both anatomical information that could identify that individual (e.g. facial features, tatoos or other unique skin lesions) and digital information (file naming conventions or image tags). The former is something that most clinicians will easily recognize, however for filing purposes, an image could be tagged with the patient's first and last name. If ever uploaded on a public website, even if the anatomical identifiers are avoided, Google is incredibly efficient at indexing names and images. Using an individual's first and last name, one could be unpleasantly surprised to be presented with images of that individual doing a simple Google image search;
- Another caution. When embedding images in presentations, remove all personally identifiable information from the original files before sharing the presentations.