Abstract
Clinical photography is an important tool for medical practice, training and research. While in the past clinical pictures were confined to the stringent controls of surgeries and hospitals technological advances have made possible to take pictures and share them through the internet with only a few clicks. Confronted with this possibility I explore if a case could be made for using clinical photography in tandem with social media. In order to do this I explore: (1) if patient’s informed consent is required for the publication of any clinical images that depicts her, irrespective of whether the patient can be identified from the image or not, (2) if social media is an adequate place for clinical images to be displayed, and finally (3) if there are special considerations that should be taken into account when publishing clinical images on social media.
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Notes
In this article I will not elaborate on the connection between my arguments and particular data protection laws (that most of the times are grounded on the concepts of privacy and informed consent) because that would vastly exceed the scope of the paper and also because I want to focus on the ethics of clinical photography independently considered of state regulations. Nevertheless, for an interesting discussion of the US Health Insurance Portability and Accountability Act see Sobel (2007) and Rothstein (2013), and for a discussion on data protection regulation in the EU see Fears et al. (2014).
I think, other things being equal, that the arguments that I advance here also apply for the type of consent required for the use of radiological images and pathology images for primary and secondary purposes.
References
Berle, Ian. 2002. The ethical context of clinical photography. The Journal of audiovisual media in medicine 25(3): 106–109. doi:10.1080/014051102320376816.
Berle, Ian. 2004. The principles of ethical practice in professional clinical photography. The Journal of audiovisual media in medicine 27(1): 11–13. doi:10.1080/01405110310001658897.
Berle, I. 2008. Clinical photography and patient rights: The need for orthopraxy. Journal of Medical Ethics 34(2): 89–92. doi:10.1136/jme.2006.019166.
Bhangoo, P., I.K. Maconochie, N. Batrick, and E. Henry. 2005. Clinicians taking pictures—A survey of current practice in emergency departments and proposed recommendations of best practice. Emergency Medicine Journal: EMJ 22(11): 761–765. doi:10.1136/emj.2004.016972.
British Medical Association. (2011). Taking and using visual and audio recordings of patients. London: BMA. Retrieved from http://bma.org.uk/-/media/Files/…/takingusingvisualaudiorecordings2011.pdf.
Cheston, C.C., T.E. Flickinger, and M.S. Chisolm. 2013. Social media use in medical education: A systematic review. Academic Medicine: Journal of the Association of American Medical Colleges 88(6): 893–901. doi:10.1097/ACM.0b013e31828ffc23.
Chretien, K.C., and T. Kind. 2013. Social media and clinical care ethical, professional, and social implications. Circulation 127(13): 1413–1421. doi:10.1161/CIRCULATIONAHA.112.128017.
Creighton, S., J. Alderson, S. Brown, and C.L. Minto. 2002. Medical photography: Ethics, consent and the intersex patient. BJU International 89(1): 67–71. doi:10.1046/j.1464-410X.2002.02558.x.
DeCamp, M., T.W. Koenig, and M.S. Chisolm. 2013. Social media and physicians’ online identity crisis. JAMA 310(6): 581–582. doi:10.1001/jama.2013.8238.
Facebook. 2012. Statement of rights and responsibilities. Retrieved September 30, 2013, from https://www.facebook.com/legal/terms.
Fears, R., H. Brand, R. Frackowiak, P.-P. Pastoret, R. Souhami, and B. Thompson. 2014. Data protection regulation and the promotion of health research: Getting the balance right. QJM 107(1): 3–5. doi:10.1093/qjmed/hct236.
Fleming, C.M., and K. Bellamy. 2004. The regulation of clinical photographers. The Journal of Audiovisual Media in Medicine 27(4): 150–153. doi:10.1080/01405110400027666.
General Medical Council. 2011. Making and using visual and audio recordings of patients: Contents. London. Retrieved from http://www.gmc-uk.org/guidance/ethical_guidance/7818.asp.
Gibson, M. J. 2011, April 1. Nursing students expelled for posting photo of a placenta on Facebook. Time. Retrieved from http://newsfeed.time.com/2011/01/04/nursing-students-expelled-for-posting-photo-of-a-placenta-on-facebook/.
Hamm, M.P., A. Chisholm, J. Shulhan, A. Milne, S.D. Scott, T.P. Klassen, and L. Hartling. 2013. Social media use by health care professionals and trainees: A scoping review. Academic medicine: Journal of the Association of American Medical Colleges 88(9): 1376–1383. doi:10.1097/ACM.0b013e31829eb91c.
Institute of Medical Illustrators. 2008. Code of professional conduct. Retrieved September 5, 2013, from http://www.imi.org.uk/file/download/2145/IMIcodeofcondustJune2008.pdf.
International Committee of Medical Journal Editors. 2010. Uniform requirements for manuscripts submitted to biomedical journals: Writing and editing for biomedical publication. Retrieved September 26, 2013, from http://www.icmje.org/roles_e.html.
Kaczmarczyk, J.M., A. Chuang, L. Dugoff, J.F. Abbott, A.J. Cullimore, J. Dalrymple, and P.M. Casey. 2013. e-Professionalism: A new frontier in medical education. Teaching and Learning in Medicine 25(2): 165–170. doi:10.1080/10401334.2013.770741.
Kaplan, A.M., and M. Haenlein. 2010. Users of the world, unite! The challenges and opportunities of social media. Business Horizons 53(1): 59–68. doi:10.1016/j.bushor.2009.09.003.
Lau, C.K., H.H.A. Schumacher, and M.S. Irwin. 2010. Patients’ perception of medical photography. Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS 63(6): e507–e511. doi:10.1016/j.bjps.2009.11.005.
Macintosh, T. 2006. Ethical considerations for clinical photography in the global South. Developing World Bioethics 6(2): 81–88. doi:10.1111/j.1471-8847.2006.00142.x.
Moubarak, G., A. Guiot, Y. Benhamou, A. Benhamou, and S. Hariri. 2011. Facebook activity of residents and fellows and its impact on the doctor–patient relationship. Journal of Medical Ethics 37(2): 101–104. doi:10.1136/jme.2010.036293.
Parent, W.A. 1983. Privacy, morality, and the law. Philosophy & Public Affairs 12(4): 269–288.
Payne, K.F.B., A. Tahim, A.M.C. Goodson, M. Delaney, and K. Fan. 2012. A review of current clinical photography guidelines in relation to smartphone publishing of medical images. Journal of Visual Communication in Medicine 35(4): 188–192. doi:10.3109/17453054.2012.747174.
Ploug, T., and S. Holm. 2013. Informed consent and routinisation. Journal of Medical Ethics 39(4): 214–218. doi:10.1136/medethics-2012-101056.
Rijt, R.V.der, and Hoffman S. 2013. Ethical considerations of clinical photography in an area of emerging technology and smartphones. Journal of Medical Ethics, medethics–2013–101479. doi:10.1136/medethics-2013-101479.
Rothstein, M.A. 2013. HIPAA Privacy Rule 2.0. The Journal of Law, Medicine & Ethics 41(2): 525–528. doi:10.1111/jlme.12060.
Salerni, G., C. Carrera, L. Lovatto, J.A. Puig-Butille, C. Badenas, E. Plana, and J. Malvehy. 2012. Benefits of total body photography and digital dermatoscopy (“two-step method of digital follow-up”) in the early diagnosis of melanoma in patients at high risk for melanoma. Journal of the American Academy of Dermatology 67(1): e17–e27. doi:10.1016/j.jaad.2011.04.008.
Salter, B.J. (2008, August 19). Nurses posts brain surgery pictures on Facebook. Telegraph.co.uk. Retrieved from http://www.telegraph.co.uk/news/uknews/2583411/Nurses-posts-brain-surgery-pictures-on-Facebook.html.
Sobel, Richard. 2007. The HIPAA PARADOX: The privacy rule that’s not. Hastings Center Report 37(4): 40–50. doi:10.1353/hcr.2007.0062.
Thompson, L.A., K. Dawson, R. Ferdig, E.W. Black, J. Boyer, J. Coutts, and N.P. Black. 2008. The intersection of online social networking with medical professionalism. Journal of General Internal Medicine 23(7): 954–957. doi:10.1007/s11606-008-0538-8.
Tranberg, H.A., B.A. Rous, and J. Rashbass. 2003. Legal and ethical issues in the use of anonymous images in pathology teaching and research. Histopathology 42(2): 104–109.
Vivas, M.L. 2012, April 18. Cesa IMSS a anestesióloga por burlarse de pacientes en Facebook. Proceso. Retrieved September 26, 2013, from http://www.proceso.com.mx/?p=304669.
Yavuzer, R., S. Smirnes, and I.T. Jackson. 2001. Guidelines for standard photography in plastic surgery. Annals of Plastic Surgery 46(3): 293–300.
Acknowledgments
The author wish to acknowledge the stimulus and support of the iSEI Wellcome Strategic Programme in The Human Body: Its scope, limits and future (Grant Number: WT 087439/Z/08/Z) and Mexico’s National Council of Science and Technology (CONACyT). I am also grateful to Adriana Clavel-Vázquez, Sarah Chan, John Harris, Nicolas Agar and Ian Berle for their comments on an earlier version of this article. Finally, I also wish to thank the comments provided by the members of the Centre for Social Ethics and Policy and the Institute for Science, Ethics and Innovation at The University of Manchester after a verbal presentation of a previous version of this article.
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Palacios-González, C. The ethics of clinical photography and social media. Med Health Care and Philos 18, 63–70 (2015). https://doi.org/10.1007/s11019-014-9580-y
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DOI: https://doi.org/10.1007/s11019-014-9580-y