Medicine, Health Care and Philosophy

, Volume 18, Issue 1, pp 63–70 | Cite as

The ethics of clinical photography and social media

  • César Palacios-GonzálezEmail author
Scientific Contribution


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.


Clinical photography Informed consent Medical publishing Patient protection Social media 



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.


  1. Berle, Ian. 2002. The ethical context of clinical photography. The Journal of audiovisual media in medicine 25(3): 106–109. doi: 10.1080/014051102320376816.Google Scholar
  2. 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.Google Scholar
  3. 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.CrossRefGoogle Scholar
  4. 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.CrossRefGoogle Scholar
  5. British Medical Association. (2011). Taking and using visual and audio recordings of patients. London: BMA. Retrieved from…/takingusingvisualaudiorecordings2011.pdf.Google Scholar
  6. 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.CrossRefGoogle Scholar
  7. 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.CrossRefGoogle Scholar
  8. 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.CrossRefGoogle Scholar
  9. 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.CrossRefGoogle Scholar
  10. Facebook. 2012. Statement of rights and responsibilities. Retrieved September 30, 2013, from
  11. 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.CrossRefGoogle Scholar
  12. 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.Google Scholar
  13. General Medical Council. 2011. Making and using visual and audio recordings of patients: Contents. London. Retrieved from
  14. Gibson, M. J. 2011, April 1. Nursing students expelled for posting photo of a placenta on Facebook. Time. Retrieved from
  15. 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.CrossRefGoogle Scholar
  16. Institute of Medical Illustrators. 2008. Code of professional conduct. Retrieved September 5, 2013, from
  17. 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
  18. 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.CrossRefGoogle Scholar
  19. 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.CrossRefGoogle Scholar
  20. 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.CrossRefGoogle Scholar
  21. 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.CrossRefGoogle Scholar
  22. 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.CrossRefGoogle Scholar
  23. Parent, W.A. 1983. Privacy, morality, and the law. Philosophy & Public Affairs 12(4): 269–288.Google Scholar
  24. 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.Google Scholar
  25. Ploug, T., and S. Holm. 2013. Informed consent and routinisation. Journal of Medical Ethics 39(4): 214–218. doi: 10.1136/medethics-2012-101056.CrossRefGoogle Scholar
  26. 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.
  27. Rothstein, M.A. 2013. HIPAA Privacy Rule 2.0. The Journal of Law, Medicine & Ethics 41(2): 525–528. doi: 10.1111/jlme.12060.Google Scholar
  28. 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.CrossRefGoogle Scholar
  29. Salter, B.J. (2008, August 19). Nurses posts brain surgery pictures on Facebook. Retrieved from
  30. 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.CrossRefGoogle Scholar
  31. 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.CrossRefGoogle Scholar
  32. 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.CrossRefGoogle Scholar
  33. Vivas, M.L. 2012, April 18. Cesa IMSS a anestesióloga por burlarse de pacientes en Facebook. Proceso. Retrieved September 26, 2013, from
  34. Yavuzer, R., S. Smirnes, and I.T. Jackson. 2001. Guidelines for standard photography in plastic surgery. Annals of Plastic Surgery 46(3): 293–300.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  1. 1.Institute for Science Ethics and InnovationThe University of ManchesterManchesterUK

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