Medical Photography: Do or Don’t (+POLL)

I’m interested to know what you think about medical photography – specifically, taking pictures of interesting anomalies or cool surgeries.

I know that a lot of doctors have personal collections of photos that they keep to… reflect on, I suppose? Use for presentations? Smart phones have made it easier and opened a new can of worms simultaneously. Decades ago, if a doctor took a picture of your tumour, you did not really worry that it would end up on Facebook, because there was no Facebook!

I have been wondering about this for quite a while. Last year during my Internal Rotation, I saw Janeway lesions for the first – and possibly last – time. I did not ask to take a picture, but I wish I had. Unless I specialise in Internal Medicine and practise till I’m eighty, I may never see something like that again (yay, antibiotics!).

Figure 1 made its debut on the iStore recently. For those of you who don’t know, it is basically instagram for doctors (coming to Android soon). Uploaders have to ensure that all identifying characteristics are removed from the photos, and it is quite a useful learning tool (certainly not without flaws, but fun).

This week in surgery, I was asked to play photographer in an interesting case – the patient’s mother had requested that a photo be taken, and afterwards she gave the doctors permission to keep the photo for personal use.

And then I examined a child with vestigial digits on each hand – not that rare, but it was the first time I saw it, and I wanted a picture. Just for myself, not for my blog or anything. I was afraid to ask the mother, because I did not want her to think that I was gawking, as I am sure others have done. And afterwards I resented myself for not asking.

So my question is first: why do we take pictures of patients? Simply for personal reasons? Or do you think it goes deeper?

And then: is it okay? I know different institutions and boards have different rules. As far as I know, most South African hospitals have a lot of red tape if one needs to take a photo: first permission must be obtained from the patient or caregiver, and second from the hospital superintendent. Most people skip the latter because getting permission for anything in our bureaucracy takes eons. Is patient consent alone okay? I am leaning towards a yes.

I think that medical photography can be quite important for progress in the field, but that does not mean that we aren’t treading an ethical minefield. I think that I would want to know if a photo of mine were to be used for a presentation, even if a doctor was not being compensated for it. And, for the record, I don’t think that ANY patient photos should ever make their way to Facebook…

So here are two questions, and I would love to hear your answers. Non-medical readers are welcome to answer too, I am quite interested in your opinions. And please feel free to elaborate upon your opinion.

 

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8 thoughts on “Medical Photography: Do or Don’t (+POLL)”

  1. I had one ovary removed because there was a “mass” on it, and by “mass” I mean apparently the fibroid was the size of a baseball. I was floored when my surgeon told me that, and asked her mother (who works at her front desk, that’s not as weird as it sounds) if they took photos at all during surgery, since I had signed a consent form saying that was allowed. I always say yes when asked, and that they can use the photos for any purpose they see fit, because I am all for someone learning something from my medical misadventures. She said “ohhh yes, there’s a photo she was showing the office of her with the mass holding it as if she’s about to throw out the opening pitch of the World Series!” Personally, I laughed my arse off. Even my fibroid had a sense of humor! I guess some people would get upset, but it’s not like my name was on the thing.

  2. For me, I think it is important to remember that we all may end up as patients someday. With that in mind, I wouldn’t mind if my pictures were taken and used in an academic setting in order to advance medicine and the science of healing. However, I may have a problem if my images showed up on the internet/blogs/Facebook etc without any idea of the content or nature of that space.

    Anecdotally, I was diagnosed with Graves’ disease 12 years ago. Soon after my diagnosis, (and wanting to be fully informed about the disease) I decided to google Graves’ disease. OH.MY.WORD! I thought I was going to die. The images that popped up and patient stories were frightening to say the least. Thankfully, I had an endocrinologist and surgeon who were very good and calmly addressed each of my fears. Incidentally, I just googled Graves’ out of curiosity and thankfully, it appears as those early pictures & stories have been removed. In its place, there seems to be a more well-balanced depiction of this disease. Thinking back now, I wonder how many of those patients were informed or even aware that their images were being used in such a public manner.

    I suppose what I am saying is that I could be persuaded to allow my image to be used in a thoughtful, well-balanced and informative place on the internet.

  3. I think it is totally reasonable to ask a patient to have photo taken of an interesting finding for academic purposes. I have never personally taken a photo of a patient, but I know of many specialists who use photos as a means of monitoring symptoms, particularly in dermatology.

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