OzEMedicine - Wiki for Australian Emergency Medicine Doctors

see also:

• clinical photography in the ED
• Aust. Institute of Medical and Biological Illustration (AIMBI) guidelines for clinical practice - consent for clinical images (pdf)
• Western Health intranet policies:
  • Consent for video & photographs (docx)
• Royal Children's Hospital:
  • consent form (pdf)
• North Sydney Central Coast NSW consent form (pdf)
• Uni. Queensland consent form
• ALL doctors should read: AMA guideline on clinical images and use of personal mobile devices such as smartphones

• Bulletin Vol 2 2008 (pdf):
  • “that taking and storing photographs of certain clinical conditions, notably skin conditions, could provide a valuable pictorial record to assist assessment and monitor progress.”
  • “digital images could easily be incorporated into the patient’s health record for future reference. As such, the images form part of the patient record and are subject to the same considerations of confidentiality, privacy and security as any other part of the record.”
  • “Practices need to have safeguards and procedures to meet appropriate legal and ethical standards concerning the privacy and security of patient records.”
  • “Doctors have a responsibility to respect and protect confidential information.”
  • “the public reasonably expects that health records are maintained in a safe and secure manner and access to them is restricted only to health personnel directly involved in providing care”
  • “The public is increasingly concerned with matters of privacy and has a high level of awareness about the need to prevent digital images from reaching unauthorised sources who are then able to disseminate them widely. This particularly applies to images in which the patient may be identified, or to images of areas of the body with particular privacy significance, such as genitals or breasts. Accordingly, practitioners need to take special care when photographing these areas and be aware of the need to obtain specific informed consent from the patient before taking any clinically warranted photograph. This consent process needs to include a clear explanation of the purpose of the photography and an explanation about the confidentiality, privacy and security of all images.”
  • this article explores the issues associated with clinical photography of those unable to give consent (in this case a resident in an Aged Care facility), and considered that sensitive photographs such as that of genitalia warranted gaining special consent from their guardian, and furthermore that showing a sensitive photograph to third parties (eg. residential care staff) outside of the consultation setting violated the patient's privacy and right to confidentiality.

• on consent to the use of clinical photography other than for the direct care of the patient
• International Committee of Biomedical Photographers, World Congress in Medical Illustration, Cairns, Australia, August 2005

• Patients have rights to privacy that should not be infringed without informed consent
• The informed consent of the patient (or other appropriate representative of the patient) is essential before any use of clinical photographs, video and audio recordings other than for the direct care of the patient or for the audit of that care (e.g. for teaching, research or publication).
• Anonymisation of images (e.g. by pixellation or other masking of the eye region) does not guarantee anonymity and does not replace the need for informed consent. This right to informed consent extends to all images including those that are not immediately identifiable, but which may become so in the context in which they are used.
• In the case of publication, the requirements of the International Committee of Journal Editors should be applied.
• Patients should be made aware (as a part of the informed consent process) that they may withdraw their consent to further use at any time. They should also be made aware (as a part of the informed consent process) that if they agree to publication of their images on the World Wide Web, it will be impossible to stop further dissemination of the images.
• Unwillingness of patients for their images to be used for purposes outside their direct care should in no way compromise their treatment.
• Patients (or other appropriate representative of the patient) have the right to access clinical photographs, video and audio recordings taken of them. Medical Institutions and Practices should ensure that appropriate storage and retrieval systems are in place to accommodate image retrieval.