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Cited by 35Digital Imaging in MedicineMedical and Health Sciences ResearchPatient Dignity and Privacy

Clinicians and their cameras: policy, ethics and practice in an Australian tertiary hospital

Open access
Burns, Kara, Belton, Suzanne·2013·Australian Health Review
DOI 10.1071/ah12039
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Abstract

Medical photography illustrates what people would prefer to keep private, is practiced when people are vulnerable, and has the power to freeze a moment in time. Given it is a sensitive area of health, lawful and ethical practice is paramount. This paper recognises and seeks to clarify the possibility of widespread clinician-taken medical photography in a tertiary hospital in Australia, examining the legal and ethical implications of this practice. A framework of law, state Department of Health policy and human rights theory were used to argue the thesis. Clinicians from 13 purposively chosen wards were asked to participate in an anonymous survey and confidential in-depth interviews. Questions were generated from the literature and local knowledge on the topics of ‘occurrence’, ‘image use’, ‘quality of consent’, ‘cameras and technology’, ‘confidentiality’, ‘data storage and security’, ‘hospital policy and law’ and ‘cultural issues’. One hundred and seventy surveys and eight interviews were analysed using descriptive statistics and theme and content analysis, then triangulated for similarity, difference and unique responses. Forty-eight percent of clinicians surveyed take medical photographs, with the majority using hospital-owned cameras. However, one-fifth of clinicians reported photographing with personal mobile phones. Non-compliance with written consent requirements articulated in policy was endemic, with most clinicians surveyed obtaining only verbal consent. Labelling, storage, copyright and cultural issues were generally misunderstood, with a significant number of clinicians risking the security of patient information by storing images on personal devices. If this tertiary hospital does not develop a clinical photography action plan to address staff lack of knowledge, and non-compliance with policy and mobile phone use, patients’ data is at risk of being distributed into the public domain where unauthorised publication may cause psychological harm and have legal ramifications for the hospital, its patients, and staff. What is known about the topic?: While professional medical photography has been widely used for recording patient condition, evidencing care and teaching, little is known about the use of digital photographs taken by clinicians in Australian hospitals. Our research demonstrates that the ubiquitous nature of personal camera phones is encouraging clinicians to practice medical photography on personal devices. Clinicians who take photographs of patients have practical, legal and ethical issues to negotiate. Without careful management of these images, especially on personal devices, accidental and deliberate misuse is possible. What does this paper add?: This paper adds to knowledge of clinician-performed medical photography practice: no other study has reported on the subject across multiple wards in an Australian tertiary hospital. This paper defines key areas of inquiry relevant to the topic, documents poor knowledge and compliance with hospital policy and highlights areas of risk to patients, staff and hospital. What are the implications for practitioners?: It is likely that the behaviours and knowledge of digital photography documented in our research site are similar to that in other hospitals. Practitioners, managers and policy makers need to be aware of the ethics and regulations regarding consent, use, storage, disposal and ownership of patients’ digital images to ensure the practice follows ethical and legislated guidelines.

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  • 60% of specialists continue to store photographs of their patients in their personal mobile phones.

    “Although 60% of specialists continue to store photographs of their patients in their personal mobile phones [72,74-77]”

    From Use of Smartphones for Early Detection of Melanoma: Systematic Review (2018) · cites this paper as [76]

    The Records management and copyright section (page unavailable) says that a small number of surveyed staff stored patient images on personal devices, including mobile phones. It does not report that 60% of specialists stored photographs on their personal phones; the Discussion instead reports that 20% of clinicians used mobile phones, which is a different measure. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • The use of personal smartphones and devices for clinical photography in Australian hospitals is common practice and privacy practice and policy is inconsistent and inadequate.

    “The studies reported that the use of personal smartphones and devices was common-practice and privacy practice and policy was inconsistent and inadequate (Burns and Belton, 2013).”

    From Patient and practitioner satisfaction with tele-dermatology including Australia’s indigenous population: A systematic review of the literature (2016) · cites this paper as Burns and Belton, 2013

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1 of the 17 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Gardiner AP. Exposing the bodyÀbaring the soul. J Audiov Media Med 2002; 25: 64-8.
  2. Dean R. The value of Kant's moral theory. New York: Oxford University Press; 2006.

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Authors
Burns, K., & Belton, S.
Affiliations
  • RMIT University (AU)
  • Menzies School of Health Research (AU)
Corresponding author
Burns, Kara
ORCID
Venue
Australian Health Review
Publisher
CSIRO Publishing
Published
2013-06-19
Volume
37
Issue
4
Pages
437-441
ISSN
  • 0156-5788 (ISSN-L)
  • 1449-8944
DOI
10.1071/ah12039
OpenAlex
W2108329429
Cited by
35
References
17
Citations by year
2025: 3 · 2024: 3 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 4 · 2018: 3 · 2017: 5 · 2016: 9 · 2015: 2 · 2014: 1
FWCI
4.10
Type
journal article
Language
en
Open access
Licence
Locations
  • Australian Health Review (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • RMIT Research Repository (RMIT University Library) (submittedVersion)
  • Figshare (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Digital Imaging in Medicine
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Medical and Health Sciences Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Patient Dignity and Privacy
Keywords
medical photography, patient consent, patient confidentiality, hospital policy compliance, smartphone photography, patient data security, copyright, image storage, human rights theory, health law, tertiary care hospital, Australian hospitals, staff knowledge and attitudes
MeSH terms
Australia, Humans, Informed Consent, Medical Staff, Hospital, Photography, Surveys and Questionnaires, Organizational Policy, Tertiary Care Centers

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