Photographing patients: an emerging unethical trend

It is increasingly common to find medical students taking bedside clinical pictures or videos of patients. It is not unusual to find even groups of students doing this, during or after a clinical class. The recent surge in the usage of cell phones with cameras, and the increasing lack of sensitivity to patients’ feelings, are responsible for this behaviour. These photographs are taken either without the patient’s consent or with casual verbal consent without an explanation of its implications. Patients may not be in a position to object to the practice because of the stress of the illness, or the fear that the medical student would treat them badly if they express any objection. Students may also justify such acts in settings where patients get treatment for free. This concept of presumed consent as a moral obligation in return for free treatment is unacceptable. This amounts to nothing but patient abuse.

There is always a chance that these casually taken pictures can land up in a presentation, uploaded on the internet, and disseminated or published in a journal. All these are against ethical norms. It is worth remembering that patients have the right to object to being photographed. Medical students should be aware of the potential ethical and legal issues associated with this behaviour. Photographs should be taken only after giving a clear explanation of the purpose of taking a photograph, and obtaining appropriate written informed consent.

Though the code of conduct of the Medical Council of India states that physicians should not publish photographs of their patients without their consent, this should be considered even before taking such photographs (1). It is necessary to create awareness regarding this issue, and to ensure that patients are not abused in this manner. Senior faculty members are responsible for the ethical conduct of students doing research under their supervision (2). It is also the duty of medical teachers to educate and take vicarious responsibility for the ethical behaviour of their students.