Taking ethical photos of children for medical and research purposes in low-resource settings: an exploratory qualitative study

Abstract

BackgroundPhotographs are commonly taken of children in medical and research contexts. With the increased availability of photographs through the internet, it is increasingly important to consider their potential for negative consequences and the nature of any consent obtained. In this research we explore the issues around photography in low-resource settings, in particular concentrating on the challenges in gaining informed consent.MethodsExploratory qualitative study using focus group discussions involving medical doctors and researchers who are currently working or have recently worked in low-resource settings with children.ResultsPhotographs are a valuable resource but photographers need to be mindful of how they are taken and used. Informed consent is needed when taking photographs but there were a number of problems in doing this, such as different concepts of consent, language and literacy barriers and the ability to understand the information. There was no consensus as to the form that the consent should take. Participants thought that while written consent was preferable, the mode of consent should depend on the situation.ConclusionsPhotographs are a valuable but potentially harmful resource, thus informed consent is required but its form may vary by context. We suggest applying a hierarchy of dissemination to gauge how detailed the informed consent should be. Care should be taken not to cause harm, with the rights of the child being the paramount consideration.

Video ethics in educational research involving children: Literature review and critical discussion

“…Clinicians and medical researchers have good reason to recognise the benefits of instant sharing of patient images for rapid and collegial diagnosis, measurement, teaching, grant applications, for different forms of sharing visual analyses, and for raising public awareness (Devakumar et al, 2013;Kling, 2018;Roberts, 2016). 'Photographs are used with best intentions to advocate for "greater good"' however photographs taken for medical practice or research can also contravene the rights of the child (Devakumar et al, 2013, p. 33).…”

“…Snyman (2012) argued that, in the context of South Africa, ethical guidelines and standards had yet to catch-up with this practice. While still arguably catching up with practice, ethical standards and guidelines, once overlooked (Devakumar et al, 2013), provide evidence of what may have been happening/happened, with the use of images, and what should happen.…”

“…Cultural historians provide a new lens on the ethical dimensions of the tradition of medical photography and in particular draw lessons for ethical guidelines based on interpretation of harrowing images of children locked into medical contraptions or holding strenuous physical poses (Osten, 2010;Roberts, 2016). Analysis of the use of images in the Internet age reveal new concerns regarding consent, experience, necessity and consequences (Devakumar et al, 2013;Kling, 2018;Roberts, 2016, Snyman, 2012. Open access publishing, digitalisation of images, the use of the internet and social media all impact on the ethical use of photographs of children in medical contexts (Devakumar et al, 2013;Kling, 2018;Snyman, 2012).…”

“…Analysis of the use of images in the Internet age reveal new concerns regarding consent, experience, necessity and consequences (Devakumar et al, 2013;Kling, 2018;Roberts, 2016, Snyman, 2012. Open access publishing, digitalisation of images, the use of the internet and social media all impact on the ethical use of photographs of children in medical contexts (Devakumar et al, 2013;Kling, 2018;Snyman, 2012). In a paradigm of image proliferation, writers have voiced contemporary concerns about issues ranging from the lack of any reasonable justification for the use of photography (Devakumar et al, 2013) to the secondary use of photography without approval of child, parent, or photographer (Snyman, 2012).…”

A novel approach for classifying protruding ears is easy to calculate and implement in daily clinical practice

“…Leonardo da Vinci appraised the ratio of different facial elements, applying what he called the golden ratio . Clinical Photography, already frequently used for medical teaching purposes , is also more recently being applied as an important diagnostic and follow‐up tool in clinical medicine . Driessen et al.…”