Department of Dermatology, University of Connecticut Health Center, 21 South Road, Farmington, CT 06030-6231, USA.
Clin Dermatol. 2012 Sep-Oct;30(5):486-91. doi: 10.1016/j.clindermatol.2011.06.017.
In dermatology, clinical photographs are an essential component of patient care, enabling clinicians to document changes in skin pathology over time. Recent advances in digital technology and the electronic medical record have revolutionized clinical photography; however, these advances bring with them new ethical, legal, and social concerns. Photographs, more than other forms of documentation, have the potential to make patients uncomfortable. The act of photography, especially for those images requiring exposure of the genital area or the entire body, can be an uncomfortable experience for patients, necessitating the clinician and photographer to take an empathic stance in this setting. The Internet has elicited an increasing, and a very real, concern for patients about possible distribution and use of images outside of their individual care. The clinician and staff can allay these fears by professionally and empathetically addressing their concerns. In addition, it is important that patients receive appropriate informed consent about clinical photographs and the potential use of the images in their care, education, and research. Given the multitude of methods for recording clinical photographs, combined with the increasing complexity of image storage, standardization becomes a critical tool in providing consistency among images and achieving more equitable and efficacious care. To achieve this goal and improve the baseline standard of continuity of care for dermatological practices, we review the role of photographs, develop a model for patient consent, and establish standards for photography so as to provide the most ethical care for the patient.
在皮肤科，临床照片是患者护理的重要组成部分，使临床医生能够记录皮肤病理学随时间的变化。数字技术和电子病历的最新进展彻底改变了临床摄影；然而，这些进步带来了新的伦理、法律和社会问题。与其他形式的文档相比，照片更有可能让患者感到不适。摄影行为，特别是对于那些需要暴露生殖器区域或整个身体的图像，可能会让患者感到不适，这就要求临床医生和摄影师在这种情况下采取富有同情心的立场。互联网引发了患者对其个人护理之外的图像可能被分发和使用的越来越多、非常真实的担忧。临床医生和工作人员可以通过专业和富有同情心的方式解决这些担忧，从而减轻这些恐惧。此外，重要的是，患者应就临床照片以及在其护理、教育和研究中使用图像的潜在用途获得适当的知情同意。鉴于记录临床照片的方法繁多，再加上图像存储的日益复杂，标准化成为在图像之间提供一致性以及实现更公平和有效的护理的关键工具。为了实现这一目标并提高皮肤科实践护理连续性的基准标准，我们审查了照片的作用，为患者同意制定了一个模型，并制定了摄影标准，以便为患者提供最符合伦理的护理。
