What are the guidelines for sharing physical exam pictures of Dupuytren's contracture?

Guidelines for Sharing Physical Exam Pictures of Dupuytren's Contracture

Informed consent is required for all medical photographs of Dupuytren's contracture, whether for medical records, teaching, or publication purposes, with explicit discussion of all intended uses of the images. 1

Consent Requirements

• All clinical photographs, even those not considered identifying, should have appropriate patient consent before being shared or published 1
• Patients must provide consent for each specific use of their images, including medical records, teaching materials, or publication 1
• For adult patients (18 years or older), their own consent is required; parental consent is generally not necessary 1
• For minors (7-18 years), both parental permission and child assent should be obtained 1
• For patients with developmental disabilities, consent should be obtained from guardians, with patient assent when possible 1

Informed Consent Process

• The photographer must explicitly discuss all intended uses of the image with the patient, especially for electronic publications that may reach wider audiences than standard medical texts 1
• Patients should be shown the specific images that will be used before publication so they understand what will appear 1
• It should be emphasized that once published, especially in electronic format, images enter the public domain and cannot be completely removed 1
• A copy of the consent form should be given to the patient with contact information for future questions or withdrawal of consent 1

Documentation Requirements

• The consent form should clearly specify all intended uses (medical record, teaching, publication) 1
• The form should explicitly state that refusing photography or requesting removal of images will not affect the patient's medical care 1
• For shared decision-making regarding Dupuytren's contracture specifically, documentation should include discussion of disease progression, available treatment options, and patient preferences 2

Patient Rights and Protections

• Patients have the right to withdraw consent at any time, requiring removal of images from displays, teaching files, or internet sites when possible 1
• The consent form should acknowledge that while digital images can be removed from most formats, print media cannot be retracted 1
• Patients should understand that the clinician cannot control further use of images downloaded by others from internet sites 1

Special Considerations for Dupuytren's Contracture

• When photographing Dupuytren's contracture, images should document the extent of palmar involvement and digit contracture for clinical assessment 3
• Photographs may be particularly valuable for documenting disease progression over time and response to treatment 3
• For research purposes involving Dupuytren's contracture images, additional research consent protocols may apply 4

Common Pitfalls to Avoid

• Failing to obtain consent for each specific use of the image (medical record, teaching, publication) 1
• Not explaining that electronic publication places images in the public domain permanently 1
• Neglecting to provide patients with a copy of their consent form and contact information 1
• Failing to recognize that consent is an ongoing process, not a one-time event 5

Following these guidelines ensures respect for patient autonomy while allowing valuable documentation of Dupuytren's contracture for clinical care, education, and research purposes 1.