Confidentiality and images

1. The rise of photography

“I am a camera with its shutter open, quite passive, recording, not thinking”-- Christopher Isherwood

Camera-equipped smartphones and tablets are behind a massive increase in the number of photos that are taken each day, with an estimated 1.2 trillion photos captured in 2017 alone (Satistica, 2017). We take photographs to capture a significant moment, as memory aids, or in order to communicate what we are seeing with others.

Read Photos, Photos Everywhere. Consider the role that photography plays in your life. On average, how many photos would you take per week?

 Smartphones Cause Photography Boom | Statista

You will find more infographics at Statista


Taking photos for work or study

There are many legitimate reasons to take and share images with other people in a work or learning environment:

  • communicate important information and quickly receive feedback from colleagues
  • share interesting case studies in an educational context
  • document your work experience in a way that respects client confidentiality.

However, even if we think we are capturing and sharing images for legitimate reasons, it can be easy to act in a way that counteracts our legal, professional or organisational responsibilities when it comes to taking, sharing and storing images.

Clinical photography is widely practised in Australian hospitals for the purposes of teaching and research, and to more effectively consult with colleagues.

A 2013 study by Burns and Belton on camera-use by Australian clinicians at an Australian tertiary hospital found that 47% of surveyed staff captured photographs of patients in the last year. The authors  found the “endemic policy non-compliance in the area of consent for clinical photography” to be particularly problematic, writing:

The current lack of compliance for consent, capture, storage and disposal of images, in conjunction with misconceptions regarding copyright, puts patients’ personal information at risk with a high potential for harm given that the security and distribution of electronic information is only as good as the least dependable individual.

If you are a clinician, you should read the Australian Medical Association’s (AMA) Clinical images and the use of personal mobile devices.

Sometimes, people can be tempted to take and share images of things or people for the wrong reasons, including:

  • in a humorous or mocking way
  • in a way that does not respect your professional or legal obligations.

The media regularly reports on instances of people working in health-related fields breaching patients’ confidentiality. A story by Pro Publica, Inappropriate Social Media Posts by Nursing Home Workers, detailed widespread breaches of patient privacy by nursing home workers in the United States.

Even seemingly innocuous photos can be a breach of privacy:

A nursing assistant posted a picture of a resident’s hand on Facebook, with a caption akin to “I am holding her hand til she falls asleep.” A comment posted below the photo by a second nursing assistant had a question that included the resident’s first name. Both employees were “counseled” for not maintaining confidentiality.


The risks in sharing photographs

  • Once you share an image it can enter the public domain and be very difficult to remove
  • Information in an image can be combined with other publicly available information to identify a person
  • Facial recognition software is increasingly able to identify people.

Before sharing images of other people you should understand your legal, professional or organisational obligations. These obligations are discussed in more detail in the next section.

There may be legal, professional or organisational rules around protecting confidentiality