requested to ensure that a more experienced,
knowledgeable physician is involved in managing a patient. The consulting physician does not
make the final clinical decisions but still has an
ethical responsibility to provide the requesting
physician with the best information and advice
possible. Similarly, the resident may be obligated to
provide the PRS with the technological knowledge
necessary to provide the best care for the patient.
Even though the PRS may have a weaker understanding of the potential risks involved, HIPAA
guidelines must continue to be followed to protect personal health information, including clinical
With increasing technological capabilities and the
large number of personal mobile devices used in
the workplace, snapping a photo of a patient for
both clinical and educational purposes can present
ethical conundrums. These ethical issues—which
include consent, respect for autonomy, photographic ownership, photographs as personal health
information, and physician responsibility to uphold
patient confidentiality—are further complicated by
the security concerns associated specifically with
An ethical case can be made for several courses
of action in the clinical scenario presented in this
article. This breadth of possibilities is evidenced
by the many variations and differences found in
hospital policies regarding clinical photography.
The issue that will most likely divide physicians
is how to define PII and to recognize the validity
of obtaining consent when warranted, specifically
when there is a potential risk to the patient’s privacy and confidentiality. Furthermore, increased
security on mobile devices is necessary and the
institution must play a role in addressing these
security measures. ♦
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