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What Chappel v Hart really stands for and some ramifications for innovative surgery

transmissibility of images to colleagues. A disturbingly high proportion (more than half) accepted ‘implied’ consent as adequate for the capture of images. Similarly, in a 2012 survey of clinicians and medical students conducted in a Victorian public hospital, 65% of respondents had taken images on a mobile phone camera, with more than 40% having no password protection on their personal device. A quarter did not obtain any kind of consent for image capture of sensitive medical information. Two-thirds of respondents kept these images and more than 90% shared images via insecure methods (SMS, MMS and e-mail). Less than a half of these respondents thought that the hospital owned the images. Sixty percent were unaware of the existence of a hospital clinical photography policy and only 5% had read such a policy. Issues regarding the ethics and legality of taking clinical photographs using personal cameras have been addressed in various publications and are of increasing concern as such devices become more prevalent and the practice more widespread. In addition, the consequences for patients of having personal information distributed throughout the Internet and beyond are significant and potentially catastrophic. In practice, however, it appears that such considerations have had little impact on many Australian surgeons, and clinical photography remains largely unsupported by an appropriate infrastructure that enables compliance with legislation. It is to be expected that solutions will be developed by institutions and individuals that will address these deficiencies; however, to date, none has appeared. In the meantime, while technology to support compliance catches up with developments in the way that clinicians use personal devices and becomes widely available, surgeons and trainees should exert considerable care in their employment of clinical photography, and if necessary, change current practice to ensure they are not engaging in activities with potentially severe legal ramifications.