1.BACKGROUND
Photographs of children are commonly taken in medical and research contexts. With the increased availability of photographs through the internet, it is increasingly important to consider their potential for negative consequences and the nature of any consent obtained. In this research, we explored the issues around photography in low-resource settings, in particular concentrating on the challenges in gaining informed consent.
2.METHOD
3. RESULTS
The overwhelming message from all focus groups was the need for consent when taking photographs, particularly of children. However, participants also highlighted difficulties in doing this.
Several barriers to informed consent were described:
3.1VALUE OF PHOTOS
In all three groups, most participants thought there was value in taking photographs.
“Photographs were seen as being able to ‘say far more than a group of demographic statistics.” [Group-1 participant-1].
3.1.1MAIN REASONS OF TAKING PHOTOGRAPHS
1. Teaching
Photographs were used for demonstrating clinical signs to medical students or other clinicians.
2. Research
Photographs were used as data in research.
3. Environment
Sometimes, photographs could be useful simply to show the environment to those who have not been there or provide context.
4. Personal Participants were clear that there was a distinction between the kind of photos that you might take as a tourist and those that you would take as a clinician.
5. Advocacy
The value of photographs was especially apparent when being used for advocacy purposes.
3.2Differing concepts of consent
In some culture, there was no concept of informed consent.
The problems of who should give consent.
3.3Language
No interpreter available.
Too many interpreters resulting in doubtful validity of communication.
Words didn’t exist in the other languages.
3.4Understanding
Cameras, computers, publication, and textbooks are unknown in some communities.
3.5Type of consent
varied according to situations/contexts
Written
- Preferable, but more difficult to get.
- Distrusted by subjects due to bad experiences
VS
VERBAL
- More practical
- More preferable in an oral culture
3.6Power disparity
Participants were concerned that people would not feel free to refuse when asked for consent and could be taken advantage of.