title: Taking ethical photos of children for medical and research purposes in low-resource settings: an exploratory qualitative study.
abstract: BACKGROUND
  Photographs are commonly taken of children 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 explore the issues around photography in low-resource settings, in particular concentrating on the challenges in gaining informed consent.
  
  
  METHODS
  Exploratory qualitative study using focus group discussions involving medical doctors and researchers who are currently working or have recently worked in low-resource settings with children.
  
  
  RESULTS
  Photographs are a valuable resource but photographers need to be mindful of how they are taken and used. Informed consent is needed when taking photographs but there were a number of problems in doing this, such as different concepts of consent, language and literacy barriers and the ability to understand the information. There was no consensus as to the form that the consent should take. Participants thought that while written consent was preferable, the mode of consent should depend on the situation.
  
  
  CONCLUSIONS
  Photographs are a valuable but potentially harmful resource, thus informed consent is required but its form may vary by context. We suggest applying a hierarchy of dissemination to gauge how detailed the informed consent should be. Care should be taken not to cause harm, with the rights of the child being the paramount consideration.
authors.affiliation: UCL Institute for Global Health, 30 Guilford St, WC1N 1EH, London, UK. d.devakumar@ucl.ac.uk
authors.forename: Delan
authors.initials: D
authors.lastname: Devakumar
authors.forename: Helen
authors.initials: H
authors.lastname: Brotherton
authors.forename: Jay
authors.initials: J
authors.lastname: Halbert
authors.forename: Andrew
authors.initials: A
authors.lastname: Clarke
authors.forename: Audrey
authors.initials: A
authors.lastname: Prost
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hall
mesh_terms: D002648:Child; D032882:Comprehension; D003219:Confidentiality / Q000941:ethics*; D032984:Ethics, Research; D017144:Focus Groups; D017408:Guidelines as Topic; D006801:Humans; D007258:Informed Consent / Q000941:ethics* / Q000592:standards; D010781:Photography / Q000941:ethics*; D010817:Physician-Patient Relations; D011209:Power, Psychological; D036301:Qualitative Research; D012106:Research; D035844:Researcher-Subject Relations / Q000523:psychology*; D013685:Telecommunications