Clinical Photography UK

Tim Zoltie BA (Hons) PgC LBIPP RMIP MIMI

Head of Medical Illustration at The University of Leeds

Director of Clinical Photography UK

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A photograph of an injury can be a powerful and effective tool in its ability to depict severity, and its subtle ability to evoke a sympathetic understanding of suffering and pain which would otherwise be difficult to portray verbally or in a written report. The demand for accurate photographic evidence has now meant many solicitors are turning to the instruction of a photographic expert, but who should be instructed for this work and why?

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Instructing the Right Expert

 

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When enquiring about a possible instruction of an expert, a solicitor must be aware that photography is a relatively ungoverned area with multiple specialties.

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Approach a photography expert with caution, as many photographers will offer to undertake medico-legal photography. Photography in general is a highly competitive industry, and there is little chance of a photographer turning any income source down unless against the law to do so. Ensure your expert is either a Registered Medical Illustration Practitioner (RMIP) (http://www.camip.org.uk/information-for-the-public) or a Clinical Photographer working within a medical illustration department. The expert should have an understanding of CPR p.35 and a suitable declaration of compliance. Photographers should also be DBS checked due to the nature of the photography they undertake.

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If instructing an agency who offer personal injury photography, the agency must provide full details of the photographer undertaking the work, including an up to date relevant CV with clear expertise of medical/medicolegal work so the above can be verified.

 

Failure to instruct an appropriate expert may lead to the provision of inaccurate evidence, unethical and unapproved photographic techniques, inability to document the condition, and less evidential weight should the photographs be relied upon in court. Instructing a qualified Clinical Photographer provides confidence in the knowledge your expert has the ability and experience to document evidence legitimately and accurately following departmental, local and governmental standard operating procedures.

 

 

Accuracy and Legitimacy is Key

 

 

Up until now knowledge of photographic manipulation has been more relevant in criminal litigation. With the increase of photography to display a claimant’s injuries however, accuracy and legitimacy have had to be addressed. Whilst there is no immediate need to approach all medico-legal photographs with scepticism, a basic understanding of image manipulation techniques should be understood. Manipulation can take on many forms, from pre-photography by the pressure on a wound to cause redness or inflammation, to post-photography by editing images to exaggerate severity. If an image seems inaccurate it should be questioned upon receipt and a relevant clinical photography expert instructed.

 

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Can it be justified?

 

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Following the reforms and a current focus on costs & proportionality, the need for photographic documentation of an injury vs. the need to minimise litigation costs has led to an increased acceptance of a claimants own photographs which may fail to depict the injury or be exaggerated due to bias. To justify instructing a photography expert as opposed to accepting a claimants photographs, the level of photography expertise must be appropriate for the function instructed. A clinical photographer has specific knowledge of how to accurately document injury to the human body through standardised practice, knowledge of anatomical positioning, and advanced techniques in lighting and perspective. 

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Practice points for instructing a photography expert:

 

 

• Instruct an expert early on in the process: this will avoid delays in settlement and provide immediate accurate documentation to assist quantum evaluation.

 

• Choose your expert carefully, ensuring he or she is a specialist Clinical Photographer

 

•  If locating a Clinical Photographer proves difficult and time consuming, use an agency that specialise in instructions to qualified Clinical Photographers such as Clinical Photography UK (www.clinicalphotography.co.uk)

 

• If instructing a medico-legal agency that offers a photography service, ensure you receive CV's for the photography experts and that they are Registered Medical Illustration Practitioners or work in Medical Illustration departments. 

 

• Be detailed in your instruction citing specific areas of interest to document and request scales where appropriate.

 

• Request 2 or 3 copies of photographic prints to avoid photocopying or printing digital images.

 

• Be cautious of the various methods of photographic manipulation and do not hesitate to question authenticity.

 

• Ensure all photographs received are accompanied with a CPR p35 declaration that the images have not been manipulated in a way as to deceive.