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I think it is unethical to photograph patients without their consent. What has happened to you is quite unfortunate and your surgeon has been very unprofessional from your account. I don't know how much the law may help you since I've never even heard of any doctor in India having to pay punitive damages for taking patient photos, though I'm sure there is a case to be made.In teaching hospitals, especially in government hospitals in India there is no requirement to take a separate photo consent because by coming for treatment and consenting to be seen by the surgeon, the consent for examination and photography is implied. I don’t remember having to take a photo consent during my residency even though I took thousands of clinical photos during my residency in a government institute. This is mainly because of huge volumes. When the hospitals are treating close to 1000 patients everyday, it is not logistically possible to take consent for every small thing. There is no administrative staff who can do such jobs in government hospital. The residents have to do everyone’s work from peon’s to the surgeon’s in a government hospital.However now that I am in private practice, the rules are different now.I take a photo consent every time I need to take a patient’s photo. I need clinical pictures for case documentation, teaching residents, for my own academic lectures in conferences, publishing in journals and textbooks. I also specify in the consent form the purposes the photos would be used for. I take care that I do not post any identifiable pictures in any public forum as well as try to hide identifiable features in conferences or journals if I can help it. I also take express consent in case patient may be identifiable in the photos. The patient can refuse to give consent to everything or just parts that s/he is OK with.Being a plastic surgeon, I work in a field where pre-operative and post-operative photos are important not only from the patient’s point of view but also from the medico-legal point of view. Most patients have no problem signing the photo consent forms. I sometimes have to remind the patients “not to smile” in these clinical photos. I remember only 2 patients ever refusing to consent for the photos. I have refused to operate on both occasions unless a minimal photo consent for “documentation purpose only” is given. The patient was free to refuse photo consent for any other academic purposes. One relented, one didn't.As a Plastic surgeon I pay four times malpractice insurance than a family physician and twice that of a surgeon. I can’t risk getting sued and not having any evidence in my defense.Personal data protection and Privacy law is very rudimentary in India and doesn't protect much in case your surgeon is taking pictures without your consent. I have also seen that surgeons in India are quite callous with patient photos and that patient identity could be revealed publicly. I have also seen several of my colleagues posting full face identifiable photos on Facebook, Whatsapp groups and their own websites. I’m sure many of these photos shared are without the patients consenting.However things are changing all over the world and privacy and personal data is being given utmost importance. In Singapore where I worked in before coming back to India, the privacy law was very strong. The Personal Data Protection Act (PDPA) was already in place and there were guidelines about the limits of how much personal identifiable data can be shared in clinical settings. There were punishments ranging from fines to even suspension of medical license.So privacy law could be amended in the future so I want to be well prepared for it.This below is the screen-shot of the photo consent that I use. It is quite flexible and consent can be given as per the patient’s wishes. I insist on at least a consent for documentation purpose for me to operate on the patient.

Much as I dislike being drawn into judging another officer (I’d rather leave that to the professional standards dept as they will have more information than me) I can’t really avoid it here, this was just too much and I can’t think of anything that can defend this.I watched the video (his own bodycam, people can’t complain that officers aren’t using them here) from both angles and although I confess I don’t know the actual legal powers he would have (I am a UK officer, I know what can be done here, not so much there) it strikes me that there is nothing that can forgive this.Let’s break it down a little and see what falls out.He was there for (I think) bloodwork on an unconscious driver, I’m guessing it was related to an accident - how serious I have no idea, might have been a fatal if a detective has become involved - and they were looking to demonstrate intoxication (or lack thereof). As the driver was unconscious they couldn’t bag him (get them to do a breath test).The nurse (I can’t remember her name, it isn’t important for this question) had listened to the request/requirement for bloods and taken the trouble to confer with her supervisor and located a suitable protocol document for this sort of event. She was acting purely to the letter of the agreement and her understanding of the legal basis.I can understand him discussing it with her, I would just to make sure I wasn’t missing something. But the moment he decided to ramp it up to an arrest he was in the wrong.Why? - legal bit here - to commit a crime you have to have some form of intent to defy a law. In other words, to commit an offence (whatever it is that he accused her of) she would have to know that his request was reasonable and lawful yet still obstruct it without reasonable excuse.That wasn’t what happened. She acted completely in good faith and honestly believed she was doing the correct thing, especially as she had managerial support and a document to fall back on. Therefore she cannot have committed obstruction.If the process itself is obstructive (perhaps the whole protocol had been written incorrectly) then an individual within it cannot be to blame, in that case the protocol should be revisited and amended - but not there and then.So for starters, she should not have been arrested for obstructing him.Then you have to think what is the desired outcome of the arrest - surely it is to obtain a blood sample from the blissfully ignorant unconscious driver. Arresting her is unlikely to get any other staff member to comply, is it. And if the officer is trained and authorised to take bloods himself (I read that he was apparently) then to allow him to do so is to permit an assault, and the hospital have a duty of care to their patients; they can’t just stand by and watch.He turned a difficult situation into a huge bloody mess, and for no good reason.The question of the other officers has also come up. Watching the video it appears that they were taken by surprise at this as well. They were more junior in status and age and you can clearly see their expressions that they are totally out of their depth and didn’t know what to do. Had they been in full agreement with him they would have assisted immediately with the restraint.There you have a couple of officers that are being put in the position of not only disagreeing with that detective, but also expected to pull him off of her. Had they known he would pull a stunt like this before they got there they may have been able to plan for that event, they didn’t. His behaviour was also matter of fact, confident and he was spouting legal language while having many more years of service than them and they had the instant moral dilemma - “Maybe he’s right?”Like it or not, that happens. In policing, military, business, medical, in fact everywhere. It is a facet of social programming and in policing a difficult area to give sufficient training in because it requires strength of character and a willingness to expose yourself to professional risk. People can and do take that risk, but it is a scary thing to do.The question has arisen about what the hospital security should have done - Exactly what I think they did do, they interceded and made representations and presumably will act as witnesses in any forthcoming tribunal or trial. They couldn’t just jump on him as you can imagine what would happen next. And what would those two police officers trailing nervously close by if they saw their colleague being bundled? Everybody had a gun there - it doesn’t bear thinking about.So, we know what shouldn’t have happened, let’s think about what should have happened instead and see how that appears.Had it been me there I would have discussed with the nurse and/or her supervisor. But as soon as they say it is the policy, and produced this document I would have to back down. It isn’t a loss of face, it is a simple, “well if that’s the agreed procedure then that’s how it is” - the system itself won’t let me get that blood sample.To rescue what you can, though, I would request a copy of the document to cover my own arse and then how about this as a solution to suit all -The hospital will most likely take bloods routinely for their own purpose (I’m sure one of the medical contributors can suggest what they might do this for) so the issue isn’t that they can’t take bloods, it is that they can’t hand them over to the police without consent, same as any other body tissue.I would request that the bloods were retained by the hospital pending me getting a warrant or patient consent later on. My understanding is that routinely blood samples are disposed of within a couple of days once the tests are done. It is a simple request that they be left in the fridge until I get those things. If I don’t manage to get them they can be tipped away later.No arguments, no breach of protocol and no huge public mess that now needs to be resolved.Does that sound like a better solution?I wonder what happened to the driver?

I have Multiple Sclerosis. In 2005 I had the diagnosis but was not yet disabled. In June that year, I got out of bed to go to my job as a trainee surgeon and said to my girlfriend, “fucking hell, my foot’s gone wierd.”By October I was using, but not confined to, a wheelchair and my neurologist, David Bates, sent me to Cambridge for an experimental drug, this drug was an obsolete cancer drug they found happened to be effective for multiple sclerosis.I traveled 4 hours to Cambridge from Newcastle with my Mum, only to be told they would not give it to me. Someone had bled to death and the drug company had halted the trial.I called Prof. Bates and said they aren’t going to give it to me. He said “I didn’t know they were going to do that, fella. I’m in the airport about to fly to Australia for a conference. I’ll see you when I get back, hopefully you’ll be better, MS being a remitting condition. If it isn’t better, don’t worry, I have a plan.Prof came back in December and called me. “How are you.?”“Not all that well Prof.”The decline in my health had accelerated. I could move nothing below my chest, my arms had begun to weaken, my fingers we’re weak (I could only type 400 words a day.My speech was slurred, my swallow wasn’t great. I had vertigo, and was blind.Prof said to me. “Well Dr. Straker, we have some Campath in the cupboard as the haematologists still use it sometimes, (for lymphoma.)”“You know the risks, do you feel lucky? Well do ya?Punk?”He didn’t actually say that, that was lust a little joke…The upshot is I did, and I signed the consent form.That March, my big toe on the left, moved. Now, nearly 13 years down the line, I can walk although I use a wheelchair for distance, I can type, talk and see again. I’m married (to my girlfriend mentioned earlier) we had two kids, my MS continues to be in remission.In answer to your question, when I was refused Campath in Cambridge back in 2005, I was really very angry!But for the avoidance of doubt, now I have only gratitude to that doctor. He had no choice regarding my particular case and his research is what has got me back on my feet.Sorry that’s so long winded! I hope I’m right that it’s worth sharing, because of the brave Prof Bates, the brilliant Cambridge researchers and not least, my long suffering girlfriend who stuck it out…The drug Campath is now called Alemtuzumab and is the go to drug for severe MS.Merry Christmas!