The Gazette 1988

GAZETTE

A Case for Med i cal Photography

FOREWORD This paper is written in the understanding that the jury system for the compu t a t i on of personal injury awards, has been abolished, and that the judge is now the final arbiter. Should the jury system be in ac t i on for some t ime after the publication of this paper, then one should read " j u r y" in place of " j udge" t hroughout this text.

more "appealing"; and finally that enlarged photographs make the injury look a great deal worse. To begin with I suppose we could do away w i t h pho t og r aphs altogether and personal injury cases would fast become one of the country's biggest spectator sports, with plaintiffs divesting in witness boxes the length and breadth of the country. It would be totally wrong not to let the judge see visibly the plaintiff's injuries and for reasons of medical ethics it is preferable to have lesions portrayed photographically. In answer to the arguement that the colour in prints is biased, it can only be said that the professional medical photographers have a duty to record as accurately as possible, any medical condition they are asked to photograph. Contrary to the occasional snide accusation made against medical photo- graphers, they do not enhance images of injuries as evidence, for any amount of money. It has yet to be recorded that a professional medical photographer risked his entire profession and the reputation of his Institute by unprofessional conduct. Adhering to the codes of practice of the various institutes and associations governing medical illustration is what allows photo- graphers put the word " p r o- fessional" after their names.

A Case for Medical Photography Whoever said that "a photograph never lies" was quite obviously, not a lawyer. But that is not to say that photographs are a "hinderance rather t han a help. In f act photographs professionally taken and printed are fast becoming an invaluable aid to the administration of justice. And at the forefront in setting high standards, and levels of professionalism, and integrity, is the "Medical Photographer". There is a hardly a week goes by without the question being asked " W h a t is a medical pho t o- grapher?". I have found the easiest way of answering this is to say that medical photographers photograph diseases, injuries, and causes of death, and it is usually at this point that people decide to make a rapid exit from your company, in the firm belief that you must be in need of very serious psychiatric help. But it is not only lay people who are squeamish about looking at injuries. Solicitors and barristers don't like looking at them either, but by virtue of their professions, a large proportion of them have to do so. If one addresses one's attention to the purpose of a tort action, it is clear, that if the injured party has to be provided wi th sufficient compensation to leave him in a position, which in legal terms is THE position he was in if the accident had not happened, full appreciation in court is dependent on the ability to provide true, fair, and convincing medical evidence. In medico-legal cases it is usual to have "medical experts" as professional witnesses as to the severity, or lack of it, of the plaintiff's injuries. These witnesses are unques t i onab ly the most reliable source of evidence in this regard.

They may on occasions bring with them radiographs to "illus- trate" the plaintiffs condition. It is a small wonder to medical illustrators how anyone can make

by Colin G. Goggin

much sense out of radiographs (X- rays) when they are produced as evidence, especially when one considers that to view them with even a modicum of clarity, it requires the radiograph to be trans- illuminated. To this end, medical illustrators have developed a procedure whereby the radiograph is photographed by passing light through it in two directions, thus increasing the contrast of the image. These photographs can then be viewed easily in a great amount of detail thereby obliterat- ing the need to hold the radiograph in the general direction of a window. One must give serious thought as to how convincing a verbal account of the plaintiff's injuries are to the judge. If a doctor tells a court that the female plaintiff has severe scarring on the pelvic region of her anatomy and that extensive plastic surgery in the future will at least be partially visible above her bikini line, does this evidence alone enable the judge to pronounce her award wi th any realistic degree of fairness? Surely med i cal photographs of her injuries would be of great assistance in arriving at a true and fair assessment. In the past however, I have come across one or t wo little problems relating to medical photography in court. In order of popularity these are that photographs play on a judge's emotions; that colour is not accurate and that it is even made

Photography can be used as an historical recording of the injury.

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