Ethical conduct of humanitarian medical missions: II. use of photographic images.

T he overarching imperative for patient care when a physician volunteers to treat patients in another country is to respect the dignity of the individuals. Because of cultural differences and language barriers, the typical patient-physician relationship will likely not be possible in its fullest extent. Therefore, the physician must make an effort to gain the trust of the patient through nonverbal communication as well as verbal (likely through a translator). A pleasant, attentive approach to patients, with appropriate friendliness, interest, and respect, will be helpful in putting them at ease. One must be cautious, however, not to cross a boundary that lies within the cultural and/or religious fabric of the population. It is very important for the volunteer physician to be adequately prepared for interacting with patients by first studying the cultural and religious customs of the country and its people. Good intentions can be marginalized and future missions jeopardized through unwittingly inappropriate interactions with patients and their families. Often the host organization or host physicians can be helpful in providing advice and understanding on what can or cannot be done in this regard.