Knowledge, attitude and practice regarding the use of digital photographs in the examination of the dead and living among doctors practicing forensic medicine in Sri Lanka

Abstract

BACKGROUND: Forensic medical photography alludes to creating images of injuries/ conditions to be used in the legal process. In many parts of the world obtaining digital forensic medical photographs are done by trained police officers. in Sri Lanka, such practice is not seen. Thus, it is not uncommon to see many forensic medicine experts develop skills of taking photographs related to injuries in the living or dead. OBJECTIVES: To study the knowledge, attitude and practice on medico-legal usage of digital forensic photographs among doctors practicing forensic medicine in Sri Lanka. METHOD: A cross-sectional descriptive study was conducted using a self-administered questionnaire among doctors who engage in forensic work in all provinces of Sri Lanka. The study was conducted mainly as an on-line survey from October to December 2018 while some returned the survey via post. RESULTS: Out of 170 forensic doctors 135 participated the study. Half of them (n=68, 50.4%) were medical officers with basic MBBS degree where 23.6% (n= 36) had more than 10 years of experience. Even though the majority (n=98, 72.6%) stated that they have a Digital SLR camera in their institutions most of them (n=110, 81.5%) didn't have external light sources. More than half of them (n=73, 54.1%) used camera phones instead of DSLR (n=48, 35.6%) to take forensic photographs. The main purpose of obtaining photographs was for the recording of evidence for later usage (n=126, 93.3%) followed by as reviewable materials for a second opinion (n=120, 88.9%). The study showed 112 doctors (83.0%) used their personal computers to store photographs whereas, 57 (42.2%) saved them in their institutional computers too. Evaluation of basic technical knowledge on exposure triangle and camera sensor showed only 13.5% (n=18) doctors were having satisfactory knowledge. The knowledge of legal aspects showed a significant difference between doctors with postgraduate qualifications and those who are either in PG training or grade medical officers. Further, there was a significant difference in the belief that including photographs in reports will provide unnecessary information to defense lawyers resulting in questioning among PG qualified and Non-PG qualified doctors. CONCLUSIONS: This study showed a big gap in the technical knowledge of taking good quality digital photographs by forensic doctors while the usage of camera phones is getting popular. There are many gaps in the practice from storage to usage. There are negative attitudes among doctors of using photographs to courts especially among grade medical officers and PG trainees. A robust educational programme followed by guidelines on quality medico-legal photographs is the need of the hour. KEYWORDS: Attitude; Digital photographs; Forensic medical photography; Knowledge; Practice.