See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/324824190

Forensic Clinical Photography: A Game Changer in Medicolegal Investigation

and Forensic Science

Article  in  Indian Journal of Forensic Medicine and Toxicology · April 2018

DOI: 10.5958/0973-9130.2018.00113.5

CITATIONS READS
0 722

4 authors, including:

Renjulal Yesodharan Vishnu Renjith

Manipal Academy of Higher Education RCSI-Bahrain
9 PUBLICATIONS   0 CITATIONS    41 PUBLICATIONS   27 CITATIONS   

SEE PROFILE SEE PROFILE

Some of the authors of this publication are also working on these related projects:

A systematic review on barriers to exclusive breast feeding View project

Migraine View project

All content following this page was uploaded by Renjulal Yesodharan on 28 April 2018.

The user has requested enhancement of the downloaded file.

 DOI Number: 10.5958/0973-9130.2018.00113.5

Forensic Clinical Photography: A Game Changer in

Medicolegal Investigation and Forensic Science

Renjulal Yesodharan1, Vishnu Renjith2, Ashwini Kumar3, Vinod C Nayak4

1
Lecturer, Department of Psychiatric Nursing, 2Junior Research Fellow, Department of Medical-Surgical Nursing,
Manipal College of Nursing, Manipal Academy of Higher Education, 3Associate Professor, 4Professor and Head,
Department of Forensic Medicine and Toxicology, Kasturba Medical College,
Manipal Academy of Higher Education

ABSTRACT

Photography is a critical factor in solving out the mysteries behind the crimes by giving out critical
information applicable to criminal, legal investigation. It was initially based on manually operated camera
and film strips and later adopted digital technology for recording and storing the visuals. Digital evidence
can show the relative position of evidence at the scene, establish the relative dimension of the evidence
and also cross compliment other evidence collection techniques. The inadequate and improper collection,
preservation and presentation of evidence can lead to crime scene errors and fewer conviction rates. Training
in forensic photography is vital, and a game changer in the medico-legal investigations.

Keywords: Forensic Photography, Photo colposcopy, Digital evidence, Cinical photography

INTRODUCTION Medicine including toxicology’ which does not include

Photography as a digital evidence1 is an integral
part of any legal systems in the world. Digital evidence
is incredibly vital in solving and preparing court cases.
Photo-documentation also improves the likelihood of
detecting injuries, increases the accuracy of diagnosis,
and allows experts to comment on the evidence without
being present at the time of forensic and medical
examination.
INDIAN SCENARIO
Forensic photography as a subject. When considering
the nurses in the emergency departments, they lack
Forensic training in any forms. The syllabus of Bachelor
of Science in Nursing (BSN) does not have forensic
science as a subject or coursework3. Nurses also have
a significant role in fields of; crime scene investigation,
toxicology, emergency & trauma care, and correctional
settings. Forensic nurse examinations are reliable
sources of evidence that leads to higher conviction rates
and fewer crime scene errors.4

The medical and surgical emergencies reported are
mostly taken care by the emergency department team
which consist of medical professionals, nurses and other
paramedical professionals of hospitals who do not have
specialized training in forensic science.2 The curriculum
of M.B.B.S has a Para-clinical subject of ‘Forensic
Corresponding author:
Mr. Renjulal Yesodharan
Lecturer, Department of Psychiatric Nursing
Manipal College of Nursing Manipal
Manipal Academy of Higher Education
Manipal 576104, Email. yrlal2005@gmail.com,
Mobile: 8095900592
FORENSIC CLINICAL PHOTOGRAPHY
Photographic evidence of the injuries and trauma
prior to treatment is very critical in the forensic
assessment and future criminal investigation.6 The
purposes of forensic photography is to record and
preserve as found conditions of the scene, show the
relative position of evidence at the scene, establish the
relative dimension of the evidence, cross compliment
other evidence, collection techniques and preserve as
found scene for future reference or second investigation.
Types of Camera
The 35-mm camera was the benchmark standard
 263 Indian Journal of Forensic Medicine & Toxicology, April-June 2018, Vol. 12, No. 2
for forensic and other clinical specialists where close-up
images and views of the head and neck were needed. It
was also equipped with a 90- to 105-mm lens with macro
capability.7 The Digital Single Lens Reflex (D-SLR)
camera is the newest option available to the forensic
expert which allows them to change the parameters such
as aperture, shutter speed, and exposure – the three most
important variables in photography.8
The aperture
These are a small set of blades in the lens that
controls the light entering the camera, and it is measured
by ‘f-stops.’ or ‘f-ratio’ (the ratio of the focal length
of the lens to the diameter of the entrance pupil of the
camera). The lower ‘f-stop’ (f-4) indicates that the
aperture hole is wide and allows more light and a higher
one (f-20) denotes that the aperture hole is very narrow.
The shutter speed
The shutter is a small ‘curtain’ in the camera that
quickly shuts over the image sensor and allows light
to shine onto the sensor for a fraction of a second. The
shutter speed determines the brightness of the image;
the slow shutter speed allows light to shine and make the
image brighter. Contrarily, rapid shutter speed produces
dark picture by allowing the light to touch the imaging
sensor for a slight fraction of a second.
ISO Rating:
ISO is a measure of the digital sensor’s sensitivity to
light. ISO settings of the DSLR cameras range from 100,
200, 400, 800 up to 12800. The greater the ISO number,
the more sensitive the sensor is to light. A change in
ISO number from 100 to 200 effectively doubles the
light. Higher ISO numbers are used to capture, low-light
images. However using a higher ISO number can make
the image noisier.
The Exposure
The digital cameras have automatic exposure
capability. The fill-in-flash attachment helps the
forensic experts to increase the exposure capabilities of
the camera. Exposure is controlled by a combination of
aperture, shutter speed and ISO. One must balance these
components to get an optimum exposure and desired
result.
The photographic experts are doing bracketing by
intentionally taking an overexposed and an underexposed
images in addition to the normally lit photographs to
compare the photographs to an item of real evidence.10
Bite mark Photography
A bite mark found on a victim is considered a non-
accidental pattern injury frequently associated with
sexual and physical violence.11 T J David and M N
Sobbel were successful to photograph 5 month old bite
mark on the shoulder of a rape victim using reflective UV
photography. Hence old bite-marks can be appreciated
using reflective UV photography.
Photo-colposcopy
Colposcope is used for the visualization of genital
injury not readily visible to the bare eyes. It can be
attached with a 35mm camera or a video camera and
can function as a photo colposcopy .The photographs
generated using colposcopy precisely give location
and extent of the injury caused by sexual abuse.12
Colposcopy allows the examiner to perform a magnified
(4x to 25x) visual inspection of the internal and external
genitalia for microscopic injury as well as bruising,
tears, abrasions, and lacerations.
Protocols for Forensic Photography
When forensic photography is used adequate
protocols also need to be implemented in the areas
of safety & security such as encryption, password
protection, and storage in safe location. Protocols
also need to be developed for getting consent from
the victims/survivors of abuse and violence for legal
proceedings, peer review and teaching. 13
Use of identifiers
Use of small labels that identifies the patient in the
photography improves the storage and recollection of
the evidence. This will also orient the viewer regarding
the details of the patient in future. A label can be made
from a white sticky paper with relevant information
regarding name of the patient, date of birth, medical
record number, medico-legal case number, current date
and photographer’s name & initials. Use of colored
labels such as ‘L’ (left) and ‘R’ (right) help the viewers
to orient the close-up shots.11 An L-shaped ruler must be
visible in all pictures for recording of dimensions.
 Indian Journal of Forensic Medicine & Toxicology, April-June 2018, Vol. 12, No. 2
Use of log
The photos need to be entered in the log as and
when it is taken. The log should include identification
data of the subject, date and time of the photography,
name of the law enforcement agency, case number
(medico-legal), and medical or hospital number,
type of examination conducted, device specification,
identification of the expert photographer, chain of
custody form, specification of storage device and
location of the storage.
Use of ruler
Using of a ruler while photographing demonstrate
the exact size of the wound in measurable terms. The
ruler can be placed parallel to the injury or in the same
plane of the body. Use, indicating scale such as hinged
L-reference scale, angled rulers, standard rulers and tape
measures are recommended for accurately measuring
the sizing of the injury. Using an American Board of
Forensic Odontology (ABFO) 2 ruler also helps the
expert to judge the white balance of the picture and can
rule out the incorrect white balance as in case of a highly
yellowish skin due to jaundice.
Use of anatomical landmarks
To definitely locate the position of the injury
the image has to include an anatomical landmark.
Anatomical landmarks orient the viewer regarding the
exact location and direction of the injury. Additional
‘overview photos’ also help to locate the injury when
macro photos of the injuries were taken.
Use of Macro-photography (Extreme close-up
photography)
Extremely close-up photography is vital in forensic
examination especially the photographing small skin
lesions. The major challenge associated with macro
photography is the reporting of ‘magnification.’
Magnification is the relationship of subject size with
image size on the film or image sensor.14
Use of a tripod:
A tripod is a portable three-legged stand device
used to stabilize camera while taking images. Using a
tripod while taking images eliminates the likelihood of
having blurred photos resulting from shaky hands. It is
essential to use a tripod when working on slow shutter
264
speeds.
Number of shots:
It is ideal to have three or four photo photographs
of a single object.
An overall view: Covers the overall view of the
crime scene. Helps in understanding the relative position
of the subject in the field.
A Medium view: Picture of where the piece of
evidence is in reference to other items.
A Close-up view: A close-up view focuses on the
details of the object.
Challenges in Forensic Photography
Consenting for forensic photography
A written informed consent must be obtained from
the victims before photography if the victim is able to
provide informed consent. It must include a statement
that the “photographs are the part of the patient’s
medico-legal records and the photographs may be used
for presentation before courts, oral presentations, and
lectures.” When the photos of the suspects are taken
for the purpose of law enforcement getting consent is
not a must. The photographs taken without the consent
should be in the individual’s best interest. In case of
accused of a crime consent can be requested but even
in absence of it reasonable force as is necessary can be
used, acting at the request of police officer not below the
rank of sub inspector to take photographic evidence on
the discretion of a registered medical practitioner as per
53(1) Cr.P.C.
A well-written informed consent should include the
reason for requesting the photograph, risk, and benefit
of the photograph, how the photograph may be used,
how the photographs will be stored and who will have
the access to view the photograph. It should be speciifed
that the photographic evidence can be for or go against
the person concerned in the court of law.11
Poor quality of the photographs
The compromises in the quality of the photographs
can generally lead to poor presentation of evidence and
reexamination of the victim. If the images are poor in
quality, no opinion can be made about the anatomy from
the images. Blurry photographs have little use in the
 265 Indian Journal of Forensic Medicine & Toxicology, April-June 2018, Vol. 12, No. 2
investigation. Using a Colposcope can overcomes this
challenge and capture magnified good quality images.15
Taking photographs which are tack sharp is critically
important to forensic photographers.16
Overexposed or underexposed images
When a photograph need to survive the challenges
in the court it has to be properly exposed. A grossly
overexposed or underexposed photograph can be
inadmissible pointing to the fact that these photograph
won’t accurately represent the scene.10
Narrow window of time for recovering evidence
Forensic examinations will likely to yield evidence
when it happens within 72 Hours of the alleged assault.17
The timing or the collection of forensic evidence also
depends on the type of assault.
Cyber Jurisprudence in India
The issues concerned with the regulatory aspect
of the technologies are also on the looming.18 The
Information Technology (Amendment) Act of 200819
is a centralized statute exclusively for the cyberspace
which has the applicability in the generation and storage
of electronic documents and information such as digital
photographs and videos. It also governs the electronic
signatures used to authenticate electronic records with
signer authentication, message authentication, and
message integrity.
Admissibility and relevancy of the digital evidence
Section 65B(4) of the Evidence Act deals with
the admissibility of the digital evidence in the court.
Any electronic document is permissible when certain
conditions were satisfied. a) There must be a certificate
which identifies the electronic record containing the
statement. b) The certificate must describe the manner
in which the electronic record was produced. c) The
certificate must furnish the particulars of the device
involved in the production of the record. d) The
certificate must deal with the applicable conditions
mentioned under Section 65B(2) of the evidence act and
e) The certificate must be signed by a person occupying
a responsible official position in relation to the operation
of the relevant device. In case of digital photography,
the person who took the photography should say that the
photograph he has taken on such day and place has not
been tampered with it. The expertise required by such
a person is to an extent that he should be contractually
capable to use the tools required to view and print/copy
the said computer output.
Authenticity of the digital evidence
Unedited raw photographs will be accepted as
evidence in Indian courts, but the genuineness, veracity
or reliability of the evidence is seen by the court only
after the stage of relevancy and admissibility.20 Question
can arise at any point regarding the authenticity of the
document. When such things happens the ‘Metadata’
may reveal when the digital evidence was created, how
many times it was edited when it was edited and the
nature of the edits.
Encryption of forensic records and photographs
One of the major concerns faced by the forensic
experts is encryption of records or photographs. People
who carry patient photos and data on either laptops or
flash drives are vulnerable to data leaks, unauthorized
access to the patient information due to chances of
devices being lost or stolen. It is also advised to not use
personal cameras and smartphone cameras to document
anything related to the patient. Images captured with
these gadgets are always vulnerable to hacking, security
breach and use for personal purpose.
Proper protocols regarding photographs need to be
in place for ensuring security and safety of the image
within the ethical and legal boundaries. The protocol
should describe how the encryption, protection, and
storage of photographs are being done and it also should
have a provision to obtain informed consent which
include all the aspect of their use (legal proceedings,
peer review and education)
Availability of photographs to the defense council
or the perpetrator during trial
The availability of the photographs of private part
of the victims to the defense counsel or the perpetrator
in the trial cause negative repercussions for the victim.21
CONCLUSION
Photographs are adjuncts to, not substitutes for,
clear and concise written documentation. Photo-
documentation have both clinical and forensic benefits.
Choosing the right camera, and right technique can
capture neutral and accurate representation of the crime
scene or evidence.
 Indian Journal of Forensic Medicine & Toxicology, April-June 2018, Vol. 12, No. 2
Conflict of Interest: Authors declare no conflict of
interest
Source of Funding: Not applicable
Ethical Clearance : Not applicable
REFERENCE
[1] Banks M, Zeitlyn D. Visual methods in social
research. Sage; 2015 May 18.
[2] Saxena A, Kumar V, Chaudhary SR, Singh J,
Awasthi S. Pattern of Medico-legal Cases in the
Casualty Department of A Teaching Hospital,
Bareilly, Uttar-Pradesh. Journal of Indian
Academy of Forensic Medicine. 2015;37(4):338-
40.
[3] Modi I. Health Care Delivery System: India. The
Wiley Blackwell Encyclopedia of Health, Illness,
Behavior, and Society.
[4] Renjith V, S. Nikitha, George A, Mhalkar V, Raju
N.J., “Forensic Nursing,” Indian Journal of Forensic
Medicine & Toxicology.2016:10(2):159-62.
[5] Sundaragiri S. Medico-Legal Cases Need a
More Professional Approach. Journal of Indian
Academy of Forensic Medicine. 2015;37(3):302-
4..
[6] Verhoff MA, Kettner M, Lászik A, Ramsthaler
F. Digital photo documentation of forensically
relevant injuries as part of the clinical first response
protocol. Deutsches Ärzteblatt International. 2012
Sep;109(39):638.
[7] Kokoska MS, Currens JW, Hollenbeak CS, Thomas
JR, Stack BC. Digital vs. 35-mm photography:
to convert or not to convert?. Archives of facial
plastic surgery. 1999 Oct 1;1(4):276-81.
[8] Nair AG, Santhanam A. Clinical photography
for periorbital and facial aesthetic practice.
Journal of cutaneous and aesthetic surgery. 2016
Apr;9(2):115.
[9] Russ JC. Forensic uses of digital imaging. CRC
Press; 2015 Nov 18.
[10] Robinson EM. Crime scene photography.
View publication stats
266
Academic Press; 2016 Jun 12.
[11] Darnell C, Michel C. Forensic Notes. Philadelphia:
F.A Davis Company, 2012.
[12] Sommers MS, Fisher BS, Karjane HM. Using
colposcopy in the rape exam: Health care, forensic,
and criminal justice issues. Journal of Forensic
Nursing. 2005 Mar 1;1(1):28-35.
[13] Fuller D, Chasson S, Macdonald S, Daiber D,
Goryl C, Mitchell S, et al. Forensic Photography
Symposium Review. On The Edge [serial on the
Internet]. (2011, Fall2011), [cited September 13,
2017]; 17(3): 1. Available from: CINAHL Plus
with Full Text.
[14] Weiss SL. Forensic Photography: Importance of
Accuracy. Pearson/Prentice Hall; 2009.
[15] Pillai M. An evaluation of ‘confirmatory’medical
opinion given to English courts in 14 cases of
alleged child sexual abuse. Journal of forensic and
legal medicine. 2007 Nov 30;14(8):503-14..
[16] Shaler RC. Crime scene forensics: A scientific
method approach. Taylor & Francis; 2011 Dec 28.
[17] Young KL, Jones JG, Worthington T, Simpson
P, Casey PH. Forensic laboratory evidence
in sexually abused children and adolescents.
Archives of pediatrics & adolescent medicine.
2006 Jun 1;160(6):585-8.
[18] Abhilash KS. Cyber Jurisprudence An
Internalisation In Indian Matrix. 24 February
2016. [Online]. Available: http://www.
legalservicesindia.com/article/article/cyber-
jurisprudence-an-internalisation-in-indian-
matrix-1987-1.html. [Accessed 9 March 2017].
[19] Ministry of Law, Justice and Company Affairs ,
The Information Technology ACT, 2008, New
Delhi, 2008.
[20] Ansar PV Vs. P.K Basheer and others: Civil
Appeal, 2014.
[21] Spangaro J, McNamara L, Blyth J, Myers B,
Boxwell R. Use of intimate photography in sexual
assault prosecution: Who is being deterred?.
Psychiatry, Psychology, and Law. 2015 Sep
3;22(5):682-7.