Patient asks you to delete their photos: how to respond

"Can you delete my photos?" The request comes after a result the patient did not like, a change in life, a scare over a data leak or simply out of caution. It touches two duties that seem to pull against each other: respecting the patient's privacy and keeping the patient record. The right answer depends on which photo, for what purpose and what legal basis. This page organizes the reasoning, without replacing the clinic's legal advice.

Which photos exist and what are they for?

Before answering, sort the images by purpose. Not all of them have the same fate.

The distinction is the key: what is part of the clinical record has its own rule. What was processed only with consent for another purpose must be deleted when consent is withdrawn. See withdrawing image authorization and image authorization for the patient record only.

What does the law say?

In Brazil, the LGPD (General Data Protection Law) gives data subjects rights over their own data, such as access, correction and erasure of data processed with consent. At the same time, it allows the controller to keep data to comply with a legal or regulatory obligation, such as retaining the patient record. Face photos tied to health are sensitive personal data, which calls for extra care. The period and the way to keep the patient record depend on the rules of your professional council and on current legislation; see patient record retention. You can check the official text of the law at the Planalto.

How to respond to the patient in four steps?

1. Acknowledge and understand the reason

Ask, without getting defensive: "Is there a specific reason? I am happy to explain." The reason guides the answer. If the patient fears exposure, the conversation is about privacy. If they are unhappy with the result, the conversation is clinical. If they plan to sue, the conversation is legal, and the patient record is your protection.

2. Map the images

List where the photos are: paper or electronic patient record, phone gallery, messaging apps, cloud, flash drives, social media, class material. Many "forgotten" photos sit in places with no controls. This is the moment to get organized.

3. Decide

• Delete now: what has no clinical purpose or legal basis to remain (selfies, personal galleries, loose files, promotional materials).
• Keep with restrictions: what is part of the patient record, for the retention period.
• Analyze: what falls in a gray area.

4. Respond and record

Answer in writing, in plain language, stating what was deleted, what was kept and why.

What happens to photos already published?

If the patient authorized publication and later withdrew, take the material down as soon as possible, from social media, the website and printed materials, and tell the patient what was done. Content already shared by third parties is out of your control, and this should be explained frankly. See image authorization for promotion: how to talk about it and what can be published (CFO and CONAR). The CFO (Brazil's dental council) and CONAR (Brazil's advertising self-regulation body) are Brazilian bodies.

What about images generated by simulation?

The simulation is an illustrative image generated from the patient's photo. Treat it as derived from that photo: if the original photo must be deleted, the simulation must be too, unless it is part of the patient record. Agree with the patient, from the start, on what will be done with the photo and with the generated image.

What precautions to take in practice?

How to avoid the problem from the start?

The best moment to address this topic is before taking the first photo. Explain what each image is for, who has access, how long it is kept and how the patient can request changes. See asking the patient for image authorization, explaining privacy to the HOF patient and consent and LGPD for photos. A well-written informed consent already answers, in advance, most of these requests.

What to record?

Record the request, the reason given, the mapping of the images, what was deleted and when, what was kept and the basis, and the answer given to the patient. This document shows that the request was taken seriously and that the handling of the data respected the law and the patient's wishes as far as possible.