Reply to: The ethics of photo licensing.

To the Editor: The article titled “The ethics of photo licensing” by Tracy et al1 addressed the sale of patients' clinical photographs for use in artificial intelligence (AI) algorithms. It is our opinion that the use of patient photographs without informed consent, particularly with monetary gain for the clinician, is unethical. Patients come to our offices, often feeling insecure and vulnerable; they trust us not to abuse the privilege they have bestowed upon us. However, with this privilege comes the responsibility of protecting our patients’ privacy and not obtaining further monetary gain from the sale of their images.