This is a pre-print of an article that is forthcoming in the Journal of Visual Communication in Medicine. Clinical photography has an important role in the education of clinicians. Because differences in skin pigmentation change the appearance of visible disease, students in the health professions should train using photographs of a variety of skin tones. Unfortunately, different skin tones are not well represented by the photographs used for medical education. This negatively impacts the ability of clinicians to treat certain populations, contributing to health disparities such that it would be beneficial to have more examples of clinical photographs on varying skin colors. When pursuing this justice in health for people of color, the social context, including the history of exploitation, cannot be ignored. Therefore, it is important to understand the complex sociotechnical processes involved in clinical photography and the ethical environment in which it is undertaken. To accomplish this, we conducted semi-structured interviews at a tertiary academic medical center with 10 clinicians, 1 medical photographer, and 1 clinical administrator familiar with the clinical photography processes at this institution.