I'll give you a Real World example of a real sensitive use. It was sold through another agency (not Shutterstock), and the customer asked permission before buying the image. It was an image of a Ghanese (African) woman crying, and the customer was designing a large poster to be used in an anti-rape campaign in South-Africa. I asked the model if it was OK for her to appear on a poster in which she would seem to be a rape victim, and she said yes, and she was glad she could do something to prevent rape in Africa.