Video-monitoring in hospitals complicates privacy question

By Healthcare Facilities Today
March 6, 2014
Neil Webb

People expect some degree of privacy in hospitals, trusting doctors with secrets in part because they take a 2,000-year-old Hippocratic oath to respect our privacy, an oath enforced by laws like the Health Insurance Portability and Accountability Act. 

But sometimes, doctors have to weigh patients’ privacy against their health and safety, and that’s when things get complicated, according to an article on the New York Times Op-Ed page by Tim Lahey, chairman of the bioethics committee at the Dartmouth-Hitchcock Medical Center and an associate professor at the Geisel School of Medicine at Dartmouth.

Video-monitoring has become more common as high-quality, inexpensive technology has become increasingly accessible. The possibilities range from watching elderly patients at risk of falling in their rooms to recording doctors and nurses at sinks to make sure they’re washing their hands, the article said.

"My hospital, where I am chairman of the bioethics committee, recently wrestled with the question of where patient and family privacy ends. Nurses in the neonatal intensive care unit (N.I.C.U.) worried that a premature infant, whom I’ll call Rickie to protect his identity, was being harmed by his parents," Lahey wrote.

Concerned about child abuse, the N.I.C.U. doctor proposed mounting a small digital camera in an unobtrusive corner of the room. Not everybody agreed. 

"At my hospital, the ethics team decided it would be acceptable to secretly monitor Rickie’s room if other methods, like confronting the parents, failed to ensure Rickie’s safety. A few days later, Rickie’s mother confessed to neglect, and to holding a pillow over his face to keep him from returning home. We never had to videotape Rickie’s room, and he now awaits placement in a safer home," he wrote

Hidden cameras should be a last resort, Lahey said. Hospitals should notify patients that covert video monitoring may be used in unusual circumstances, and only with the oversight of a hospital ethics committee. 

Read the article.



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