Opinion 5.045 - Filming Patients in Health Care Settings
The use of any medium to film, videotape, or otherwise record (hereafter film) patient interactions with health care providers requires the utmost respect for the privacy and confidentiality of the patient. The following guidelines are offered to help ensure that the rights of patients are protected when filming occurs. These guidelines specifically address filming with the intent of broadcast for public viewing. As such, they consider physicians’ role in striving to deliver information to the public that is both complete and accurate. They do not address other uses such as filming for medical education (see Opinion 5.046), forensic or diagnostic filming, or the use of security cameras.
(1) Educating the public about the health care system should be encouraged, and filming of patients may be one way to accomplish this. This educational objective can be achieved ethically by filming only patients who can consent.
(2) Filming patients without consent is a violation of the patient’s privacy. Consent is therefore an ethical requirement for both initial filming and subsequent broadcast for public viewing. Because filming cannot benefit a patient medically and may cause harm, filming should be done only if the patient being filmed can explicitly consent. When patients cannot consent, dramatic reenactments utilizing actors should be considered instead of violating patient privacy. Consent by a surrogate medical decision-maker is not an ethically appropriate substitute for consent by the patient because the role of such surrogates is to make medically necessary decisions, and whether to film for public broadcast is not a medical decision. A possible exception exists when the person in question is permanently or indefinitely incapacitated (e.g. a patient in a persistent vegetative state) or is a minor child, in which case the consent should be obtained from a parent or legal guardian who has the authority to make non-medical decisions.
(a) Patients should have the right to have filming stopped upon request at any time and the film crew removed from the area. Also, persons involved in the direct medical care of the patient who feel that the filming may jeopardize patient care should request that the film crew be removed from the patient care area.
(b) The initial granting of consent does not preclude the patient from withdrawing consent at a later time. After filming has occurred, patients who have been filmed should have the opportunity to rescind their consent up until a reasonable time period before broadcast for public viewing. The consent process should include a full disclosure of whether the tape will be destroyed if consent is rescinded, and the degree to which the patient is allowed to view and edit the final footage before broadcast for public viewing.
(c) Due to the potential conflict of interest, informed consent should be obtained by a disinterested third party, and not a member of the film crew or production team.
(3) Information obtained in the course of filming medical encounters between patients and physicians is confidential. Persons who are not members of the health care team, but who may be present for filming purposes, must demonstrate that they understand the confidential nature of the information and are committed to respecting it. If possible, it is desirable for stationary cameras or health care professionals to perform the filming.
(4) Physicians retain their responsibility to maintain professional standards whenever medical or surgical encounters are filmed for public broadcast. They should be mindful that the educational content of the finished product may become marginalized, potentially distorting the portrayal of the patient-physician encounter and of the medical procedures. Physicians should accurately convey the risks, benefits, and alternatives of treatments to an audience of prospective patients, and should refuse to participate in programs that foster misperceptions or are otherwise misleading.
(5) Independent peer groups, such as medical specialty societies, also may help prevent misleading information from reaching the public by making themselves available to producers to assess the accuracy of program content. They may help dispel misperception by providing educational resources and, if necessary, taking corrective or disciplinary action.
(6) As advocates for their patients, physicians should not allow the care they provide or their advice to patients regarding participation in filming to be influenced by financial gain or promotional benefit to themselves, their patients, or their health care institutions.
(7) If a physician is compensated beyond services to the patient, the amount and conditions of compensation must be disclosed to the patient.
(8) To protect the best interests of patients, physicians should participate in institutional review of requests to film.
(9) Programs regarding various aspects of health care are commonly televised; therefore, physicians should recognize that their patients may have preformed expectations from public broadcasts that may need to be addressed. (I, IV, VII, VIII)