Opinion 5.046 - Filming Patients for the Education of Health Professionals
It is important to recognize that filming patients for educational purposes has direct implications in relation to privacy, which itself has become the object of recent detailed federal regulations. Therefore, filming for educational purposes in the health care setting should comply with relevant laws and regulations. In addition, filming for educational purposes should be analyzed from the perspective of the ethics of the patient-physician relationship. In this regard, an important distinction can be drawn between filming for commercial purposes (see Opinion 5.045, "Filming Patients in Health Care Settings") and filming for educational purposes, since the latter is performed and viewed by members of the health care team, who are bound by ethical responsibilities regarding patient autonomy, privacy, and confidentiality. Specifically:
(1) Informed consent should be obtained before filming whenever possible. If it is not possible to obtain consent from the patient before filming, then consent must be obtained before the film is used for educational purposes. A surrogate decision-maker may give consent for filming only if the patient temporarily lacks capacity to give consent before the filming. When the patient regains decision-making capacity, his or her consent should be obtained before the film is used. In the case of minor children or permanently incompetent adults, consent may be obtained from the patient's parent or guardian (see Opinion 5.045, "Filming Patients in Health Care Settings").
(2) When obtaining consent, physicians should disclose information similar to that provided for other medical interventions, including an explanation of the educational purpose of film, potential benefits and harms (such as breaches of privacy and confidentiality), as well as a clear statement that participation in filming is voluntary and that the decision will not affect the medical care the patient receives. Moreover, physicians should be aware that filming may affect patient behavior during a clinical encounter. The patient should be given ample opportunity to discuss concerns about the film, before and after filming, and a decision to withdraw consent must be respected.
(3) Information contained in educational films must be held to the same standards of confidentiality as other patient information. If filming requires the presence of non-clinical persons, these persons must agree to protect the patient’s privacy and confidentiality. Viewing must be limited to health professionals, professionals-in-training, and students in the health professions, unless it has been disclosed to the patient that non-health professionals would view the film and the patient has consented to such viewing. If the film is to be distributed outside the institution in which it was produced, disclosure of the distribution must be made and explicit consent obtained.
(4) Films contain a record of personal patient information. Depending on its content, a film may or may not be considered part of the patient’s medical record, and may be protected under privacy law. Irrespective of these legal standards, films should be securely stored and final disposal should ensure that they are properly destroyed. (I, IV, V, VIII)