Opinion 5.0591 - Patient Privacy and Outside Observers to the Clinical Encounter
Outside observers are individuals who are present during patient-physician encounters and are neither members of a health care team nor enrolled in an educational program for health professionals such as medical students.
Physicians are ethically and legally responsible for safeguarding patient privacy and, therefore, must inform outside observers about medical standards of confidentiality and require them to agree to these standards.
Outside observers may be present during the medical encounter only with the patient's explicit agreement. Physicians should avoid situations in which an outside observer’s presence may negatively influence the medical interaction and compromise care. The presence of outside observers during encounters between physicians and patients who lack decision-making capacity should not be permitted, except under rare circumstances and with consent of the parent or legal guardian.
Physicians should not accept payment from outside observers because accepting such payment may undermine the patient-physician relationship. (I, IV, VIII)