Back to Chapter 3 Privacy, Confidentiality & Medical Records
Opinion 3.1.3

Audio or Visual Recording Patients for Education in Health Care

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Audio or visual recording of patients can be a valuable tool for educating health care professionals, but physicians must balance educational goals with patient privacy and confidentiality. The intended audience is bound by professional standards of respect for patient autonomy, privacy, and confidentiality, but physicians also have an obligation to ensure that content is accurate and complete and that the process and product of recording uphold standards of professional conduct.

To safeguard patient interests in the context of recording for purposes of educating health care professionals, physicians should:

  1. Ensure that all nonclinical personnel present during recording understand and agree to adhere to medical standards of privacy and confidentiality.
  2. Restrict participation to patients who have decision-making capacity. Recording should not be permitted when the patient lacks decision-making capacity except in rare circumstances and with the consent of the parent, legal guardian, or authorized decision maker.
  3. Inform the patient (or authorized decision maker, in the rare circumstances when recording is authorized for minors or patients who lack decision-making capacity):
    1. about the purpose of recording, the intended audience(s), and the expected distribution;
    2. about the potential benefits and harms (such as breach of privacy or confidentiality) of participating;
    3. that participation is voluntary and that a decision not to participate (or to withdraw) will not affect the patient’s care;
    4. that the patient may withdraw consent at any time and if so, what will be done with the recording;
    5. that use of the recording will be limited to those involved in health care education, unless the patient specifically permits use by others.
  4. Ensure that the patient has had opportunity to discuss concerns before and after recording.
  5. Obtain consent from a patient (or the authorized decision maker):
    1. prior to recording whenever possible;
    2. before use for educational purposes when consent could not be obtained prior to recording.
  6. Respect the decision of a patient to withdraw consent.
  7. Seek assent from the patient for participation in addition to consent by the patient’s parent or guardian when participation by a minor patient is unavoidable.
  8. Be aware that the act of recording may affect patient behavior during a clinical encounter and thereby affect the film’s educational content and value.
  9. Be aware that the information contained in educational recordings should be held to the same protections as any other record of patient information. Recordings should be securely stored and properly destroyed, in keeping with ethics guidance for managing medical records.
  10. Be aware that recording creates a permanent record of personal patient information and may be considered part of the medical record and subject to laws governing medical records.
AMA Principles of Medical Ethics: I, IV, V, VIII
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Related Opinions

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Opinion 3.1.1

Privacy in Health Care

Respecting patient privacy is a fundamental expression of respect for patient autonomy and a prerequisite for trust. Patient privacy includes personal space (physical privacy), personal data (informational privacy), personal choices, including cultural and religious affiliations (decisional privacy), and personal relationships with family members and other intimates (associational privacy). Physicians must seek to protect patient privacy in all settings to the greatest extent possible.
Opinion 3.1.2

Patient Privacy & Outside Observers to the Clinical Encounter

When individuals who are not involved in providing care seek to observe patient-physician encounters, physicians should safeguard patient privacy by permitting such observers to be present only when the patient has explicitly agreed to the presence of the observer(s), the presence of the observer will not compromise care, and the observer has agreed to adhere to standards of medical privacy and confidentiality.
Opinion 3.1.4

Audio or Visual Recording of Patients for Public Education

Audio or visual recording of patient care for public broadcast is one way to help educate the public. However, physicians have an obligation to protect patient interests and ensure that professional standards are upheld. Physicians also have a responsibility to ensure that information conveyed to the public is complete and accurate.
Opinion 3.2.1

Confidentiality

Physicians have an ethical obligation to preserve the confidentiality of information gathered in association with the care of the patient. With rare exceptions, patients are entitled to decide whether and to whom their personal health information is disclosed.