Back to Chapter 3 Privacy, Confidentiality & Medical Records
Opinion 3.1.4

Audio or Visual Recording of Patients for Public Education

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Audio and/or visual recording of patient care for public broadcast is one way to help educate the public about health care. However, no matter what medium is used, such recording poses challenges for protecting patient autonomy, privacy, and confidentiality. Filming cannot benefit a patient medically and may cause harm. As advocates for their patients, 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 (including the risks, benefits, and alternatives of treatments).

Physicians involved in recording patients for public broadcast should:

  1. Participate in institutional review of requests to record patient interactions.
  2. Require that persons present for recording purposes who are not members of the health care team:
    1. minimize third-party exposure to the patient’s care;
    2. adhere to medical standards of privacy and confidentiality.
  3. Encourage recording personnel to engage medical specialty societies or other sources of independent expert review in assessing the accuracy of the product.
  4. Refuse to participate in programs that foster misperceptions or are otherwise misleading.
  5. 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.
  6. Inform a patient (or authorized decision maker) who is to be recorded:
    1. about the purpose for which patient encounters with physicians or other health care professionals will be recorded;
    2. about the intended audience(s);
    3. that the patient may withdraw consent at any time prior to recording and up to an agreed on time before the completed recording is publicly broadcast, and if so, what will be done with the recording;
    4. that at any time the patient has the right to have recording stopped and recording personnel removed from the area;
    5. whether the patient will be allowed to review the recording before broadcast and the degree to which the patient may edit the final product;
    6. whether the physician was compensated for his participation and the terms of that compensation.
  7. Ensure that the patient has had the opportunity to address concerns before and after recording.
  8. Ensure that the patient’s consent is obtained by a disinterested third party not involved with the production team to avoid potential conflict of interest.
  9. Request that recording be stopped and recording personnel removed if the physician (or other person involved in the patient’s care) perceives that recording may jeopardize patient care.
  10. Ensure that the care they provide and the advice they give to patients regarding participation in recording is not influenced by potential financial gain or promotional benefit to themselves, their patients, or the health care institution.
  11. Remind patients and colleagues that recording creates a permanent record and may in some instances be considered part of the medical record.
AMA Principles of Medical Ethics: I, IV, VII, VIII
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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 3.1.3

Audio or Visual Recording Patients for Education in Health Care

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. 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.