Thursday, August 7, 2014

Patient Dignity 14: Video Recording Patients

There has been some ongoing debate about teaching institutions recording patients for "research" or "teaching" purposes. I am not addressing those issues here. What I am going to address is that:


The patient can revoke consent at any time, should be given a copy of the "raw" recording, and must give final approval of the finished product.

On October 28, 2013, Bob Wachter M.D. posted an article on KevinMD titled: "How video can reduce medical errors and improve patient care." The article was originally posted on his web site "Wachter's World" titled "Lights, Camera, Action… In Healthcare" where you could buy his books, book him for a speaking engagement....

He starts out by telling the store of how he improved his golf swing with video recording. He goes on to list the beneficence of video recording. He states:
Yet we hardly ever use this extraordinarily powerful tool in healthcare. Thankfully, that’s beginning to change. Earlier this year, Johns Hopkins surgeon Marty Makary published a JAMA article entitled “The Power of Video Recording.” It’s a thoughtful and eye-opening piece, well worth a read.

It seems that Johns Hopkins is leading the nation in the video recording of their patients. Take another Johns Hopkins advocate of video recording patients: Dr. Nikita Levy.

Dr. Nikita Levy had secretly taken videos and photos of his patients' sex organs. A federal investigation led to discovering roughly 1,200 videos and 140 images stored on computers in his home. 
This is one of the largest on record in the U.S. involving sexual misconduct by a physician, $190 million. It seriously threatened the reputation of one of the world's leading medical centers (that advocates video recording of patients).  
62 girls (children) were among the victims, and that Levy violated hospital protocol by sending chaperones out of the exam room.   
Hopkins sent out letters to Levy's entire patient list last year, apologizing to the women and urging them to seek care with other Hopkins specialists (who also video record patients, maybe?) 
But hundreds were so traumatized that they "dropped out of the medical system," and some even stopped sending their children to doctors, the victims' lead attorney, Jonathan Schochor said.

You can read more about Dr. Levy here:

Update: Auguse 14, 2014

I just came across the following article, "Google Glass Enters the Operating Room" on the New York Times website.

DURHAM, N.C. — Before scrubbing in on a recent Tuesday morning, Dr. Selene Parekh, an orthopedic surgeon here at Duke Medical Center, slipped on a pair of sleek, black glasses — Google Glass, the wearable computer with a built-in camera and monitor. 
He gave the Internet-connected glasses a voice command to start recording and turned to the middle-aged motorcycle crash victim on the operating table. He chiseled through bone, repaired a broken metatarsal and drilled a metal plate into the patient’s foot. 
Dr. Parekh has been using Glass since last year, when Google began selling test versions of its device to thousands of handpicked “explorers” for $1,500. He now uses it to record and archive all of his surgeries at Duke, and soon he will use it to stream live feeds of his operations to hospitals in India as a way to train and educate orthopedic surgeons there. 
“In India, foot and ankle surgery is about 40 years behind where we are in the U.S.,” he said. “So to be able to use Glass to broadcast this and have orthopedic surgeons around the world watch and learn from expert surgeons in the U.S. would be tremendous.” 
At Duke and other hospitals, a growing number of surgeons are using Google Glass to stream their operations online, float medical images in their field of view, and hold video consultations with colleagues as they operate. (Source: NY Times website)

Surgeon tests Google Glass in the operating room

SEATTLE -- When Dr. Heather Evans, a trauma surgeon at Seattle's Harborview Medical Center, stepped into the operating room wearing an eyeglasses-like, Internet-connected device known as Google Glass, she quickly realized its potential and its pitfalls... 
...Like other surgeons, Evans is excited about the potential of this new device. But she also has learned that Glass has technical issues that, for now, make it less than ideal in the operating room, as well as difficult privacy concerns.
Some arise because of complex federal privacy laws, which govern the transmission of patient information, including photographs or videos. Other privacy issues come up just from wearing Glass. 
If she wore Glass down the hospital hallway, Evans said, she could be accused of violating privacy. 
Glass has particularly prickled privacy advocates, even earning its own Urban Dictionary epithet -- "Glasshole" -- for those who flaunt their early access, wear Glass into private spaces such as restrooms or instruct the device -- "OK, Glass, take a video" -- in public.Despite such fears, Evans had some specific tasks for Glass in mind when she applied to be an early explorer. 
To win her spot, she linked to a YouTube video showing an event rarely caught on camera: a man's heart attack and resuscitation. A BBC crew, shooting a documentary on an emergency helicopter service, had just arrived at its office when the dispatcher suddenly slumped. 
The crew kept the cameras rolling as emergency workers gave the man CPR and shocked him with a defibrillator, saving his life. (Source: TH Online)

I can see the advantages that Google Glass to look up something quickly, I can even see the advantages for teaching. Here is the problem:

All information is transferred and stored on Google's servers, if a violation occurs, there no way to delete and guarantee the images/video are deleted.

Don't believe me? Consider Google's own policy on the Glass:

Google accused of hypocrisy over Glass ban at shareholder shindig 
Google's directors were accused of hypocrisy over a regulation banning attendees at its annual shareholder's meeting in California from wearing Google Glass hardware at the event. 
"Cameras, recording devices, and other electronic devices, such as smart phones, will not be permitted at the meeting. Photography is prohibited at the meeting," attendees were told, something that rankled with Consumer Watchdog's privacy policy director and Google shareholder John Simpson. 
"Google Glass is a voyeur's dream come true," Simpson said, citing the need to protect children. "It seems to me to be a little bit hypocritical to actively abet and aid possible privacy violations by so many others outside but so jealously protect your own privacy." (Source: Iain Thomson, The Register)

A Voyeur's Dream Come True

The potential for abuse is staggering and there are very few laws to protect people.

Existing laws need to be rewritten as they are not phrased well enough to deal with these immoral and reprehensible acts. The Massachusetts highest court ruled last week that a man who took cellphone photos up the skirts of women riding the Boston subway did not violate state law because the women were not nude or partially nude. The court ruled that existing Peeping Tom laws protected people from being photographed in dressing rooms and bathrooms when nude or partially nude, but did not protect clothed people in public area. (Source: Lucius on Security)

 Even Nudists Fear Google Glasses
Nudists already know about the way that camera-equipped cell phones have altered the balance of privacy on beaches and in clubs.  While clubs have rules regulating their usage, it’s not always easy to tell the difference between someone holding a normal conversation and one who is trying to invade others’ privacy by taking unwanted pictures.  Imagine if the world becomes heavily populated with people who depend on their Google Glasses for directions and communications.  Now imagine trying to determine whether someone wearing such glasses on a nude beach is simply texting a friend or uploading footage to a You Tube account. (Source: Bare Platypus Blog)

Google glasses prompt personal privacy fears
Nick Pickles, director of privacy campaign group Big Brother Watch, said: “Google Glass doesn’t just challenge our assumptions about consent, it challenges whether we even have a choice any more. 
“It makes it seem perfectly normal to collect data on other people, without ever asking their permission and that is a dangerous step that poses a fundamental threat to our current notion of privacy. 
“People wearing Google Glass don’t own the data, they don’t control the data, and they definitely don’t know what happens to the data.
“This is turning members of the public into a Google army, collecting data for the sole benefit of selling advertising and boosting Google’s profits.” (Source: Irish Examiner)

Video Voyeurism is a Crime in Some Places Already

Before his original March 11 sentencing on five counts of video voyeurism, Hughes, 28, apologized for sneaking around with his smartphone and recording about 30 videos in the women's bathrooms at Patch Reef and Red Reef parks. 
In his April 30 motion for a reduced sentence, the attorney asked Burton to consider that another judge on April 3 imposed only a one-year jail sentence and five years probation on former Florida Atlantic University librarian Seth Thompson, 40, of Lake Worth. 
Thompson secretly filmed men while they urinated in campus bathrooms and then uploaded videos onto pornographic websites, according to court records. (Source: Sun Sentinel)

Patients expect more privacy in a hospital/doctor's office than in a public restroom. What else can I say???

--A. Banterings


  1. I imagine if one of these perverts.... uh... "doctors".... who are in favor of recording without patient knowledge or consent under the guise of "research of education" were to stumble upon a hidden camera in the doctors locker room / shower area they'd change their tune mighty quickly.

    Jason K

  2. Let's not forget all the illegal cell phone pics by female nurses, ma's and cna's
    posting to their stupid Facebook accounts.


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