The Ethics of Hospital Surveillance Cameras

By Carlton Purvis, Published Apr 04, 2014, 12:00am EDT

We recently examined a case where a hospital came under fire for placing a hidden camera in a patient’s room. We talked to NYU’s Division of Medical Ethics Director Arthur Caplan on the ethics of using cameras in hospital settings.

Why More Hospitals are Adding Cameras

The main reason is because hospitals are trying to protect themselves from litigation, Caplan says.

“They are recording patient care so they can show they did everything right,” he said. Secondary to that, he says cameras are used for general security from outsiders (people who aren’t supposed to be there) and insiders (people stealing drugs or contraband).

He also says patients wandering is a “huge problem” and cameras have been installed to keep track of where people wander off to.

Notification Required, Consent is Not

Caplan says in a hospital setting, people should always be aware of they are being watched or not.

“If you don’t put up signs saying there are cameras and if you don’t notify people then that’s unethical and you’re crossing a line,” he said. Caplan believes that people have an expectation of privacy in a hospital setting.

The cameras can be covert or overt, but the important thing is that people know they are there.

“It’s important to notify people because people may engage in intimate acts, including sex in the hospital and they don’t realize someone is watching. A lot of things happening in a hospital is private an personal. Behaviors, diseases, bathing. You need to say if you’re watching,” he said.

But that extends beyond just private actions. Information recorded on video can also be protected by HIPAA if it deals with treatments, medications and care received in a hospital.

Hospitals do not have to get consent from the patient, however he said.

Differences in Cameras for Security vs. Patient Care

The differences are location and monitoring. Cameras in hallways and common areas are generally used for security while cameras in rooms and clinical areas are used for patient care.

Those cameras in hallways and common areas are generally linked to a central monitoring area like the security department and are monitored live and recorded. Cameras in patient rooms and clinical areas will sometimes have monitors on that floor, but generally don’t. Footage is recorded and stored for 60 days.

Doctor’s Offices

Caplan said most hospitals are adding cameras these days, however, he’s not sure how far the use of surveillance extends to private doctor’s offices.

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