COMMENTARY

Hospital Security Cameras: Too Much Invasion of Privacy?

Arthur L. Caplan, PhD

Disclosures

March 24, 2014

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Hi. I am Art Caplan, at the Division of Medical Ethics at the New York University Langone Medical Center in New York City.

How would you feel if you were a patient and found out that, in your room, or in the waiting room, or in the emergency room there was a camera and it was watching you without your knowledge?

More and more in our hospitals, and even in some private practices, people are putting up cameras to conduct surveillance of what is taking place in a healthcare setting. There are lots of reasons for doing this. Sometimes you want a camera in a room to see if a patient wanders. In nursing homes and hospitals, wandering is a huge problem. We cannot have nurses be with a patient every second, but if you have a camera and are monitoring it, you can see that a particular woman is not in her bed anymore. Where is she? She is not where she is supposed to be. That protects patient safety.

Sometimes someone comes to the emergency room who has been the victim of gang violence, for example, and you may be worried that the culprit will try to come in and finish off this person who they did not succeed in killing as part of a gang war. Surveillance might help keep an eye on who is coming in and out of that emergency room, and get security there quickly if someone tries to extend criminal activity inside the hospital.

Perhaps you are concerned that someone is stealing drugs from the pharmacy. If you place a camera there, you can see what is going on. Certainly, plenty of surgeons and interventionists love to videotape what they are doing so that if someone says the physician did not do it right, or sues for malpractice, he or she can produce the tape and say, "We did absolutely what was indicated in this procedure." There are good reasons to have those cameras running.

Consent or Notification?

On the other hand, patients may be thinking, "I did not consent to this. You are violating my privacy. I do not want you to tape me and I do not agree to this kind of constant surveillance."

I have to say, I believe that our older patients, and perhaps older doctors, are more worried about this than the younger ones. In the age of social media -- Facebook, Twitter, and other social outlets -- people's views of privacy are shifting rapidly and are moving toward the view of "I do not have privacy; I do not expect it." If you walk down a city street in New York, London, or other big cities around the world, cameras are all over the place. They are watching how fast you are driving your car. They are keeping an eye out for terrorists on street corners. More and more, people are getting used to the idea that, like it or not, they are constantly under surveillance. So it may be that the older generation is worried about privacy but the younger generation less so.

In my own view, there is a simple solution to this: Tell people up front when they enter the hospital that there are cameras there. "You may be filmed by them. We do not know whether you will be in an area of the facility, clinic, or nursing home where the cameras may be, but they could be there." That is a condition of life in today's modern hospital. Primarily it is for safety and that is what we are doing. I do not believe you need consent, but I do believe you need notification.

I am Art Caplan, from the Division of Medical Ethics at the NYU Langone Medical Center. Thanks very much for watching.

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