patient videos

[J.R.theR.N2b]

i was reading some of the remarks from 2010 post concerning patient modesty in conjunction with surgical procedure. one poster stated that, in her hospital, they tape their trauma surgeries, and instruct all involved staff to keep quiet about this. this is so extremely difficult to believe. with the emergency and most usually life and death issues dealt with here makes it even harder to believe. adding insult to this privacy invasion was the effort made to cover this up and to keep it secret. so please comment on this and offer sound medical reasons for this policy, if it indeed does happen.

[Morainey, BSN, RN]

The only time I've seen photos or videos from a medical procedure, and I mean in the storage format (DVD or printed images), they were in the patient's chart. They were imprinted with the patient's name and MR number. They were usually associated with a procedure in which there is a reasonable expectations that they will take video or stills - joint arthroscopy, endoscopy, colonoscopy, etc. In each case the MD may or may not decide to share these with the patient. They are part of the medical record and are in the chart, upon the patient's discharge they go to medical records. Are you concerned that these are ending up on YouTube or something?

[J.R.theR.N2b]

i have no fear of these procedure videos ending up on you tube. i do strongly feel, however, that such videotaping and photography are very serious privacy issues for the patient, and as such, patients should be informed face to face by the surgeon as part of the informed consent process. this is far too serious an issue to expect the patient to comb through the fine print of the initial consent to treat form to discover the possibility that they and their procedure may be videotaped. somehow one gets the feeling that the medical staff and the hospital feel that most patients would object and refuse consent if told in the upfront manner they should. i guess it meets all the legal requirements to handle it in this way but it still seems they would much rather the patients never to become aware of this. i have no fear of these tapes ending up on you tube or otherwise used in any form not in the best interests of the patient, and would readily consent if informed face to face by the surgeon, but would refuse if, discovered this by reading the fine print of the initial consent form. this is far too serious an issue to not inform the patient up front, espescially when the surgeon pretty well knows that the procedure the patient is having is one in which videotaping and still photography is likely. if the patient requested a copy of his medical records after such a procedure, would these videos and stills be made available to them?

[SaoirseRN]

since my last comments i have done more research on the internet dealing with patient consent issues on videotaping of patient procedures. i feel that relegating this as an aside on the consent form signed at admittance is insufficient. what if the patient is unable to read or to adequately comprehend the form? what if the patient is experiencing too much pain to be concerned with the contents of the form? most patients would never have dreamed that a hospital might videotape their medical procedure. this is a very serious patient privacy issue with many potentially dangerous consequences, and patients should be FULLY informed of the possibility of being videotaped and FULLY informed that can refuse this, and that their care will not be affected in any way by such refusal. these issues and their possible consequences are way too serious to expect a patient to pull this possibility from an aside on a very broad consent form, and in my opinion, considering this as INFORMED CONSENT is ludicrous, even if it may be legal. has anyone posting on these forums been involved in or been privy to any discussions of what medical staff feel would be the most likely response of a patient if they were indeed told face to face of this possible videotaping? one final question to anyone who has actually seen one of these videos, are any facial or otherwise identifying features clearly visible? i realize that what i have written here will probably be polar opposites of the opinions held by the majority of posters here, and humbly apologize in advance if they offend some of you, for that was certainly not my intent. thank you very much.[/quote']

If the patient is unable to read, he will have to have the form read to him before signing, and will find out that way. If a patient is impaired or incompetent, but requires a procedure, a substitute decision maker would have to sign, and therefore read the consent, on their behalf. If a person choses NOT to fully read the consent form before signing, that is their choice as adults.

[J.R.theR.N2b]

i guess what i am really asking is why the patients are not informed of the videotaping possibility by the surgeon when he/she obtains informed consent for the patient's original procedure? do you not feel privacy issues are important enough for patients that they should not have to comb through the entire consent form to discover the possibility that their medical procedure might be videotaped?

[Morainey, BSN, RN]

Yes, in fact, I have gone into patient's rooms and in some cases they have prints from their procedure. They are usually the one who shows it to me, actually - "look at the tear in my knee!" It's really not a big deal. Any patient can request a copy of their medical records. What specific part of this concerns you? Are you concerned that the patient is not being treated with dignity and respect?

[canoehead, BSN, RN]

If the patient is stable they have a responsibility to go through the entire consent form. There's not just photography/video permission in those forms. They talk about who they can share information with, how long the permission lasts, that volunteers and students may be part of the patient's care, and that a student may do procedures under supervision. That translates to someone who may never have done surgery before might do all or part of yours, with supervision. So read the papers, or get someone you trust to do it.

I think this thread deals mostly with taping trauma situations. There's no way in hell's high water that you can get a coherent informed consent from a multi trauma victim. On the other hand the sicker they are, the more we want to tape the trauma and learn from it. It's a HUGE benefit to patients to have dozens of traumas to watch and dissect before a practitioner actually goes into the trauma room and tries to make sense of it. So the benefits arguably outweigh the negatives. The hospital would have to review the policy before it's put into effect. That would mean a committee meeting or three, and possibly review by the ethics committee, and the hospital lawyers. The patient might not be consulted at all. Does anyone work in a hospital that does this? Do they tell the patient or give them the option to opt oput after the fact?

[Poochiewoochie]

sweet_wild_rose------thank you for your answer. i feel that by intending to videotape a patient's procedure without directly informing him is somehow an invasion of his privacy. it seems the physician is attempting to circumvent the consent process hoping the patient will not read the entire form. does the hospital feel this is right? the feeling must be that the hospital feels most patients would object if asked beforehand. i myself would consent to my procedure being taped as long as i was asked prior to the taping. i would, however, feel very hurt and angry if they tried to slip it past me, and would never, ever, use the services of that hospital or surgeon again.

I just want to day that at the hospital where I have had my surgeries since 2010 the consent says that the surgery may be videotaped at the discretion of the physician for diagnosis/treatment of the condition and that a separate consent must be used for photographing/videotaping for educational purposes.

The bottom line is that you are in control. It's important to read EVERYTHING on that consent form and if you don't it's your own fault for them doing something you didn't want. Just don't glance over it and sign it. I highly doubt the surgeon is trying to circumvent the consent process if everything is written down on it and you fail to read it all even if the surgeon goes over it with you.

[Poochiewoochie]

i guess what i am really asking is why the patients are not informed of the videotaping possibility by the surgeon when he/she obtains informed consent for the patient's original procedure? do you not feel privacy issues are important enough for patients that they should not have to comb through the entire consent form to discover the possibility that their medical procedure might be videotaped?

Like I said, it's your responsibility to "comb" through the entire consent form before you sign it if. I really don't know what the big deal is to reading it-the one at my hospital is two pages.

[Poochiewoochie]

The only time I've seen photos or videos from a medical procedure, and I mean in the storage format (DVD or printed images), they were in the patient's chart. They were imprinted with the patient's name and MR number. They were usually associated with a procedure in which there is a reasonable expectations that they will take video or stills - joint arthroscopy, endoscopy, colonoscopy, etc. In each case the MD may or may not decide to share these with the patient. They are part of the medical record and are in the chart, upon the patient's discharge they go to medical records. Are you concerned that these are ending up on YouTube or something?

Methinks it is someone who might be looking to see if they have a lawsuit against the hospital because they found out they were videotaped yet signed a consent that had it on it and now claims ignorance of it because "why should the person have to comb through the whole consent before signing it?".

[Morainey, BSN, RN]

Maybe the OP is concerned their MD is like, showing their colonoscopy video to all their friends or something. And it shows... their... face too?

[J.R.theR.N2b]

my one and only hospitalization was in february of 1995. i was admitted for a cardiac catheterization and was told i would stay overnight and be discharged the next day. after arriving at the appointed time of six am i was prepped and awaiting the procedure by seven am. a patient of the cardiologist scheduled to do the caths that day had a patient have a heart attack earlier that morning, and it was after three in the afternoon before they could take me back for the procedure. i was asked if i wished to reschedule but since i was already registered and my iv was already in i decided to wait. the doc discovered blockages in three coronary arteries, and decided not to attempt angioplasty. my physician left for the night without informing me of what he had found. i was okay with this since i was told i would be spending the night afterward. later that night two nurses came to my room with orders i was to be transferred to the open heart unit. now i was scared, so scared that i refused to cooperate or go anywhere until i was informed just what was happening. my cardiologist was summoned back to the hospital, and after informing me of the blockages, bypass surgery was recommended, and i signed the consent without even looking through it. so on the present. for weeping angel i have absolutely no concern that patients are not being treated with dignity and respect, and for poochiewoochie, i have no interest in suing anyone. i would just like some good and solid reasons why the surgeon cannot inform the patient of the possibility that their procedure may be videotaped when they obtain the original informed consent form? i have nothing against procedures being taped, have no worries that patients would not be treated with dignity and respect, even though i might discover a procedure of mine were taped without my knowledge due to my failure to fully read entire consent form, i would still not sue anyone. i was unaware that procedure and surgical consent forms were only two or so pages in length, so there isn't any real reason not to read the entire thing,

[J.R.theR.N2b]

i wanted to comment on the last remarks from weepingangel about me thinking the MD is showing my colonoscopy video to all his friends...... your attempt at humor was in very poor taste and was not appreaciated. i have never made any comments attempting to ridicule anyone in these forums and would appreaciate you doing the same. patient privacy is very dear to me and my posts here have all been attempts at gauranteeing they will always remain so. you asked in a previous post if i had any concerns about patients not being treated with dignity and respect, and from your last remark, maybe i should.