ETHICS MADE REAL

Gordon Self

February 25, 2013

A number of years ago my wife and I and our youngest daughter went to New York City and visited the Empire State Building. While up on the crowded observation deck with cameras in tow, I noticed a woman who looked very familiar, there with her own young children.

Suddenly, it dawned on me who she was. I had never seen a Hollywood movie star up close, nor one as famous and beautiful as her. It was crowded and I thought how easy it would be to take pictures and surreptitiously film her without her ever knowing.

But I stopped short, for just as my wife, daughter and I were enjoying family time together away from work, I thought she too was entitled to private time with her own family. I felt ashamed for wanting to take her picture just so I could show my trophy photo to others back home. I chalked it up as a life lesson about respecting the privacy and dignity owed to others, no matter how famous they were.

I wish others would return the privilege. While I am certainly no celebrity, there is admittedly something about wearing a kilt in downtown Edmonton on a January night that might turn a few heads.

While I was crossing the street to attend the annual Robbie Burns Dinner in my Scottish clan colours, a group of tourists blocked my path on the road and, without asking permission, rudely took multiple photographs with total disregard for my own safety or theirs from oncoming traffic.

I suppose some might say it was flattering, even amusing, to think later that night my photograph may be posted to someone's Facebook page with blog comments about my knobby knees, but it seems to me that basic human decency around respect and privacy is quickly becoming an anomaly in our world.

So with all this in mind, you can imagine that as more camera phones, nanny-cams, spy watches and other concealed audio and video recording devices start showing up in hospital settings without the expressed consent of the patient, resident or staff member being filmed or recorded, a number of legitimate ethical issues are raised.

As a family member, I too would certainly want to know if my loved one is being treated safely with quality, compassionate care. Use of web technology can certainly help family members stay connected to their loved ones when away from the facility, reassured they are OK.

BABY MONITORS

Many parents have long relied on baby monitors to respond to their child's earliest cries, despite the nursery being located elsewhere in the house. But baby monitors have also been known to pick up signals from neighbours' cordless phones, which could be used illegitimately to listen in on what we shouldn't be listening to.

Readers who grew up with party lines remember the same moral code not to eavesdrop when you picked up the phone and discovered the line was already in use.

In like fashion, care must be ensured that photos or recordings in hospital settings do not inadvertently pick up sights or sounds of other patients whose consent has not been obtained. This is a non-negotiable and fundamental standard that we must uphold.

The new revised Health Ethics Guide provides helpful direction regarding new and emerging ethical issues, but it also has a lot to say about the "basics."

Sadly, in 2013 it appears we still have not as a society mastered the art of privacy and confidentiality, and increasingly new social media forums are pushing the envelope in defining what is of public interest.

RELATIONSHIP OF TRUST

We often talk about the privileged doctor-patient relationship as the basis of trust in the healing encounter. What I disclose to my doctor in confidence must be protected. Other clinicians equally deserve to provide care and service in a trusting environment without fear they are being covertly filmed without their consent.

Hospitals are just beginning to grapple with these exceedingly complex moral and legal issues. Some argue the public has a right to film with concealed cameras to ensure their loved one is being treated well. Others see that as an erosion of the trust relationship in health care.

Perhaps there are other ways in which families can be assured their loved one's care needs are being met and exceeded without introducing other untoward risks. We need to examine our own behaviour to ensure we are doing everything appropriate in providing quality care and service so as not to ever leave a family member in doubt.

(Gordon Self is vice president, mission, ethics and spirituality for Covenant Health and can be reached at mes@covenanthealth.ca.)