Gabrielli Mauricio, Valera Luca, Barrientos Marcelo
Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile.
Department of Philosophy, Bioethics Centre, Pontificia Universidad Católica de Chile, Santiago, Chile
J Med Ethics. 2020 Apr 2. doi: 10.1136/medethics-2019-106056.
The idea of video recording (VR) in the operating room (OR) with panoramic cameras and microphones is a new concept that is changing the approach to medical activities in the OR. However, VR in the OR has brought up many concerns regarding patient privacy and has highlighted legal and ethical issues that were never previously exposed.
To review the literature concerning these aspects and provide a better ethical and legal understanding of the new challenges concerning VR in the OR.
There is a disparity between the two main legal models concerning VR in the OR, namely the European legal system (General Data Protection Regulation (GDPR)) and the American legal framework (Health Insurance Portability and Accountability Act (HIPAA)). This difference mainly deals with two distinct bioethical paradigms: GDPR places a strong emphasis on protecting patients' privacy to improve the public health system, whereas HIPAA indicates the need to generate protocols to safeguard the risks connected to medical activity and patient privacy. Following from this point, we may argue that, at the ethical and bioethical level, GDPR and HIPAA depend mainly on two different ethical models: a perspective based on moral acquaintances and weak proceduralism, respectively. It is worth noting the importance of developing additional guidelines concerning different world regions to avoid the ethical problems that may emerge when simply applying a foreign paradigm to a very different culture.
使用全景摄像头和麦克风在手术室（OR）进行视频录制（VR）的想法是一个新概念，正在改变手术室中医疗活动的方式。然而，手术室中的VR引发了许多关于患者隐私的担忧，并凸显了以前从未暴露过的法律和伦理问题。
回顾有关这些方面的文献，并对手术室中VR带来的新挑战提供更好的伦理和法律理解。
关于手术室中VR的两种主要法律模式之间存在差异，即欧洲法律体系（《通用数据保护条例》（GDPR））和美国法律框架（《健康保险流通与责任法案》（HIPAA））。这种差异主要涉及两种不同的生物伦理范式：GDPR强烈强调保护患者隐私以改善公共卫生系统，而HIPAA则表明需要制定协议以防范与医疗活动和患者隐私相关的风险。基于这一点，我们可以认为，在伦理和生物伦理层面，GDPR和HIPAA主要依赖于两种不同的伦理模式：分别基于道德熟人关系和弱程序主义的视角。值得注意的是，制定有关不同世界地区的额外指南非常重要，以避免在将外国范式简单应用于截然不同的文化时可能出现的伦理问题。
