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医疗机构中对患者进行视频录制的伦理审议——范围综述。

Ethical deliberations on video recording of patients in healthcare facilities- a scoping review.

机构信息

Universiti Sains Islam Malaysia, Faculty of Medicine and Health Sciences, Nilai, Negeri Sembilan, Malaysia.

Universiti Teknologi MARA Malaysia, Department of Medical Ethics and Law, Sungai Buloh, Selangor, Malaysia.

出版信息

Med J Malaysia. 2024 Nov;79(6):785-793.

Abstract

INTRODUCTION

The modern healthcare landscape with the emergence of video recording, has found applications in research, training, audit, quality improvement, and safety surveillance. Notably, advancements in camera technology have led to the development of smaller, lighter devices, enabling discreet usage and enhancing usability in clinical settings. Its adoption represents more than technological advancement; it entails a complex balance between improving patient care and respecting individual rights. Ethical considerations surrounding patient privacy, ownership of recordings, patient autonomy and healthcare provider responsibilities have garnered significant attention. In Malaysia, the adoption of video recordings in clinical interactions and consultations has been accepted in research, training and several medical fields. However, recording patients during clinical practice can be challenging, as there are scarce ethical guidelines for its practice. This review aims to gather and categorise the ethical challenges associated with recording videos of patients in healthcare facilities globally and identify research gaps specific to Malaysian healthcare settings. By addressing the ethical challenges globally, we can ensure the responsible and ethical use of video recording technology to enhance patient care while respecting individual rights.

MATERIALS AND METHODS

Articles from Scopus, Web of Science and PubMed databases were collected following PRISMA guidelines. Key term searches included "video recording," "ethical issues," and "patients." Inclusion criteria encompassed video and audio recording interactions between healthcare providers and patients in any clinical setting, final publications, and the English language. Exclusions were imaging or photography recording and non-clinical settings. The qualitative synthesis involved iterative reading, thematic coding analysis in Excel, and specific analysis to address the research question.

RESULTS

Initial database search, identified 363 records. After screening, a total of 22 articles were included for analysis. Five themes were identified from the selected articles: i) privacy and confidentiality, ii) informed consent, iii) beneficence and non-maleficence, iv) integrity and professionalism and v) governance, policy and legal framework. Majority of the reviewed articles concentrate on backgrounds within the fields of psychiatry, neurology and surgical-based medical specialities. The identified themes have demonstrated consistency across the majority of the articles analysed. Among the most frequently discussed themes, it's evident that ethical concerns extend beyond just the patient's realm to encompass the responsibilities of the healthcare provider (HCP) as well. Both patients and HCPs have their respective rights and responsibilities in ensuring the ethical use of video recording in clinical settings.

CONCLUSION

In conclusion, this review has highlighted the multifaceted ethical challenges surrounding the integration of video recording in healthcare settings. While video recording offers benefits for patient care, education, and quality improvement, its adoption presents complexities. Ethical dilemmas concerning patient privacy, consent, and data management must be addressed alongside practical barriers like technological limitations and resource constraints. Collaboration among healthcare providers, policymakers, and stakeholders is crucial to navigating these challenges ethically. Future research should delve into patient perspectives, develop ethical guidelines, and assess the impact of video recording on patient outcomes. By understanding these implications, healthcare can effectively leverage video recording to improve patient care while maintaining ethical standards.

摘要

简介

随着视频录制技术的出现,现代医疗保健领域在研究、培训、审核、质量改进和安全监测方面得到了广泛应用。特别是,摄像技术的进步使得更小、更轻的设备得以开发,这使得这些设备在临床环境中能够更隐蔽地使用,并提高了可用性。视频录制技术的采用不仅代表着技术的进步,还需要在改善患者护理和尊重个人权利之间取得复杂的平衡。围绕患者隐私、记录所有权、患者自主权和医疗保健提供者责任的伦理问题引起了广泛关注。在马来西亚,视频录制技术已在研究、培训和多个医学领域的临床交流和咨询中得到接受。然而,在临床实践中记录患者可能具有挑战性,因为针对其使用的伦理准则相对较少。本综述旨在收集和分类全球范围内与医疗保健设施中患者视频录制相关的伦理挑战,并确定马来西亚医疗保健环境中特有的研究空白。通过解决全球范围内的伦理挑战,我们可以确保负责任和合乎伦理地使用视频录制技术,以提高患者护理水平,同时尊重个人权利。

材料和方法

根据 PRISMA 指南,从 Scopus、Web of Science 和 PubMed 数据库中收集了文章。关键词搜索包括“视频录制”、“伦理问题”和“患者”。纳入标准包括医疗保健提供者与患者在任何临床环境中进行的视频和音频记录交互、最终出版物和英语语言。排除标准为影像学或摄影记录和非临床环境。定性综合涉及迭代阅读、在 Excel 中进行主题编码分析以及专门分析以解决研究问题。

结果

最初的数据库搜索确定了 363 条记录。经过筛选,共有 22 篇文章被纳入分析。从选定的文章中确定了五个主题:i)隐私和保密性,ii)知情同意,iii)善行和不伤害,iv)完整性和专业性,以及 v)治理、政策和法律框架。大多数综述文章主要集中在精神病学、神经病学和以手术为基础的医学专业领域的背景下。分析的文章中确定的主题在很大程度上是一致的。在讨论最多的主题中,显然伦理问题不仅涉及患者领域,还涉及医疗保健提供者(HCP)的责任。患者和 HCP 都有各自的权利和责任,以确保在临床环境中合理使用视频录制。

结论

总之,本综述强调了视频录制在医疗保健环境中的应用所带来的多方面伦理挑战。虽然视频录制在患者护理、教育和质量改进方面具有优势,但它的采用带来了复杂性。必须解决涉及患者隐私、同意和数据管理的伦理难题,同时还需应对技术限制和资源约束等实际障碍。医疗保健提供者、政策制定者和利益相关者之间的合作对于以合乎道德的方式应对这些挑战至关重要。未来的研究应该深入探讨患者的观点,制定伦理准则,并评估视频录制对患者结局的影响。通过了解这些影响,医疗保健可以有效地利用视频录制来改善患者护理,同时保持伦理标准。

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