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Ethical and Legal Considerations for Recording in the Operating Room: A Systematic Review

INTRODUCTION

The integration of high-resolution video into surgical practice has fostered widespread interest in capturing surgical video recordings for the purposes of patient care, medical training, quality improvement, and documentation. The capture, analysis, and storing of such recordings inherently impact operating room (OR) activities and introduce potential harms to patients as well as members of the surgical team, which can be analyzed from both ethical and legal perspectives.

METHODS

Following Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines, a systematic literature search of PubMed was conducted. The citations of included articles were then reviewed to find any articles not captured by our initial search.

RESULTS

62 Articles were included in the review (52 from PubMed search and 10 from citation review). Prevalent key issues in the literature at present include privacy, consent, ownership, legal use and discoverability, editing, data security, and recording's impact on the surgical team.

CONCLUSIONS

This review aims to spark proactive discussions of the ethical and legal implications of recording in the OR, which will guide transformation as the medical field adapts to new and innovative technologies without compromising its ideals or patient care.

Legal perspectives on black box recording devices in the operating environment

Background

A video and medical data recorder in the operating theatre is possible, but concerns over privacy, data use and litigation have limited widespread implementation. The literature on legal considerations and challenges to overcome, and guidelines related to use of data recording in the surgical environment, are presented in this narrative review.

Methods

A review of PubMed and Embase databases and Cochrane Library was undertaken. International jurisprudence on the topic was searched. Practice recommendations and legal perspectives were acquired based on experience with implementation and use of a video and medical data recorder in the operating theatre.

Results

After removing duplicates, 116 citations were retrieved and abstracts screened; 31 articles were assessed for eligibility and 20 papers were finally included. According to the European General Data Protection Regulation and US Health Insurance Portability and Accountability Act, researchers are required to make sure that personal data collected from patients and healthcare professionals are used fairly and lawfully, for limited and specifically stated purposes, in an adequate and relevant manner, kept safe and secure, and stored for no longer than is absolutely necessary. Data collected for the sole purpose of healthcare quality improvement are not required to be added to the patient's medical record.

Conclusion

Transparency on the use and purpose of recorded data should be ensured to both staff and patients. The recorded video data do not need to be used as evidence in court if patient medical records are well maintained. Clear legislation on data responsibility is needed to use the medical recorder optimally for quality improvement initiatives.