医疗机构中病人录像的伦理审议——范围审查。

Q3 Medicine
Medical Journal of Malaysia Pub Date : 2024-11-01
H Zainal Abidin, H Y H Razali
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引用次数: 0

摘要

简介:随着视频记录的出现,现代医疗保健领域已经在研究、培训、审计、质量改进和安全监控中找到了应用。值得注意的是,相机技术的进步导致了更小,更轻的设备的发展,使谨慎的使用和提高临床设置的可用性。它的采用代表的不仅仅是技术进步;它需要在改善病人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考虑引起了极大的关注。在马来西亚,研究、培训和若干医疗领域已接受在临床互动和咨询中采用录像。然而,在临床实践中记录患者可能具有挑战性,因为其实践缺乏伦理指南。本综述旨在收集和分类与全球医疗机构中患者录制视频相关的伦理挑战,并确定马来西亚医疗机构的具体研究差距。通过应对全球的道德挑战,我们可以确保在尊重个人权利的同时,以负责任和道德的方式使用视频记录技术,以加强患者护理。材料和方法:按照PRISMA指南从Scopus、Web of Science和PubMed数据库中收集文章。关键词搜索包括“录像”、“道德问题”和“病人”。纳入标准包括任何临床环境中医疗保健提供者和患者之间的视频和音频记录互动、最终出版物和英语语言。排除影像或摄影记录和非临床设置。定性综合包括迭代阅读、Excel专题编码分析和针对研究问题的具体分析。结果:初始数据库搜索,识别出363条记录。经筛选,共纳入22篇文章进行分析。从选定的文章中确定了五个主题:i)隐私和保密,ii)知情同意,iii)慈善和非恶意,iv)诚信和专业以及v)治理,政策和法律框架。大多数被审查的文章集中在精神病学、神经病学和外科医学专业领域的背景。所确定的主题在分析的大多数文章中都表现出一致性。在讨论最频繁的主题中,很明显,道德问题超出了患者的范畴,也包括了医疗保健提供者(HCP)的责任。在确保在临床环境中合乎道德地使用视频记录方面,患者和医务人员都有各自的权利和责任。结论:总之,这篇综述强调了围绕在医疗环境中整合视频记录的多方面的伦理挑战。虽然视频录制为患者护理、教育和质量改进提供了好处,但它的采用呈现出复杂性。关于患者隐私、同意和数据管理的伦理困境必须与技术限制和资源约束等实际障碍一起解决。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从道德上应对这些挑战至关重要。未来的研究应该深入研究患者的观点,制定伦理准则,并评估视频记录对患者预后的影响。通过了解这些含义,医疗保健可以有效地利用视频记录来改善患者护理,同时保持道德标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ethical deliberations on video recording of patients in healthcare facilities- a scoping review.

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.

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来源期刊
Medical Journal of Malaysia
Medical Journal of Malaysia Medicine-Medicine (all)
CiteScore
1.20
自引率
0.00%
发文量
165
期刊介绍: Published since 1890 this journal originated as the Journal of the Straits Medical Association. With the formation of the Malaysian Medical Association (MMA), the Journal became the official organ, supervised by an editorial board. Some of the early Hon. Editors were Mr. H.M. McGladdery (1960 - 1964), Dr. A.A. Sandosham (1965 - 1977), Prof. Paul C.Y. Chen (1977 - 1987). It is a scientific journal, published quarterly and can be found in medical libraries in many parts of the world. The Journal also enjoys the status of being listed in the Index Medicus, the internationally accepted reference index of medical journals. The editorial columns often reflect the Association''s views and attitudes towards medical problems in the country. The MJM aims to be a peer reviewed scientific journal of the highest quality. We want to ensure that whatever data is published is true and any opinion expressed important to medical science. We believe being Malaysian is our unique niche; our priority will be for scientific knowledge about diseases found in Malaysia and for the practice of medicine in Malaysia. The MJM will archive knowledge about the changing pattern of human diseases and our endeavours to overcome them. It will also document how medicine develops as a profession in the nation. We will communicate and co-operate with other scientific journals in Malaysia. We seek articles that are of educational value to doctors. We will consider all unsolicited articles submitted to the journal and will commission distinguished Malaysians to write relevant review articles. We want to help doctors make better decisions and be good at judging the value of scientific data. We want to help doctors write better, to be articulate and precise.
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