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Ethical and Practical Issues in Video Surveillance of Psychiatric Units


Appenzeller, Yahel E; Appelbaum, Paul S; Trachsel, Manuel (2020). Ethical and Practical Issues in Video Surveillance of Psychiatric Units. Psychiatric Services, 71(5):480-486.

Abstract

Objectives:
Video surveillance is used in inpatient psychiatry in many countries and institutions. However, its use varies considerably because of a lack of research, discussion, and agreement on best practice. This review provides an overview of current issues in the use of video surveillance in psychiatry, with a focus on ethical questions and their practical implications.
Methods:
A narrative review of literature on video surveillance in psychiatry was conducted. References were identified through searches of PubMed, CINAHL, MEDLINE, PsycINFO, and Google Scholar for articles published before December 2018. Sixteen articles in English and German were reviewed.
Results:
The ethical challenges and practical implications differ between surveillance of public spaces versus private areas, such as bedrooms or seclusion rooms. The most common reason for video surveillance was to increase security and safety. However, empirical evidence suggests that it is not useful in increasing security of shared spaces on psychiatric wards. Some evidence exists for clinical benefits of video surveillance in private spaces (e.g., allowing patients to sleep undisturbed). Video surveillance can increase patients’ choices regarding monitoring options. The main ethical conflict lies in balancing patients’ autonomy and privacy versus patient and staff security and safety.
Conclusions:
Whether video monitoring is used in the most effective and ethical manner needs to be reconsidered. Available evidence does not support its use as a security measure. More research is needed to evaluate the benefits, risks, and best practices of using video monitoring for patient observation, with consideration given to increasing the role of patient consent.

Abstract

Objectives:
Video surveillance is used in inpatient psychiatry in many countries and institutions. However, its use varies considerably because of a lack of research, discussion, and agreement on best practice. This review provides an overview of current issues in the use of video surveillance in psychiatry, with a focus on ethical questions and their practical implications.
Methods:
A narrative review of literature on video surveillance in psychiatry was conducted. References were identified through searches of PubMed, CINAHL, MEDLINE, PsycINFO, and Google Scholar for articles published before December 2018. Sixteen articles in English and German were reviewed.
Results:
The ethical challenges and practical implications differ between surveillance of public spaces versus private areas, such as bedrooms or seclusion rooms. The most common reason for video surveillance was to increase security and safety. However, empirical evidence suggests that it is not useful in increasing security of shared spaces on psychiatric wards. Some evidence exists for clinical benefits of video surveillance in private spaces (e.g., allowing patients to sleep undisturbed). Video surveillance can increase patients’ choices regarding monitoring options. The main ethical conflict lies in balancing patients’ autonomy and privacy versus patient and staff security and safety.
Conclusions:
Whether video monitoring is used in the most effective and ethical manner needs to be reconsidered. Available evidence does not support its use as a security measure. More research is needed to evaluate the benefits, risks, and best practices of using video monitoring for patient observation, with consideration given to increasing the role of patient consent.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Biomedical Ethics and History of Medicine
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Psychiatry and Mental health
Language:English
Date:1 May 2020
Deposited On:16 Jan 2020 08:31
Last Modified:29 Jul 2020 12:39
Publisher:American Psychiatric Publishing, Inc.
ISSN:1075-2730
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1176/appi.ps.201900397
PubMed ID:31847737

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Content: Accepted Version
Filetype: PDF - Registered users only until 18 December 2020
Size: 217kB
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Embargo till: 2020-12-18