TY - JOUR
T1 - Ethical perspectives on surgical video recording for patients, surgeons and society
T2 - systematic review
AU - Walsh, Ross
AU - Kearns, Emma C.
AU - Moynihan, Alice
AU - Gerke, Sara
AU - Duffourc, Mindy
AU - Corrales Compagnucci, Marcelo
AU - Minssen, Timo
AU - Cahill, Ronan A.
N1 - R.A.C. reports speaker fees from Stryker, Olympus, and Ethicon Johnson and Johnson, and consultancy fees from Arthrex, Diagnostic Green, and Distalmotion. The authors declare no other conflict of interest. S.G. also reports grants from the European Union (Grant Agreement no. 101057099), the National Institute of Biomedical Imaging and Bioengineering (NIBIB) of the National Institutes of Health (Grant Agreement no. 3R01EB027650-03S1), and the Rock Ethics Institute at Penn State University. T.M. also reports funding from the Novo Nordisk Foundation for a scientifically independent Collaborative Research Programme in Biomedical Innovation Law (Grant Agreement no. NNF17SA0027784). R.A.C. also reports research funding from Intuitive Corp and from the Irish Government (with IBM Research and Deciphex) and EU Horizon (with Palliare).
This work was funded in part by the European Union (Grant Agreement no. 101057321). Views and opinions expressed are, however, those of the authors only and do not necessarily reflect those of the European Union or the Health and Digital Executive Agency. Neither the European Union nor the granting authority can be held responsible for them. Acknowledgements
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Background: Operating-room audiovisual recording is increasingly proposed, although its ethical implications need elucidation. The aim of this systematic review was to examine the published literature on ethical aspects regarding operating-room recording. Methods: MEDLINE (via PubMed), Embase, and Cochrane databases were systematically searched for articles describing ethical aspects regarding surgical (both intracorporeal and operating room) recording from database inception to the present (the last search was undertaken in July 2022). Medical subject headings used in the search included 'operating room', 'surgery', 'video recording', 'black box', 'ethics', 'consent', 'confidentiality', 'privacy', and more. Title, abstract, and full-text screening determined relevance. The quality of studies was assessed using Centre for Evidence-Based Medicine grading and no formal assessment of risk of bias was attempted given the theoretical nature of the data collected. Results: From 1048 citations, 22 publications met the inclusion criteria, with three more added from their references. There was evident geographical (21 were from North America/Europe) and recency (all published since 2010) bias and an exclusive patient/clinician perspective (25 of 25). The varied methodology (including ten descriptive reviews, seven opinion pieces, five surveys, two case reports, and one RCT) and evidence level (14 level V and 10 level III/IV) prevented meaningful systematic grading/meta-analysis. Publications were narratively analysed for ethical thematic content (mainly education, performance, privacy, consent, and ownership) that was then grouped by the four principles of biomedical ethics of Beauchamp and Childress, accounting for 63 distinct considerations concerning beneficence (22 of 63; 35 per cent), non-maleficence (17 of 63; 27 per cent), justice (14 of 63; 22 per cent), and autonomy (10 of 63; 16 per cent). From this, a set of proposed guidelines on the use of operative data is presented. Conclusion: For a surgical video to be a truly valuable resource, its potential benefits must be more fully weighed against its potential disadvantages, so that any derived instruments have a solid ethical foundation. Universal, ethical, best-practice guidelines are needed to protect clinicians, patients, and society.
AB - Background: Operating-room audiovisual recording is increasingly proposed, although its ethical implications need elucidation. The aim of this systematic review was to examine the published literature on ethical aspects regarding operating-room recording. Methods: MEDLINE (via PubMed), Embase, and Cochrane databases were systematically searched for articles describing ethical aspects regarding surgical (both intracorporeal and operating room) recording from database inception to the present (the last search was undertaken in July 2022). Medical subject headings used in the search included 'operating room', 'surgery', 'video recording', 'black box', 'ethics', 'consent', 'confidentiality', 'privacy', and more. Title, abstract, and full-text screening determined relevance. The quality of studies was assessed using Centre for Evidence-Based Medicine grading and no formal assessment of risk of bias was attempted given the theoretical nature of the data collected. Results: From 1048 citations, 22 publications met the inclusion criteria, with three more added from their references. There was evident geographical (21 were from North America/Europe) and recency (all published since 2010) bias and an exclusive patient/clinician perspective (25 of 25). The varied methodology (including ten descriptive reviews, seven opinion pieces, five surveys, two case reports, and one RCT) and evidence level (14 level V and 10 level III/IV) prevented meaningful systematic grading/meta-analysis. Publications were narratively analysed for ethical thematic content (mainly education, performance, privacy, consent, and ownership) that was then grouped by the four principles of biomedical ethics of Beauchamp and Childress, accounting for 63 distinct considerations concerning beneficence (22 of 63; 35 per cent), non-maleficence (17 of 63; 27 per cent), justice (14 of 63; 22 per cent), and autonomy (10 of 63; 16 per cent). From this, a set of proposed guidelines on the use of operative data is presented. Conclusion: For a surgical video to be a truly valuable resource, its potential benefits must be more fully weighed against its potential disadvantages, so that any derived instruments have a solid ethical foundation. Universal, ethical, best-practice guidelines are needed to protect clinicians, patients, and society.
UR - https://www.scopus.com/pages/publications/85162773422
UR - https://www.scopus.com/inward/citedby.url?scp=85162773422&partnerID=8YFLogxK
U2 - 10.1093/bjsopen/zrad063
DO - 10.1093/bjsopen/zrad063
M3 - Review article
C2 - 37354452
AN - SCOPUS:85162773422
SN - 2474-9842
VL - 7
JO - BJS open
JF - BJS open
IS - 3
M1 - zrad063
ER -