Dr Alastair Macdonald1
1CCDHB- Wellington Hospital
In recent years the sophistication and utility of mobile phones has been remarkable as has their ubiquity. These developments have enabled patients/family or their whanau, to covertly and easily record clinical encounters.
If health care professionals discover that their conversation is being covertly recorded, it is not surprising that a common reaction is one of consternation and even anger. The implicit sense of trust and privacy embodied in the consultation process are betrayed by such actions. Health professionals can therefore rightly view the use of this technology in a very negative fashion.
Whilst these issues remain very important, this negative view has to be integrated with a more enlightened perspective view that the use of recording devices actually has the potential to significantly improve the consultation process. There is good evidence that information recall by patients, the ability to confer with family / whanau members and decisional regret are all positively influenced by the ability to replay the recording. Not a surprise given that patient-centred care is at the heart of a successful consultation process!
Traditionally clinical ethics committees identify three areas of involvement, individual case consultation, education and policy development. However policy development by ethics committees is conspicuous by its absence in the literature and in practice.
This presentation outlines the processes involved in the development of a policy which addresses the issue of the use of recording devices in the consultation process. The justification for this includes the inevitable increasing use of these devices in the future. In addition there needs to be recognition that the appropriate use of this technology has the potential to benefit the patient /family and whanau experience. It follows that any policies that are developed in the future need to recognise these realities.
I am a retired renal physician. I have been involved in the promotion of clinical ethics to the extent that I believe that “Clinical ethics is everyone’s business”. The sustainability of our health services is a reasonable prospect if it is based upon robust, ethical decision making at an individual level in the context of the broader concept of stewardship of these valuable resources. If neither of these concepts is developed to their full potential then we have no one to blame but ourselves if our “health” future turns out to be bleak!