Subject(s)
Asian People , Cosmetic Techniques/ethics , Native Hawaiian or Other Pacific Islander , Ophthalmologic Surgical Procedures/ethics , Surgery, Plastic/ethics , Blepharoplasty/ethics , Blepharoplasty/trends , Cosmetic Techniques/trends , Esthetics , Female , Humans , Ophthalmologic Surgical Procedures/trends , Stereotyping , Surgery, Plastic/trendsABSTRACT
Video recording in ophthalmic surgery has immense potential to drive quality improvement in patient care, ophthalmology training, and research. Not only do surgical videos permit introspective and critical analyses of surgical technique, they also allow for objective assessment, allow for more informative audits, and are an invaluable medium for surgical education. Unfortunately, medical-grade video recording equipment is often costly. Various novel methods of video recording that utilize commercially available products offer adequate alternatives. Certain ethical and legal issues also need to be considered before the commencement of video recording in the operating room to protect both the patient and surgeon. We review the current applications and methods of video recording in ophthalmic surgery described in the literature, as well as the potential ethical and legal issues surrounding video recording.
Subject(s)
Ophthalmologic Surgical Procedures/methods , Ophthalmology , Video Recording , Humans , Ophthalmologic Surgical Procedures/ethics , Ophthalmology/education , Teaching MaterialsABSTRACT
OBJECTIVE: To provide preliminary evidence of the types and amount of involvement by healthcare industry representatives (HCIRs) in surgery, as well as the ethical concerns of those representatives. METHODS: A link to an anonymous, web-based survey was posted on several medical device boards of the website http://www. cafepharma.com. Additionally, members of two different medical device groups on LinkedIn were asked to participate. Respondents were self-identified HCIRs in the fields of orthopedics, cardiology, endoscopic devices, lasers, general surgery, ophthalmic surgery, oral surgery, anesthesia products, and urologic surgery. RESULTS: A total of 43 HCIRs replied to the survey over a period of one year: 35 men and eight women. Respondents reported attending an average of 184 surgeries in the prior year and had an average of 17 years as an HCIR and six years with their current employer. Of the respondents, 21 percent (nine of 43) had direct physical contact with a surgical team or patient during a surgery, and 88 percent (38 of 43) provided verbal instruction to a surgical team during a surgery. Additionally, 37 percent (16 of 43) had participated in a surgery in which they felt that their involvement was excessive, and 40 percent (17 of 43) had attended a surgery in which they questioned the competence of the surgeon. CONCLUSIONS: HCIRs play a significant role in surgery. Involvement that exceeds their defined role, however, can raise serious ethical and legal questions for surgeons and surgical teams. Surgical teams may at times be substituting the knowledge of the HCIR for their own competence with a medical device or instrument. In some cases, contact with the surgical team or patient may violate the guidelines not only of hospitals and medical device companies, but the law as well. Further study is required to determine if the patients involved have any knowledge or understanding of the role that an HCIR played in their surgery.
Subject(s)
Clinical Competence , Health Care Sector/ethics , Surgeons , Surgical Instruments , Surgical Procedures, Operative/ethics , Adult , Anesthesiology/ethics , Anesthesiology/instrumentation , Cardiac Surgical Procedures/ethics , Cardiac Surgical Procedures/instrumentation , Endoscopes/ethics , Female , Health Care Sector/standards , Health Care Sector/trends , Humans , Internet , Lasers , Male , Middle Aged , Ophthalmologic Surgical Procedures/ethics , Ophthalmologic Surgical Procedures/instrumentation , Oral Surgical Procedures/ethics , Oral Surgical Procedures/instrumentation , Orthopedic Procedures/ethics , Orthopedic Procedures/instrumentation , Surgeons/standards , Surgical Instruments/ethics , Surgical Instruments/statistics & numerical data , Surveys and Questionnaires , United States , Urologic Surgical Procedures/ethics , Urologic Surgical Procedures/instrumentationABSTRACT
Video documenting is increasingly used in ophthalmic training and research, with many ophthalmologists routinely recording their surgical cases. Although this modality represents an excellent means of improving technique and advancing knowledge, there are major ethical and legal considerations with its use. Informed consent to record is required in most situations. Patients should be advised of any risk of identification and the purpose of the recording. Systems should be in place to deal with issues such as data storage, withdrawal of consent, and patients requesting copies of their recording. Privacy and security of neither patients nor health care professionals should be compromised. Ownership and distribution of video recordings, the potential for their use in medical litigation, the ethics and legality of editing and the impact on surgeon performance are other factors to consider. Although video recording of ophthalmic surgery is useful and technically simple to accomplish, patient safety and welfare must always remain paramount.
