Surgery for spectators

There’s a lot of press coverage about a piece by Simon Chapman in the BMJ. He describes a charity auction where one prize was to attend a neurosurgical operation. He thinks it was wrong to do so; so do I.

Yet this is the logical outcome of so many voyeristic cameras in the consulting room. I don’t like TV programmes where the imbalance of power between knowledgable doctors and un expert patients are held up to a lens and for the titillation or enjoyment of others. The ethics of protecting patients are now being crushed by accusations of paternalistic doctors not wanting people to know what’s going on behind closed doors.

Paternalism, believe me, is the last thing on my mind. A couple of years ago a Guardian piece featured a journalist in the same vehicle as a psychiatric crisis team who were being sent out to assess patients for dentention under the mental healthcare act. The piece was praised by mental health charities who thought it reduced stigma. But what about the individuals who were so unwell as to be meriting losing their freedom -how could they possibly consent at the time to a journalist being present? Even a patient declining the journalists’ presence had her details discussed and her address obvious. I can imagine being unwell and afraid not to consent. I don’t think that was fair, or right.

People and patients should be able to expect confidentiality from their health service. There are good ways to shine lights into dark corners of the NHS which don’t necessitate a camera crew. Operations can go wrong. People may behave differently when healthcare professionals have other priorities. There are too many cameras and an evaporating understanding of what confidentiality means.

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