Without evidence of benefit, an intervention should not be presumed to be beneficial or safe.

- Rogue Medic

The Streisand Effect and EMS Patient Care

At Fire Law, there is a very interesting post.

In response to our discussions about the 1st Amendment and the right of the media and citizens to photograph emergency scenes, I received a great question from Firehrguy. We will turn that into today’s burning question:

One of our Paramedics asked if there was any rule on a patient recording and filming their treatment. He had a patient that was recording the Paramedic as he was taking vitals and assessing the patient and the patient recorded all this with his phone.

I am not aware of any law or case that even remotely begins to address this issue. The closest analogy I can think of would be whether or not an arrestee has a right to film his/her arrest, but that analogy is admittedly not a good one.[1]

What would be my authority to take a phone/camera from a patient?

If I demand that the patient stop filming, but I do not take the patient’s camera, what recourse do I have?

Do I have the authority to refuse to treat the patient?

If I do refuse to treat the patient (as long as the camera is on), are paramedic initiated refusals permitted in my system?

Do I present the informed refusal information with the camera on? If I insist that the camera be turned off, first, and the patient later insists that I did not provide any such information, how will I be able to demonstrate otherwise?

If I do claim that the camera/phone interferes with patient care, what exactly am I supposed to claim that it interferes with?

What is the danger to the patient?

Why am I trying to hide what I do in the back of an ambulance?

What about the patient filming my care of the patient deprives that patient of the ability to make decisions for himself?

If I have to accept that the patient can film his patient care in public, how can I claim that this is suddenly interfering with patient care when we are out of public view?

The camera was OK when other people could see, but now your life is in danger!

Don’t kill me. I’ll turn it off.

And that will be recorded and that will be the way some people interpret it, even if those are not the words used.

Even if my ambulance is not public, private colleges and universities have been made to comply with the Constitution because they accept dollars from the US government. Since we generally accept payment from Medicare, do we fall into the same category? If this is a 911 call, does that make it more likely that a court will decide in favor of the patient?

Is the First Amendment about whether the recording is suitable for public display or is the First Amendment about accountability? We seem to be permitted to record the police, because it is about the accountability of those who work for the public. In states that have laws prohibiting public recording, the charges end up being dropped, or overturned on appeal, when the charges are for recording the police.

When we are responding to a 911 call, aren’t we de facto[2] public employees?

Yes, the film can be edited in many ways by the patient, but the same is true for any filming done in public.

Maybe we need to insist that our employers record us in the back of the ambulance to protect us from any possible editing of any patient’s video.

Suppose there is harm to the patient because of a fight over the patient’s phone/camera. How do I defend that?

Suppose the patient says, Your mother sews socks that smell. On camera. What if that film ends up on TV and my mother sees it? That would not be pleasant, but the patient could just as easily say this outside of the ambulance as inside. One is acceptable, while the other is questionable. Why treat them differently?

If the patient says rude things to me, so what. That is just a part of the job. Is this any different?

If I let people know that I don’t want to be filmed, is this any different from Barbara Streisand insisting that her home is not to be filmed?[3] Isn’t this just an invitation to film me whenever I am in public?

Even if it turns out that we do have the legal authority to insist that the patient turn off the camera, although we probably do not have any authority to physically remove the camera from the patient’s possession, aren’t we doing ourselves more harm by insisting that the camera be turned off?

Isn’t the perception of the public going to be –

What are we trying to hide?

Doesn’t this put us in a similar position to the politician being asked, Is it true that you’ve stopped beating your wife? We may not break any law, but the impression of being untrustworthy has been created.

What are we trying to hide?

There are a lot of questions about this. I am not a lawyer, so I do not pretend that I have the answers to these questions, but what happens in moving from a public space to the back of an ambulance that I need to protect myself from?

Should our accountability to the patient end at the doors of the ambulance?

Isn’t the only person interfering with patient care, the medic who is insisting that the camera be turned off?

Read what Fire Law wrote and read the comments.

Also see –

EMS Continues Its War On Photography over at The Social Medic.

Another Suffolk County NY Responder Needs Media Training over at FireGeezer.

The First Amendment lives. U.S. Court of Appeals in Boston says there is nothing illegal about shooting video of police doing their jobs. over at STATter911.

Footnotes:

[1] 1st Amendment Dilemma: Can a Patient Video Their Own Treatment?
Fire Law
Article

[2] De facto
Wikipedia
Article

[3] Streisand effect
Wikipedia
Article

Wikipedia’s justification for posting the picture (which applies just as much to my use of the picture) –

Description
Pictopia.com’s picture of Barbra Streisand‘s house, that led Ms. Streisand to unsuccessfully sue photographer Kenneth Adelman for privacy concerns.
taken Mon Sep 23 13:30:47 2002 (PDT -0700; 20:30:47 UTC) by the California Coastal Records Project; published by The Smoking Gun May 30, 2003

Source
“Barbra Sues Over Aerial Photos | The Smoking Gun”. The Smoking Gun. May 30, 2003. Retrieved 2010-11-22. Photo taken by Kenneth Adelman.

Article
Streisand effect

Portion used
The picture is show completely, in a size/resolution good enough for viewing on the web or small prints. The original at The Smoking Gun is at http://i.cdn.turner.com/dr/teg/tsg/release/sites/default/files/imagecache/750×970/documents/barbrahouse1.jpg and the original at the California Coastal Records Project is at http://www.large.images.californiacoastline.org/images/2002/large/0/3850.JPG (not directly accessible) as displayed by http://www.californiacoastline.org/cgi-bin/image.cgi?image=3850&mode=big&lastmode=sequential&flags=0&year=2002 and thumbnailed by http://www.californiacoastline.org/cgi-bin/image.cgi?image=3850&mode=sequential&flags=0&year=2002 with caption “N34 00.65 W118 47.24 Image 3850 Mon Sep 23 13:30:47 2002” (including the aircraft position when photographing)

Low resolution?
Yes

Purpose of use
This is the image of singer Barbra Streisand‘s house that was taken as a series of 12,000 aerial photographs of the coastline of California in 2003 and placed on the internet. When Streisand demanded the image be removed, the publicity surrounding the controversy caused hundreds of thousands of hits to the image, creating what became known as the Streisand effect. As it represents the center of the controversy that created of the term, words are insufficient in describing the ideas and concepts relayed in the photograph.

Replaceable?
Since this very picture itself is discussed in the Streisand effect article, no other image, free or non-free could serve as a replacement.

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