I agree with the concerns with the issue of informed consent and that
this is not the only issue being debated on
Having dealt with patients and producers of at least 2 different
primetime TV medical programs in Australia on occasions in the last 5
years I do have concerns about how some of these programs have been made.
Some of the initial introduction of the TV producers is made by the
treating doctors to make it look legitimate though often many consultants
does not appear to be fully aware of the implications of involving a
commercial entity to what is effectively a private contractual
relationship between a doctor and the patient.
The issue that the TV programme will be in a public dormain is rarely
fully explored by the producers in their dicussion with the patients to
get their consent. In fact for practical reasons, the actual process of
getting consent from the patient is delayed long after the initial day of
admission, say on the day of injury, such that there would have been hours
of footage of the initial consultation at the emergency department (when
the patient is drugged up on narcotics) and several operations performed.
I dont know whether the TV station destroy the footage if the patient
ultimately refused consent or just kept in cold storage for the future.
In terms of capacity to consent, while theoretically "if anyone can
consent for surgery then they should be good for consent for TV access as
well", we often forget that most of the consent for procedure between
doctors and patients is mostly influenced by the patient's trust and
goodwill with the doctors, whereas the consent with the TV station is a a
true commercial contract which the TV station will take their entitement
to the fullest within the contract once it is signed. Patients do not
realise that until they have a dispute with the TV station.
And then there is the issue of practicality and patient care, getting
a film crew in operating theatre will involve at least 2 extra persons in
the enclosed area and the surgical team have to watch them closely to
ensure infection control is not breached (no matter how experienced thay
are at this, especially with all that camera and sound equipment). We all
know that we should limit number of unnecessary staff in theatre during a
total joint replacement to reduce microbal load, so are the TV crew
essential staff?
Lastly, if someone can buy into a seat at the operating theatre, then
similarly patients can request their (non-paying) partner or children or
their pets to be present in the theatre during the operation; they (except
the pets) would have more vested interest in the successful outcome of the
surgery than some spectators who paid to be rubbing sterile shoulders with
the surgeon
While I support the idea of demystifying the medical miracle, I do
not see a circus as part of the solution
Competing interests:
I am learning to be an orthopaedic surgeon
Rapid Response:
Re:Is informed consent the only issue?
I agree with the concerns with the issue of informed consent and that
this is not the only issue being debated on
Having dealt with patients and producers of at least 2 different
primetime TV medical programs in Australia on occasions in the last 5
years I do have concerns about how some of these programs have been made.
Some of the initial introduction of the TV producers is made by the
treating doctors to make it look legitimate though often many consultants
does not appear to be fully aware of the implications of involving a
commercial entity to what is effectively a private contractual
relationship between a doctor and the patient.
The issue that the TV programme will be in a public dormain is rarely
fully explored by the producers in their dicussion with the patients to
get their consent. In fact for practical reasons, the actual process of
getting consent from the patient is delayed long after the initial day of
admission, say on the day of injury, such that there would have been hours
of footage of the initial consultation at the emergency department (when
the patient is drugged up on narcotics) and several operations performed.
I dont know whether the TV station destroy the footage if the patient
ultimately refused consent or just kept in cold storage for the future.
In terms of capacity to consent, while theoretically "if anyone can
consent for surgery then they should be good for consent for TV access as
well", we often forget that most of the consent for procedure between
doctors and patients is mostly influenced by the patient's trust and
goodwill with the doctors, whereas the consent with the TV station is a a
true commercial contract which the TV station will take their entitement
to the fullest within the contract once it is signed. Patients do not
realise that until they have a dispute with the TV station.
And then there is the issue of practicality and patient care, getting
a film crew in operating theatre will involve at least 2 extra persons in
the enclosed area and the surgical team have to watch them closely to
ensure infection control is not breached (no matter how experienced thay
are at this, especially with all that camera and sound equipment). We all
know that we should limit number of unnecessary staff in theatre during a
total joint replacement to reduce microbal load, so are the TV crew
essential staff?
Lastly, if someone can buy into a seat at the operating theatre, then
similarly patients can request their (non-paying) partner or children or
their pets to be present in the theatre during the operation; they (except
the pets) would have more vested interest in the successful outcome of the
surgery than some spectators who paid to be rubbing sterile shoulders with
the surgeon
While I support the idea of demystifying the medical miracle, I do
not see a circus as part of the solution
Competing interests: I am learning to be an orthopaedic surgeon