In a news item posted today at ABCNews.com, http://abcnews.go.com/sections/living/DailyNews/munchausen000606.html , it was reported that an Atlanta hospital uncovered 23 cases of Munchausen by proxy by videotaping activities in the rooms of 41 children who were mysteriously remaining ill when no other cause could be found. The videotaping was done over the course of 4 years. A number of the mothers were subsequently arrested for child abuse and other charges.
For those not familiar with the term, Munchausen by proxy is a mental illness in which a parent (usually the mother) is driven to harm their child so that the child is the focus of medical attention, and the parent then receives the attention or sympathy they crave.
Doctors at the hospital published the results of their study in the journal Pediatrics. They encourage other hospitals to also install videocameras in the rooms of children who are not getting well as they should, because the doctors feel that Munchausen by proxy may be underdiagnosed. However, some medical professionals feel that videotaping is an invasion of privacy, and doctors with concerns should simply remain silent rather than violating the privacy of the patient and his/her family.
My take on this: Videotaping is indeed an intrusion, and should only be used after careful consideration of a particular case. But when there is no logical reason for a child to remain ill, or to become repeatedly ill with a variety of illnesses that don’t appear to have a logical explanation, the prevention of possible harm to the child should take precedence over privacy concerns. (And really, now, how much privacy is there to be violated in the average hospital room, anyway?)
Doesn’t it violate the Hippocratic Oath to “first, do no harm” if a doctor keeps his or her mouth shut when they have probable cause to believe that a parent is abusing the child? How different is this from parents videotaping a caregiver to see whether the caregiver is abusing children under their supervision?
It was my understanding that a hospital counts as a public place, which is why they can install security cameras in the hallways (to cut down on abductions from the nursery, etc.) I wouldn’t suppose that a hospital room would be considered any more “private” than the hallway.
Parents videotaping a caregiver is different because the taping takes place either in the caregiver’s residence, which is private, or the caregiver’s workplace, like a daycare center, which is a different kind of private, or in the parents’ home, in which case they are perfectly entitled to videotape what goes on in their absence.
However, I am not a lawyer–I don’t know exactly how the privacy laws run on this.
Certainly, if a doctor thinks a patient is not getting better because of Munchausen by proxy, he has an obligation to speak up. Are you saying that some doctors didn’t say anything, before the video cameras were set up? Maybe the possibility of Munchausen by proxy just didn’t occur to them. Doctors, as well as patients, tend to be very focussed on “technology” to solve problems. More tests, more pills, more different stuff to try. Something as simple as MBP might just have been way down the list of possibilities.
Also, since MBP can mimic so many different kinds of illnesses, it might be doubly confusing.
I gather that the doctors who performed the study had not considered that MBP might be such a significant cause of recalcitrant illnesses. In light of the results, they now encourage other doctors to consider MBP and resort to videotape, if need be.
It’s other medical professionals (possibly including ethicists, although none were mentioned in the article) who are apparently raising an objection, and it is their attitude I don’t understand, and don’t agree with.
I see your point about a home being distinct from the hospital in terms of one’s expectation of privacy, and I agree with it; I was just thinking about videotaping from the perspective of doing something to protect a child’s welfare. But as anyone who’s spent time in or around a hospital knows, there’s really no such this as privacy in a hospital unless you’re able to swing a private room. Otherwise, everything is pretty much on display or in earshot, in the hallways or in the rooms… So what’s the big deal about using a videocamera when (AND ONLY WHEN) there’s suspected abuse occurring within the hospital itself?
I don’t see where there is any reasonable expectation of–or right to–privacy in a hospital, public or private, unless you happen to own it. I say turn the cameras on and catch these lunatics.
On a side note, I have long had a personal theory that many of the deaths attributed to SIDS are actually the results of abuse.
The slippery slope, my friends, the slippery slope. I agree that, when Munchausen by proxy is suspected, videotapes might be the appropriate response, but safeguards (including, possibly, a court order) should be put in place. Such safeguards are particularly important where, as in the OP, the videotape was turned over to the cops for criminal prosecution. You should probably have as much expectation of privacy in a hospital room as in a hotel room.
The fundamental problem is – just becaue you aren’t doing something illegal doesn’t mean you aren’t doing something you don’t want others to know about. (My favorite example, in other circumstances - you’re pulled over at 2:00 A.M. at a sobriety checkpoint. You’re sober, but in the car with you is the preacher’s wife.) Hell, what if mom or dad, rather than making their child ill, is sitting in the kid’s room picking his/her nose? Without safeguards, is the video going to end up on the net through the operation of a “funny” hospital security guard?