5 pros and cons of cameras in ambulances

If we can’t afford two providers in the back of every ambulance on every call, maybe it’s time for video surveillance in the event of patient care lawsuits


The lowest of the low, in my opinion, are the lawsuits that arise from someone just doing his or her job; trying to be thorough and professional, only to be accused of wrongdoing for a quick buck.

Here's a real-life scenario

It’s a regular call on a regular shift on a regular day.

A unit is called to the report of a female in her 30s, with abdominal pain and vaginal bleeding for nearly a month. The male medic does his assessment, including vital signs, and a physical exam.

The somewhat large patient consents to a visual assessment of her vagina using no scopes or specula — just a visual, routine examination. Unfortunately, her girth and shorts make access difficult. The medic decides, with patient approval, to simply pull one leg of the shorts to the side to expose the area to be viewed, and provide a pad if necessary.

The exam lasts roughly four to seven seconds. There is no sign of injury or exsanguination. He documents his findings and the transport concludes without incident.

When the patient is turned over to the staff at the emergency department, however, she claims that she had been sexually assaulted by the medic in the ambulance.

“He touched my vagina,” she says.

The police are called, supervisors respond; it’s a big deal.

The medic directs all comers to his PCR and gives a full, honest account of the transport to the officials who question him.

“He violated me! I’m going to sue you,” she yells across the ER. “You’re going to pay!”

It’s his word against hers.

The EMSA and his LEMSA are investigating. As of yet, the police have not closed the investigation. Nevertheless, the medic was immediately placed on administrative leave without pay, and fired less than a week later — deemed guilty without so much as a completed investigation.

Cameras as the second set of eyes we can’t afford?

Have we really reached the point where EMS providers can no longer do what they are trained and expected to do for fear of being accused of and fired for something that didn’t happen?

Do we need to consider having two providers in the back of every ambulance on every call? Is it time to create the position of ‘Fair Witness’ that Robert Heinlein predicted in 1961? Probably not a bad idea, but I cannot think of a single system that can afford such a position.

If we can’t afford to further bloat EMS budgets with additional personnel, maybe it’s time for video cameras in ambulances. Maybe it’s time for the last corners of privacy in society to be stripped away in order to keep everyone honest. That would certainly help fulfill the prophecies of Kafka, Orwell, Heinlein, Bradbury, and Huxley.

As you can see, it makes me angry to think of it … but maybe it is time.

Police car dashboard cameras have proven guilt and confirmed innocence with near equal accuracy. Cellphone video, security video, and GoPro video have done wonders to keep police officers honest (or accountable) — and have helped convict the guilty 

So, what would happen if the same technology was employed in EMS?

Pros and cons of cameras in EMS

PROS

  1. Every patient interaction would be chronicled
  2. Speech patterns, specific statements, patient complaints, skin color, and other environmental factors could all be confirmed and considered by the secondary and tertiary providers
  3. Specific treatments, techniques, and processes could be chronicled and used for future reference and training
  4. False accusations could be easily refuted and mistreatment or misconduct just as swiftly assuaged
  5. There would be accountability

CONS

  1. Every patient interaction would be chronicled
  2. The existence of information begets the disclosure of information
  3. Privacy could become compromised to the point of extinction
  4. The fear of disclosure could prevent some patients from sharing highly sensitive and medically essential facts
  5. Appropriate accountability could give way to unsupported judgment by unqualified armchair quarterbacks — and lawyers

On the whole, it’s not the worst idea I have ever heard, and it is an idea whose time has probably come.

But is the industry ready for it?

Are providers ready, willing, and able to be on top of their game, 100 percent of the time? Are agencies ready to assume liability they otherwise may have been able to avoid  — by a preponderance of the evidence? Are the weak links ready to be called to task? And are agencies willing to call them to task?

Is EMS ready for the kind of accountability video cameras would foist upon it? Of course, I don’t know. There are just too many variables.

But, I do know this: ready or not, it’s coming. 

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