02.04.11: Looking through both sides of the lens
There’s a hot discussion going on over at the New York Times Room for Debate webpage regarding cameras in the delivery room. Some hospitals are imposing “camera bans” to prohibit parents from photographing, videotaping and using cell phones to record their child’s birth. Should they be able to do that? No, but that doesn’t mean hospitals and patients alike shouldn’t use common sense. Birth pictures aren’t just Kodak moments anymore. The Internet, cell phones and medical malpractice have changed everything about the American birth industry and it’s not a pretty picture.
Parents have good reason to be upset about proposed camera-bans. Birth pictures are a cherished part of our culture and tradition and hospitals shouldn’t try to take that away. Parents are sick and tired of hospital control issues surrounding childbirth and this is going too far. But it’s not really the cameras that are the problem. It’s videotaping that makes everyone uncomfortable. Now that every camera and cell phone has video capabilities, some births have more cameras than major Hollywood movies.
Hospitals say filming is a safety concern for babies and hospital staff and a breach of privacy for doctors and nurses. They’re right. Few patients ask our permission before they film and post us on YouTube and Facebook. It’s not like in the “olden days,” when the only people who’d see these pictures were the patient’s friends and family. Now, we invite the world into the delivery room via the Internet.
Hospitals worry about video footage in the event that something goes seriously wrong. Childbirth isn’t scripted reality TV. It’s “reality;” the kind, where real people are doing a difficult job. Having a camera in your face while you’re trying to save a life (or maybe just manage a tricky procedure) is intimidating. It makes you hyperaware of the camera when you need to be hyperaware of your patient. We’re not actors. We’re not used to paparazzi. We’re health care providers.
When families film everything, so they can use it in case they want to sue us, it changes the whole dynamic in the delivery room from one of mutual support and trust, to one of animosity. Suddenly, we’re not caretakers, we’re bad guys under surveillance. Think about how you’d feel if someone filmed you doing your job, so they’d have evidence to fire you, or worse, take you to court.
Camera rights don’t go both ways. Hospitals can’t use surveillance cameras in patient rooms, because privacy laws protect patients, but shouldn’t hospital staff be afforded some privacy and protection too? On the other hand, sometimes patients do receive poor care and knowing you’re on film might make some caretakers be more vigilant. Maybe we should set up discreet cameras like they do on rollercoaster rides. When the ride is over, patients and hospitals can choose the shots they want and archive the film.
Years ago, I was admitting a patient in labor with her first baby. When I went into her room to introduce myself, her husband had a video camera rolling and announced he’d be filming my every move. It felt like a stick up with his camera pointed at me. I expected him to say, “So don’t try any tricky stuff.”
He filmed hour after hour of his wife’s long labor, essentially leaving her without any emotional support besides me. Labor support is a big part of my job, but most women want their partner and Cameraman left her hanging. He kept asking, “What are you doing to my wife?” I’d answer, “Uh, rubbing her back. Cleaning up her barf.” It was weird.
When I went to start the IV, he zoomed in for a close-up. When I told him he was blocking my light and I couldn’t concentrate with his camera in my face, he refused to move. I apologized to my patient, (who was a real sweetheart) but told her I couldn’t provide care under these circumstances. The woman shouted at her husband to, “quit being a jerk and put down the damn camera.” He shouted at her that he was just trying to protect her. I asked, “Protect her from what?”
It turned out Cameraman had a friend whose baby was stillborn and was convinced it was caused by hospital error. Cameraman was terrified, assumed his wife would be mistreated and wanted to keep me on guard. He figured filming was his best defense against tragedy happening to his family. Once he realized he was being a bully and doing more harm than good, he put down the camera and get down to supporting a birth instead of a potential lawsuit.
And that’s what it really comes down to: the potential lawsuit. Hospitals don’t want staff distracted and don’t want all that film to be admissible in court. Parents want to memorialize their child’s birth, but some also want their own legal documentation. It’s all about trust.
Should hospitals ban cameras for everyone? Of course not. Whenever we institute one-size-fits-all rules for everyone, especially for liability reasons, we create animosity. Instead lets look at the real problem – lawsuits, but let’s look at this from both sides of the camera lens. The American Birth Industry is built around legal defense against medical malpractice claims. That’s why we do so much fetal monitoring, so many interventions and c-sections, and have VBAC bans. Patients sue us when things don’t turn out perfectly. Hospitals can’t afford settlements unless they’re insured. Insurance requires we treat every patient like a potential lawsuit. Sometimes there is malpractice, usually there isn’t. Childbirth is risky and the stakes are high. Everyone wants safe births, but when parents and healthcare providers treat each other like potential criminals, we’re all in big trouble. What’s the answer? Common sense, not another ban.
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