…to not get these 24 hr in A& E ‘fly-on-the-wall’ documentaries?

[NellesVilla]

Good evening, all,

So I’m watching that 24 hours in A & E show and although I’m reasonably bright, I’m just wondering how they go about filming the separate stories?

Do they just shove a camera in the face of someone who’s just broken their back and neck in a road accident or would they speak to the family first if the victim is unconscious?

It’s not like they can go “Oh mate, I know you’ve crushed your pelvis and are in excruciating pain, but before we sedate you, could you sign this waiver for filming, please?” Or say to the family: “Yes, dad’s dying but could we do a few close ups, please?”..

I’m honestly interested and fascinated about this and ethically, how people feel about genuine victims/patients being filmed in the aftermath of a horrific crash?

Also- and yes I’ve had a drink as a non-drinking person so could be overthinking this- but do we really believe that they’re like that on the arrival of a new patient? When they stand to attention and listen reverently to the head surgeon give their orders on what to do with the patient? Is this staged? Bigged up for telly? Or is A & E really like this- a theatre in a theatre?

Also the 24 hours in police custody thing: are they allowed to film the suspect? If I were a possible murderer I know you’ve probably waived some rights such as privacy, but personally I’d hardly want to be filmed and perhaps wouldn’t answer the questions properly under that pressure.

I remember having a real thing for Nurse Jen years ago, back when 24hrs in A&E was at the previous hospital before the current one.

Probably should name change for this! DD had an accident this summer and they needed 3 ambulances to stabilise her. A film crew arrived with one and asked my permission to film her rescue. I said ok.
A month or so later I got a call asking for my consent for them to use the footage, which I gave. It's going to be on tv early next year. DD is fine with it.

I went to our GP once and they were filming GPs Behind Closed Doors. They had a few separate cameras set up, notices about filming and they asked me to sign a consent form.

I really hope that's not true as well! It's such a breach of privacy.

A friends grandson was being taken into A and E, and asked if he minded being filmed, he declined as it was quite an intimate problem, they didn't film him. When I worked for a GP practice which trained young doctors, they sometimes filmed, I had to ask people's permission on the way in and on the way out and get them to sign a consent form. The film was always wiped after the doctor had gone through it with the trainee.

A film crew were on the maternity unit whilst I was labouring - filming ‘Life and Birth’. I saw them often during my antenatal appointments too and there were leaflets on the desk asking pregnant women if they would like to sign up to feature on it.

I worried that when it aired I’d see myself pacing the corridors in the background but they cut and edited so well that it was rare anyone was seen in the background.

There is a big difference though between a department like A&E being filmed, and stuff out in the community like with 999: What's Your Emergency,

You can walk into A&E/maternity ward, and see signs and leaflets about filming going on. The crew that were out with the 999 lot just followed them regardless. Film now, get consent later.

I often wonder why, when they put out a trauma call they say its either male or female. Does it make a difference?
As there are some A&E staff on here I'm hoping that they can let me know

I have real concern about the issue of consent. An unconscious or seriously injured person cannot consent and it would be hard to claim filming them in such a vulnerable state was in their best interests.

I think it's not something that should be permitted but is simply voyeuristic.

I don't see the entertainment value in filming someone else's pain and misery. I would not be comfortable with a TV crew filming me at my most vulnerable and getting consent from my family or asking me when I'm feeling better. I don't want my face blurred. I don't want any hospital to give permission for film crews to be anywhere near a hospital.

I work for an organisation involved in this type of programme. Consent is sought at the time where possible, but the truly informed consent comes later. Only 10-15% ever make the final series.

It’s tightly controlled and usually involves fixed cameras, body cams and maybe one person actually with a camera. Editing takes a lot of effort and precision to make sure the situation is portrayed accurately - cutting a complex situation to a few minutes can unintentionally change the narrative.

The well made programmes make a huge difference to public understanding

@ceecee32 well of course it does - different sexes have different physiognomies.

@ceecee32 do for example if someone who is biologically male of childbearing comes in unconscious filling severe, sudden onset lower abdominal pain, we can be certain he doesn’t have a ruptured ectopic, so we’d be more likely looking at an appendix or something gastric, whereas with a woman we might be looking at a gynae emergency.

Childbearing age, even. Sorry / being used as a climbing frame by dog and child

I don't find them voyeuristic at all. I think these programmes are made sensitively and thoughtfully, and show the professionals in a superb light, and make the public far more aware of how brilliant the professionals are, what hospitals/ambulances/the NHS is really like and how difficult the situations are.

How can it be in any way reasonable for non-NHS personnel - like camera crew etc to be up close and personal during intimate procedures without clear, advanced informed written consent?

@ElizabethBest
Thank you. I was thinking more of broken bones and heart problems. Makes perfect sense now

Truly informed consent should be provided at time of filming or it is not consent, is it?

People who cannot give consent should have their privacy and dignity respected. Anything less is not being respectful and hospital staff have an obligation to protect the privacy of those unable to do so for themselves.
It's probably a breach of professional codes of conduct for health professionals and certainly the MCA to not step in and say no if patients haven't agreed to being filmed.
Consent to.being filmed cannot be retrospective. That is not consent. Consent to showing the film may take place later but you can't undoubtedly filming that someone would not have wanted.

I agree. I’d be mortified if I was in a critical state and there was someone from an entertainment company who wasn’t involved with saving my life - filming me. Also the thought of the footage being watched back by colleagues before they ‘contact me for consent’ gives me the jeebies.

Totally agree.

The crew filming 999 WYE in my town did an episode on mental health. There were people on top of car parks in the episode. Imagine being approached about consent for filming when you are at your absolute rock bottom?!

Like I said in a previous post, I was told by police that the crew would film you anyway, and get consent later. This would not be happening in A&E etc..

Just to add.. the A&E departments taking part in filming would have signs and leaflets everywhere. I can't say I saw a similar leaflet at the bottom of the multi story car park I was wanting to leap from.

Personal bodycams for safety of crews on ambulances are entirely different to a film crew filming for commercial reasons. Legally and ethically.
Leaflets can't be read by someone with dementia or who is unconscious.
Consent is not given for filming but absolutely should be. It violates patient confidentiality regardless of whether retrospective consent is given afterwards.

I don't believe that informed consent exists.
Not ever, not truly.
Amuses me that people put IC on a pedestal.
We're all just guessing.

Not sure I understand. Do you mean there is very little certainty? That's true but people in hospital should be made aware of risks and benefits plus alternatives and likely outcomes. That offers information on which you base your consent. The information does ot have to give absolutes - it has to give information to weigh up risks. With filming when someone has no capacity to consent, they cannot make an informed choice.

Impossible to give truly informed consent before many things happen and especially for 24hinA&E because...

can they have heard about All the risk and benefits? All the alternatives and likely outcomes? How can anyone know whether a complete enough list exists, and if it covers the priorities of the specific individuals? What about unintended unlikely consequences? What is the threshold between enough consequences and not enough that are 'likely' ?

My point being that you can't cover them all off, and if you did no one would ever consent (they wouldn't have time) to anything, and certainly not the actual medical procedures they might receive. Also, who has the expertise (social for the filming & medical for the treatment) to weigh up the risks : most people don't, and certainly people feeling awful don't. It's a con. We get explained to by the experts what the experts hope is a reasonable list of things to know. There's a chance to ask questions and someone hopes that's enough.

That's what the filmers do, that's what the HCPs do, in practice.

If someone lacks capacity to give informed consent to be filmed as a prospective featured patient on 24HinA&E, they lack capacity to consent to any medical procedures too. Kids or those with dementia. Yet, The fact that almost always the persons broadcast do a post-event interview on 24HinA&E suggests that they feel ok subsequently about having been filmed. Many are cheerful in their presentation at that point.

It's only afterwards that informed consent may be given, is what I'm really saying. When you've been thru it and you know what actually happened and that it actually was ok or even good experience. Also, you're feeling better & can think straight. Only At that point I think they might have capacity. But some people don't feel ok about what they consented to. Look at how many women on MN consented to things happening when they gave birth, that they now regret and sometimes even feel angry about.

So it's a con to pretend that informed consent exists for anything before many things happen, pretending that anyone really understands what they have consented to.

Main benefits & risks should be explained, the patient or their representative needs to be part of the decision-making, & have a chance to understand the options being suggested. But what they really need is trust that the medical staff have their best interests in mind. Let's not pretend that their "informed" consent is ever very informed before events happened. It can't be. So this thread fuss about filming lacking "informed consent" is amusing, esp. in environment where so many medical procedures will happen that have much more potentially important impacts on most people. And no way will many people understand the medical interventions they had.