…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.

@ceecee32 heart problems tend to present very differently in men and women too - that’s why female heart attacks are so easily misdiagnosed.

@lljkk . Yes, you have some understanding but tnot a comprehensive understanding of consent legislation. The MCA is absolutely clear. Where you lack capacity to make a specific decision must be made in your best interest. That cannot be ignored. It’s one of the underlying principles of The Act.
The Act applies to everyone over 16 with certain caveats for those aged 16-18 years of age. It applies to every decision around health and social care provision.

That bit not about best interest is essential. Nobody can consent on behalf of another unless they have Lasting Power of Attorney or a deputyship. Even then they must act in the best interests of the person who cannot make an informed decision. No ‘next of kin’ can decide unless they have registered an LPA. Every decision must be considered separately.

A clinical team can be clear that iIt is in the best interests for a sixty year old to receive thrombolysis for a stroke or for a ninety-two y-ear-old to have surgery for a fractured neck of femur. Even if the family say mum wouldn’t want surgery, the clinicians would still likely decide it was in the person’s best interest to reduce pain and help them regain mobility. That is entirely within the Act.

It cannot be argued that filming is in someone’s treatment when they are incredibly vulnerable is in their best interest. People have a right to believe their medical treatment is confidential and that their privacy and dignity is protected when they are unable to ensure this for themselves. Nobody should be overriding that for personal or corporate gain.

Consent cannot be retrospective. Think about whether it’s OK for someone to ask if it was OK to have sex after a woman sobered up rather than obtaining consent before they assaulted a very drunk woman? The answer is, of course not.
No more is it acceptable to film someone in a state of undress or distress, share those images with a film production crew or editorial team and ask afterwards if they minded. You can seek consent to show the film when someone regains capacity (if they do) but you cannot seek retrospective consent to film them.

Nobody else can give that consent either, unless the person died. Then family can decide but a person with dementia cannot give consent and worse, in lucid days or moments before dementia really advanced, they might well have said they would not want to be filmed covered in blood and with a hospital gown hanging off them leaving them feeling exposed or undignified. These are people not hand puppets/actors and are not there to provide cheap entertainment.

As above the person with them is rarely their representative. LPA needs to be registered and the hospital staff need to see that before allowing them to make any decision. They can and should be involved in discussion but responsibility remains with the clinical team. LPAs can only consent in someone’s best interests - it is still about what the person would have wanted, if they had capacity. It is not Carte Blanche to agree to throw their privacy out of the window.

Most of the cameras are fixed to walls and fittings and there's signs everywhere, letting people know filming is going on. However, if they capture a really good story, consent to use and air the footage is usually sought afterwards. That's when the programme makers sit down later with the doctor/staff and patient and do an actual interview. These shows are a basically a splice of fixed point cameras mixed in with post-event interviews.

Awful. It's not like you have much choice to go elsewhere if you end up incapacitated and vulnerable in A&E. The signs aren't really particularly helpful at that point.