Privacy, but Not So Much

Economist reports today on a new idea that really is half-baked. Because of rising complaints among British patients of abuse by physicians during intimate examinations, particularly sexual abuse, the Virtual Chaperone has been invented. It is a clever name, sort of, for a video camera and microphone in the examination room, recording every detail of the examination so as to protect both patient and physician. Sounds like the sort of solution a malpractice lawyer would work out.

One of my favorite passages in The Republic involves Socrates' discussion of a ring that allows the wearer to become invisible and undetectable. The discussion that ensues is about what sort of thing those with whom Socrates is in dialog would do with that kind of power. Eventually they are honest and admit that with that power they would be unable to resist using the power to get away with all sorts of evils. Socrates makes the interesting point that one can only be trustworthy when there is the temptation to violate the trust of someone, that is, there's no point in discussing whether or not you are a good person until you have the opportunity to be bad without anyone's knowing it. This is the essence of clinical trust. If you are going to violate patients unless there is a camera in the room, you really shouldn't be a physician. But that is no argument for cameras to root out dangerous docs.

Cameras cannot protect a patient from a physician, and there is simply no way to justify the additional invasion of privacy - from a camera designed only to protect physicians from charges of sexual abuse. Think about it - the physician has you naked. They do exams that are intimate. If they are drawing enjoyment from that, beyond what is appropriate for a clinician, how in the world are you going to prevent that by exposing the patient to a further violation of privacy? The risk is also pretty obvious that the tapes will be stolen: keep in mind that the cameras are supposed to be super-discrete (says the Economist), so how long do you think it will be before those videos are traded among residents, or even uploaded or sold as porn tapes? This is a really stupid idea, and the Economist appears to have thought about it for all of fifteen minutes.