Cases in Bioethics: Health Research Ethics in Southeast Asia
Keywords

privacy, video monitoring, consent, participant selection, psychiatric research, qualitative research, mentally unstable patients

Technology interventions are increasingly being used in hospitals to monitor and record the behaviors of patients in psychiatric wards. One system, known as a psychiatric behavioral monitoring system (PBMS), uses cameras placed in psychiatric wards to monitor and record patient behavior. PBMS is thought to be useful for monitoring clinical symptoms and outcomes, but little research has been done to understand the impact on patient privacy.

A Malaysian research team developed a qualitative study to investigate the privacy perspectives of psychiatric patients in a local hospital. Specifically, the team developed scenarios, based on the information system development privacy framework,1 to solicit insights from psychiatric patients regarding use of PBMS. The researchers interviewed 25 participants who were patients in a psychiatric ward of a teaching hospital. To generate themes, each participant in the study answered questions in their own words, guided by efforts from interviewers to make sure participants fully understood the questions.

The hospital’s research ethics committee (REC) approved the study to enroll inpatients and outpatients between 18 and 40 years old. Mentally unstable patients, including those experiencing a psychotic episode at time of interview, were excluded. Thematic analysis was performed on the data, and, using a hybrid deductive and inductive approach, the researchers proposed factors specific to people receiving care in psychiatric wards for inclusion in the privacy framework for information systems development.

Questions

  1. What are some examples of privacy issues that can arise when using recording technology in a hospital setting? Are there differences between a public hospital, teaching hospital, and private hospital?

  2. How should consent be obtained for the qualitative research described in this case? What suggestions do you have regarding assessment of capacity to consent? Should the researchers only recruit individuals who can demonstrate capacity to consent? Why or why not? If not, from whom else might they seek permission?

  3. What kinds of selection criteria for qualitative research are appropriate for psychiatric research participants?

  4. What kind of training should interviewers go through before interviewing psychiatric patients?

References

Carew, Peter J, and Larry Stapleton. Towards a Privacy Framework for Information Systems Development. Springer US, 2005.

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