Elizabeth Newman, Senior Editor
Elizabeth Newman

Before I had a child, I know I rolled my eyes at parents who installed cameras in stuffed animals in order to monitor their babysitter.

While I still would never do that, I’ve become more sympathetic to those who worry about their loved ones, especially when those family members aren’t able to talk. After all, security cameras outside of businesses or homes can be a deterrent or help catch a criminal when something bad happens. It’s natural to have a twinge of “maybe this will give me peace of mind.”

The problem, according to Clara Berridge, Ph.D., an assistant professor of social work at the University of Washington, is nursing home cameras can raise more legal and moral issues than they solve.

Berridge has published her work in AJOB Empirical Bioethics and Elder Law Journal, and dives into some of our misconceptions around nursing home abuse. She notes that the most likely cause of abuse is by relatives, but that the public can be misguided by nursing home incidents. It all has led to more state laws allowing “granny cams,” without enough discussion of the moral qualms they raise.

“This preliminary research indicates that we need serious engagement, including research, that addresses the ways that surveillance might affect residents’ privacy and dignity and might promote an overly technocratic, less relational culture of care,” she told McKnight’s.

Berridge outlines three big ethical issues: The risk that in-room cameras pose to residents’ privacy and dignity, the risk of undermining care workers’ sense of being fiduciaries for residents, and the probable extension of camera use by facilities to monitor staff and residents.

In other words, what we’re all struggling with is a lack of trust. The caregiving relationship relies on not only dedicated staff, but the family trusting their loved one is in good hands. When I drop my baby at daycare, while it’s often hard to say good-bye, I know without a shadow of a doubt that he is safe, loved and ready to have a great day.

If your residents’ family members aren’t feeling that, I’m not sure a camera is going to help.

Surveillance practices “risk denigrating care relationships, in part because surveillance of workers can send a message that they are not trusted to provide for the patient’s best interests,” Berridge says. “In the worst-case scenario, practices that dehumanize workers will also dehumanize residents.”

That brings us to another thorny question: How do the residents feel about these cameras? For many of them, especially ones who cherish privacy, living under surveillance may increase their isolation and feelings of loneliness. Plus, who gets to decide who is being monitored?

“Most nursing home residents have a roommate. Protecting their privacy when a camera is in the room would be very difficult in practice, especially if the camera picks up audio,” Berridge said. “We found that the real-life constraints on opportunities to selectively move or cover a camera in a given situation are not acknowledged in the state laws. These are chronically understaffed settings.”

Finally, Berridge notes that too few laws or policies have examined the legal responsibility a camera owner has for the security of the feed. Let’s say as an administrator you shrug and say “okay” when a family member sets up the camera. Who is responsible for the security of the feed? What if the resident and roommate are exposed to hackers?

Ultimately, Berridge’s posing of questions convinced me that we haven’t thought enough about these cameras. Or maybe we have and realized, in this day and age, the concept of privacy seems quaint.

But I hope, for the sake of our employees, residents and roommates, we spend some time examining whether these laws make sense.

Follow Senior Editor Elizabeth Newman @TigerELN.