There are three new shows that have, or are soon to start, on Australian television

  • “Emergency Call” on Channel 7;
  • “Paramedics” on Channel 9; and
  • “Ambulance Australia” on Channel 10.

We’ve all seen these reality shows before and there have been shows from the UK riding along with the ambulance services or broadcasting emergency calls.  I’m sure they are great entertainment but how are they legal or ethical?

From an ethical point of view people don’t ring 000 in order to be a source of entertainment. They ring in order to receive services at times when they are most vulnerable.  If an ambulance turns up either with cameras in the ambulance or on the paramedics, or worse, with a camera crew, those things are not there for the benefit of the patient.  The ethical duty on the service and on the paramedics (more so when they become registered) is to act in their patient’s best interests and filming them has no therapeutic benefit for the patient.

Although there is no common law right to privacy so people can film whatever they see form a public place, inside a patient’s home or inside an ambulance is not a public place. Further there is a right to confidentiality in relationships that come with that expectation.  Being in an ambulance (or a doctor’s surgery or an emergency department) would be the sort of places where an expectation of privacy is highest yet people are being filmed when they are at their most vulnerable.  And their experience is being used for entertainment, not to advance patient care.

Paramedics Australasia (PA; of which I am a board member) says:

Members must maintain confidentiality of any information they obtain in the course of their work. They must not disclose any such information to a third party unless there is a legal or professional duty to do so.

Filming that information and releasing it to a television channel is not consistent with that principle.  Of course PA is not a regulator. The Paramedicine Board is the regulator  The Code of Conduct for Paramedics, that will apply when paramedics are registered says:

Practitioners have ethical and legal obligations to protect the privacy of people requiring and receiving care. Patients or clients have a right to expect that practitioners and their staff will hold information about them in confidence, unless release of information is required by law or public interest considerations. Good practice involves:

a) treating information about patients or clients as confidential and applying appropriate security to electronic and hard copy information

b) seeking consent from patients or clients before disclosing information, where practicable

c) being aware of the requirements of the privacy and/or health records legislation that operates in relevant states and territories and applying these requirements to information held in all formats, including electronic information

d) sharing information appropriately about patients or clients for their healthcare while remaining consistent with privacy legislation and professional guidelines about confidentiality…

f) providing appropriate surroundings to enable private and confidential consultations and discussions to take place

g) ensuring that all staff are aware of the need to respect the confidentiality and privacy of patients or clients and refrain from discussing patients or clients in a non-professional context…

Coming in with cameras and worse, no clinical film crews is simply inconsistent with these principles.

With respect to collecting data, and in particular triple zero calls, the Privacy Principles enshrined in law say that an agency that collects data can only use that data for the purpose for which it is collected (Australian Privacy Principle 6).  Agencies received triple zero calls for the purpose of dispatching emergency assistance.  Using it to supply a television channel with content appears to be a breach of the Australian Privacy Principles (Privacy Act 1988 (Cth)).

It is irrelevant to suggest that the footage will only be used with the patient’s consent. It is being being recorded when they cannot consent or even if they can consent it is unfair and unreasonable to ask them to consent at the time of service provision.  How is a patient assured that if they refuse consent, it won’t affect the level of care that they receive when the paramedics have cameras on their uniform and perhaps a cameral crew with them?  When it comes to seeking consent to use the footage, there may be pressure on people too consent given the footage has already been recorded.

With respect to calls to triple zero, it is an offence to share calls made to triple zero.  Under the Telecommunications Act 1997 (Cth) s 278 it is an offence for an ‘emergency call person’ (that is a person who receives triple zero calls and forwards them to the relevant emergency service) to:

… disclose or use any information or document that:

(a)       relates to:

(i)        the contents or substance of a communication that has been carried by a carrier or carriage service provider; or

(ii)       the contents or substance of a communication that is being carried by a carrier or carriage service provider; or

(iii)      the affairs or personal particulars (including any unlisted telephone number or any address) of another person;

A person rings the emergency services and discloses details about themselves to obtain an emergency response.  Those details may be very personal and may be admissible in court proceedings or at least relevant to subsequent investigations.  This legislation says that the person who takes the call is not allowed to share the information – what happens at work stays at work but not if a television station is allowed to record and rebroadcast that recording.

How are these programs legal?

I have no idea. I was asked this question some time ago and wrote to both NSW Police and NSW Ambulance media and received no response. I have no idea how the ambulance services can justify allowing these programs to be made. They may be great PR for the service and good recruiting they may even serve some role in community education but fundamentally they use the patient as a means to an end – the patient is being used for the purposes of the ambulance service or television station.  To film events within an ambulance without the patient’s consent (even if it not used without their consent) is a fundamental breach of confidentiality and trust.

For related discussion, including a paramedics concern to protect a patient’s privacy see Bystanders photographing an emergency (February 2, 2016).