Patient’s consent must for live broadcast of surgery

Hyderabad: In these days of teleconsultation and robot-assisted telesurgery, many private hospitals have started commercially exploiting patients by using them unwittingly as models through surgery broadcast in conferences. To curb this intrusive and unhealthy practice, the National Medical Commission (NMC) has issued guidelines to regulate the conduct and broadcast of live surgeries by insisting on prior permission from the patient, relevant regulatory bodies and the state medical councils concerned.

The Ethics and Medical Registration Board of the NMC has issued a public notice following a writ petition filed in the Supreme Court in the matter of Rahil Chaudhary and others vs. Union of India and others. NMC secretary Dr Raghav Langer said the petitioner held that many private hospitals were commercially exploiting the patients and using them as models to fulfill their ulterior motives through live surgery broadcasts in conferences. Various companies were promoting themselves and making a fortune out of the miseries of the exploited patients.

Advertising sponsorship and professional showmanship overshadow the true purpose of these broadcasts. Healthcare facilities showcase their capabilities, surgeons flaunt their skills and companies promote their products at the expense of patient safety.

In pursuance of the petitioner’s prayer, a committee was constituted by the NMC to give recommendations to ensure that guidelines and regulatory framework was made to regulate the conduct of live surgery broadcast. Based on the report by the committee, detailed guidelines were made to regulate the conduct and broadcast of live surgeries.

The report expresses concern on the live surgery. The report said, “While live surgery can be educational, it may not provide the same depth of learning as interactive or hands-on training. Observers might miss key details or fail to grasp complex nuances of the procedure. Live surgery, in any case, may seem valuable for experiential learning, however, it lacks concrete evidence supporting its educational effectiveness when compared to pre-recorded surgical videos. Pre-recorded videos offer better frame-by-frame analysis, video editing, and labelling, enhancing the educational experience.”

In the name of live surgery, patients are probably commercially exploited and used as models to fulfil ulterior motives of various companies, which is complete ignorance of the ethical standards laid down for surgery by the NMC to make a fortune out of the miseries of the exploited patients, the report said.

The live surgeries can be done in accredited hospitals and these should have essential services like OT should have all necessary preoperative, operative and post-operative, laboratory etc.

In view of the above, the EMRB, NMC was in favour of promoting recorded video, wet lab, cadaveric and simulation-based surgeries/procedures as these entails no risk to the patient. The NMC said that prior permission from the relevant regulatory body/Association/institution is mandatory for conducting live surgical demonstrations. Approval must also be sought from the authorities concerned based on the sponsorship of the hospital (e.g. - Dean for government hospitals, State Medical Council for private hospitals).

An apex committee should oversee arrangements to ensure compliance with ethical guidelines, safety protocols, and educational objectives. Professional associations should self-regulate to prevent any promotional or commercial activities during live demonstrations.

The informed consent process should be conducted by the operating surgeon/team and clearly explaining the purpose, risk and right to withdraw consent, according to the report of NMC.