The ethics of video-recorded informed consent: A qualitative study of expert perspectives

ABSTRACT

Introduction: Informed consent is a fundamental process, yet standard written documentation occasionally fails to capture the nuanced interactions of clinical encounters, contributing to increasing medical litigation. While these challenges span the broader Malaysian healthcare system, they carry significant implications for primary care, where high patient volumes and complex consultations require a delicate balance between clinical efficiency and robust documentation. Video-recorded informed consent (VIC) offers a high-fidelity alternative, although its viability remains largely unexamined. This study investigated the ethical, legal and operational challenges of implementing VIC within contemporary medical practice.
Methods: This study employed a qualitative design to navigate an intervention that is not yet standard practice. Purposive sampling was used, and 10 experts comprising healthcare professionals, institutional stakeholders and legal experts were interviewed. Data were analysed inductively and deductively based on Beauchamp and Childress’s Four Principles of Biomedical Ethics.
Results: Thematic analysis revealed four themes: consent for recording, privacy and confidentiality, legal implications and systemic resource constraints. Experts recognised VIC’s capacity to preserve critical nonverbal cues and nuanced interactions, offering superior evidentiary value compared with written records. However, significant ethical and administrative tensions were identified, particularly regarding the logistical friction of a ‘dual consent’ model and heightened anxieties surrounding data security and patient privacy.
Conclusion: While VIC can enhance communication and disclosure fidelity, its integration depends on resolving privacy, legal and resource challenges. Sustainable adoption requires balancing digital ethical risks with technology that elevates patient-centred care. For general acceptance, standardised operating procedures for consent workflows and data protection are essential.