Complex problems require complex solutions: body-worn cameras in public health

As readers will no doubt be aware, violence against healthcare workers is increasing year on year—and not just in the UK (Vento et al, 2020). Ambulance trust staff are particularly at risk, with 33.4% of ambulance staff reporting violence in the workplace, compared with 14.5% in other NHS trusts (NHS, 2020). A key part of the NHS Long Term Plan is to prevent violence against paramedics through rolling out body-worn cameras (BWCs) to act as both a deterrent, and a prosecution tool (NHS, 2019). However, BWCs pose serious ethical and practical questions for the profession, which deserve greater consideration before they are adopted into widespread use.

To understand why BWCs pose an ethical question, it is first important to consider the role of the paramedic in society, the role of surveillance, and to examine some of the predictive factors for patients who can be violent. Paramedics are autonomous professionals who deliver care across the boundaries of healthcare, social care, public health and public safety (College of Paramedics, 2021). Paramedics are also required to shoulder a number of ethical obligations (Health and Care Professions Council (HCPC), 2016) including delivering care to all those who need it, upholding the rights and dignity of all service users and always acting in their best interest.