Covert video surveillance: an important investigative tool or a breach of trust?

Abstract

There has been controversy among professionals and the public surrounding the use of covert video surveillance (CVS) in cases of suspected child abuse. Opinion is divided as to whether it is necessary to make a “diagnosis” of child abuse and whether it is ethical and legal. CVS for documentation of apnoea by smothering was first used in 1983,1 and since then more than 20 reports have appeared.2-7 Its primary use is to detect imposed upper airways obstruction, which normally presents in small babies under the age of 1 year with an apparent life threatening event. It is a well recognised entity requiring immediate and urgent assessment. It is a dangerous form of abuse with high mortality and morbidity.8 It can be difficult to differentiate a “normal” apparent life threatening event from an imposed upper airways obstruction purely on clinical grounds. It may require multichannel monitoring of physiological function with concurrent CVS in an environment where prompt action can be taken to protect the child. Covert video surveillance is the video and audio recording of interactions between a child and his or her carer, usually the mother. It is conducted without the knowledge of the carer under strictly controlled conditions within a hospital based paediatric department. It is normally undertaken in a designated cubicle where two cameras (smaller than an electric light switch) are installed to provide coverage of the area from opposing positions. Two cameras reduce the possibility of a single camera angle being inadvertently obscured and abusive behaviour being undetected or misinterpreted. A typical CVS monitoring of a potentially life threatening situation would involve a child under 2 years of age connected to a multifunction polygraph for clinical monitoring in a cubicle. This helps to maintain a fairly fixed position relative to the camera while giving …