Video Recording on EMS Units

Today’s burning question:  My fire department is installing video cameras on each ambulance, covering both inside the cab and box, and outside as well. Is this is legal? I think the administration is merely trying to spy on us and I also wonder about patient confidentiality.

Answer: Interesting question and one that police departments confronted years ago. Let me start off by saying that cameras have caught more than a few police officers doing bad things. In the big picture, is that a good thing or bad thing? I think we’d all agree that it is a good thing. So wouldn’t we be a bit hypocritical to use a different set of standards when it comes to ourselves?

Perhaps the bigger point to consider with regard to law enforcement and videos is – as much as cameras have captured some police officers acting improperly – they have caught way more bad guys acting improperly… including many who try lie about it and accuse the officers of misconduct. By far, most police officers now believe in dash cams and most can recite story after story where officers have been exonerated from allegations of wrongdoing by virtue of video surveillance.

But your question was not about whether video cameras were a good idea or bad idea… right? Your question was about the “legality” of video surveillance.

There are a number of issues that can arise when an employer decides to use video surveillance in the workplace. Arguably it is a change in working conditions that in a union environment must be negotiated. Some states (Connecticut) require advanced written notice to employees before an employer can engage in any form of electronic surveillance in the workplace.

In an EMS environment there are also patient privacy and medical confidentiality issues. Confidentiality issues can be addressed by ensuring that videos are properly secured and that personnel do not violate confidentiality by improperly accesses, viewing or disseminating them. In most respects managing the videos would be no different than how we manage patient information in our run reports.

The bigger legal question is privacy. In this regard states differ tremendously.

There are two sets of concerns: audio and video.

In regards to audio, it is illegal for someone to secretly record a conversation they are not a party to. This principle holds true in all 50 states.

While employees can be required in advance to consent to audio recording as a condition of employment (assuming any collective bargaining hurtles are successfully cleared), the same cannot be required of patients and third parties. Therefore, to the extent that the video cameras record audio and capture conversations between parties who have not consented, the recordings may violate state law. Most states require the consent of at least one party to a conversation for it to be recorded, and 12 states require the consent of all parties.  The consent issue can be addressed in most states by placing warning signs cautioning others that they are being recorded – but it needs to be thoroughly researched on a state level… and it is not a perfect solution.

In regards to recording video, there are a number of states that prohibit the use of cameras in certain areas. Some states limit photo and/or video recording in areas such as bathrooms, changing rooms, locker rooms, bedrooms, and patient treatment areas. Other states refer to any location where people have an “expectation of privacy”. The back of an ambulance could be one such place where a patient believes he/she has an expectation of privacy. Again, it is important to know your state laws.

In terms of a overcoming a patient’s expectation of privacy in the back of an ambulance, that can be addressed through the proper placement of signs, similar to the way we would address audio recording.  However, with regard to signs there remains the issue of language barriers, folks who cannot read, and the blind…. Lots to think about!

So the bottom line is – there are a few legal issues that need to be addressed in order to put video cameras on EMS units.  Using cameras that record both audio and video raises a few more issues than cameras that record video only, but in either event it is probably doable in most jurisdictions if done right.

About Curt Varone

Curt Varone has over 45 years of fire service experience and 35 as a practicing attorney licensed in both Rhode Island and Maine. His background includes 29 years as a career firefighter in Providence (retiring as a Deputy Assistant Chief), as well as volunteer and paid on call experience. He is the author of two books: Legal Considerations for Fire and Emergency Services, (2006, 2nd ed. 2011, 3rd ed. 2014, 4th ed. 2022) and Fire Officer's Legal Handbook (2007), and is a contributing editor for Firehouse Magazine writing the Fire Law column.
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