Technological advances and digitalisation are opening up new possibilities in healthcare. Tools to support diagnosis, treatment and care are now widely used in clinical practice, including digital surveillance systems. Long used in intensive care, they are now making their way into inpatient and long-term care facilities, promising greater safety and efficiency. When considering the use of such tools, the ethical, medical and legal aspects must be weighed carefully against the expected benefits, particularly in the context of continuous and widespread surveillance systems.
Particular attention must be paid to protecting the privacy of inpatients and nursing home residents. These individuals are forced to temporarily or even permanently give up their private space due to their dependence on medical or nursing care. This applies to all areas of inpatient care – from acute hospitals and psychiatric wards to rehabilitation clinics and long-term care facilities.
Digital surveillance systems, whether visual, audio or based on artificial intelligence, are used to improve the quality of care. They interfere with privacy to varying degrees, affecting those being monitored as well as their relatives, visitors and healthcare professionals.
In many circumstances, the use of digital surveillance systems has become indispensable as a complement to care and treatment. In intensive care units, for example, real-time image transmission helps to identify critical situations when no professional is present at the patient's bedside. The temporary use of digital surveillance systems, when medically indicated, can enhance patient care and is often deemed acceptable. However, non-anonymised (continuous) audio and video surveillance with data recording and storage raises ethical and legal questions. Careful consideration should be given to whether it is authorised and permissible.
When assessing digital surveillance systems, it should also be noted that, depending on how they are used, they can act as measures that restrict liberty. Restricting freedom of movement or personal liberty constitutes a coercive measure. Although those affected may perceive a digital measure as less invasive or restrictive than other means, such as pressure mat sensorsor one-to-one observation, the same medical-ethical and legal provisions apply as for other coercive measures in medicine.
Position statement by the Central Ethics Committee of the SAMS
In the summer of 2025, the Central Ethics Committee (CEC) set up a working group to examine the opportunities and challenges associated with the use of digital surveillance systems and to provide recommendations for their responsible use. Chaired by Prof. Dr iur. Regina Aebi-Müller, the group's task is to prepare a position statement.
The position statement is expected to be published in summer 2026.
Composition of the working group
Prof. Dr. iur. Regina Aebi-Müller, Luzern, Law (Chair)
Dr. iur. Dominika Blonski, Zürich, Law
Dr. med. Rebecca Dreher, Morges, Geriatrics
Dr. med. Antje Heise, Thun, Intensive Care Medicine
Dr. sc. med. Manya Hendriks, SAMW, Bern (ex officio), Ethics
Dr. iur. Iris Herzog-Zwitter, Bern, Law
Prof. Dr. med. Stefan Klöppel, Bern, Geriatric Psychiatry
Prof. Tanja Krones, Zürich, Ethics
Bianca Schaffert-Witvliet, Schlieren, ANP Medicine, Long-Term Care