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 Surgical activities were classically a public affair – the operating “theatre” was open to colleagues, family members, and even the interested public. In the 20th century, however, the operating room became increasingly sequestered for clinical, social, and legal reasons, leading to a substantial disconnect between what patients and the public expect occurs during surgery and what operating room insiders know about surgical proceedings. Decreasing trust in most institutions (e.g., medicine, government, law enforcement), increasing demands for transparency from these institutions, and a desire for more patient empowerment have brought about a new environment of accountability regarding operating room activities. Such trends are beneficial in many ways, but have complex ethical, legal and practical consequences that need clarification and careful attention as increased surgical surveillance develops.

An important part of this new environment of accountability are technological innovations that enable continuous recording of operating room activities (video, audio, and other sensor data). These are designed to support quality improvement, performance assessment, and patient safety, and they have shown significant promise in enhancing surgical care. Furthermore, both nationally and internationally, lawmakers have proposed mandatory operating room recording for these reasons. However, the potential for widespread recording of operating room activities combined with expectations of transparency raises many difficult, unanswered questions in need of close study and analysis.

This first global conference on the Ethical, Legal and Social Implications of Surgical Video brought together experts in ethics, law and surgery to examine the potential impact of this paradigm shift towards objective recording. The meeting included public panel sessions, as well as breakout groups to identify knowledge gaps and set research agendas for the coming year.

The leadership of this conference values inclusion and diversity, the voice of the public, and elevation of early-stage researchers and scholars; this meeting was planned and conducted in accordance with these values.