It's compelling television, to be sure. But there is a growing debate about whether allowing cameras to capture vulnerable medical moments like these represents a violation of trust between doctor and patient. Critics charge that shows like Houston Medical and The Learning Channel's Trauma: Life in the ER are at worst voyeuristic and exploitative. And they argue that in an emergency medical setting, allowing patients to be filmed for commercial reasons is almost always unethical.

A patient in the process of receiving emergency care is usually not in a position to judge what is best for them, says Joel M. Geiderman, MD, director of Cedars-Sinai Medical Center's department of emergency medicine. And filming often takes place at hospitals that are overrepresented by poor and minority patients, who may not feel they can say no.

In an article published July 17 in The Journal of the American Medical Association, Geiderman and colleague Gregory Larkin, MD, explore the ethical and legal issues surrounding the commercial filming of hospital patients.

Houston Medical was filmed over the course of one year at Houston's Memorial Hermann Hospital. A hospital spokesman declined to discuss the filming with WebMD. But Hermann is just one of a large number of respected hospitals -- including UCLA and Johns Hopkins -- to allow commercial film crews through its doors.

Geiderman tells WebMD that he began researching the issue when producers of "Trauma: Life in the ER" asked permission to film in his emergency department. The producers routinely tape patients during treatment and then obtain their permission after the fact.

"I considered it a complete violation of our patients' privacy, so I said no," he says. "Everybody wants their 15 minutes of fame, so I wasn't all that popular around the hospital for a while. But the head of our bioethics program agreed that getting permission after the fact is not ethical. By that point the patient's privacy has been violated."

Geiderman and Larkin contend there are also serious legal ramifications to filming patients without their permission. They cite the case of a wife who sued NBC after seeing her husband's fatal heart attack on television several weeks after his death. A film crew had followed paramedics into their home without consent. The network eventually settled out of court.

Two of the country's largest emergency medicine organizations -- the American College of Emergency Physicians (ACEP) and the Society for Academic Emergency Medicine (SAEM) -- recently weighed in on the issue of cameras in emergency rooms. Both groups found the practice to be problematic, and SAEM came out strongly against allowing filming for commercial reasons.

"Image recording by commercial entities does not provide benefit to the patient and should not occur in either the prehospital or Emergency Department setting," the SAEM statement reads.

Medical College of Ohio associate professor Catherine A. Marco, MD, leads SAEM's ethics committee and co-wrote the policy statement. She disagrees with the argument that filming patients is justifiable because it serves an educational purpose.

"Shows like ER that use actors serve the same educational purpose without involving real-life patients in traumatic situations," she says. "These programs take advantage of people during their worst moments, and I, personally, don't think there is any need for it."

Emergency medicine specialist James Adams, MD, agrees that filming emergency patients violates their trust. Adams is a professor of medicine at Northwestern University's Feinberg School of Medicine and is chief of the emergency medicine at Northwestern Memorial Hospital.

"Patients have to trust us, not only to deliver technical quality, but also to maintain their confidences and to be their advocates," he tells WebMD. "Commercial filming doesn't further those ends. It threatens the very business we are in because it threatens our obligation to our patients."