Emergency Medicine

(Nancy Kaufman) #1

Police, Coroner and Attending Court


Administrative and Legal Issues 453

(i) They may receive treatment under common law if there is the
overriding principle of best care by the treating doctor.

5 Similarly a patient deemed not competent due to alcohol, drugs or medical
illness causing acute confusion may be advised to stay against his or her will
under common law, if there is an overriding medical precedent to continue
care, such as following a head injury in an intoxicated patient.


POLICE, CORONER AND ATTENDING COURT


The police are involved within the ED in a number of ways.


Police request for patient information


1 All medical information concerning the care of a patient in the ED is confi-
dential and must not be divulged without the patient’s written consent,
except on beha lf of a coroner (or procurator f isca l in Scot land).


2 Traffic police investigating a crash may be told the name, address and age of
any patient involved, and a brief description of the injury, and in particular
whether the crash is likely to prove fatal or whether the patient is to be admit-
ted or sent home.


3 A doctor may disclose information to a senior police officer concerning a
patient suspected of being involved in a serious arrestable offence, such as
murder, rape, child abuse, armed robbery or terrorist activity, thereby acting
in the public interest for the safety of the lives of others.
(i) Obtain the advice of the senior ED doctor or hospital
administration whenever there is any doubt as to the
appropriateness of releasing information to the police.


Police request to interview a patient


1 Grant permission if the patient is medically in a fit state to be seen, after
informing the patient.


2 The doctor may suggest a time limit.


Police request for an alcohol breath test or blood sample


1 The doctor should first give the police permission to perform these, provided
the patient’s clinical condition will not be adversely affected.


2 Permission cannot be granted in certain circumstances: if the patient is uncon-
scious, critically ill, or incapable of cooperating, possibly due to a facial injury.
Local legislation may still permit a blood alcohol sample to be drawn.


3 Inform the patient that you have allowed the police to be involved if permis-
sion is granted, and write in the ED record that in your opinion the patient
was fit to be seen at the time.

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