Guidance Offered on Police Access to Patients

By Dixon, Bruce K. | Clinical Psychiatry News, February 2007 | Go to article overview

Guidance Offered on Police Access to Patients


Dixon, Bruce K., Clinical Psychiatry News


CHICAGO -- What should a physician do when a police officer walks into the emergency department and seeks permission to interview a patient?

This scenario occurs daily in hospitals across the country, yet law enforcement access to patients is not explicitly regulated by federal or state law, relevant professional guidelines are negligible, and medical literature on the subject is minimal, Dr. Paul M. Jones said at the annual meeting of the American Academy of Psychiatry and the Law.

Decision making by both clinicians and police is therefore unstructured, ad hoc, and potentially susceptible to adverse outcomes that might be preventable with appropriate guidance, explained Dr. Jones of the division of child and adolescent psychiatry at New York University, New York.

"The most common situations that the police are investigating are motor vehicle and other kinds of accidents, followed by assault and attempted murder," he said. "The patient being interviewed is a witness, a victim, or a suspect, and the police are often in a hurry to get information to help find a perpetrator or build their case."

Particularly in the emergency department, police efforts to obtain immediate access to patients may delay or interfere with patient evaluations or procedures, or worsen a patient's medical condition. In addition, physicians responding to police requests for interviews must reconcile two potentially competing ethical imperatives: to respect the decisions of competent patients, and to protect patients and possibly others from harm, said Dr. Jones and his colleagues in a recently published commentary (JAMA 2006;295:822-5).

Writing for the Massachusetts Work Group on Law Enforcement Access to Hospital Patients, Dr. Jones and his colleagues proposed five recommendations or principles around which guidance for clinicians responding to police interview requests could be framed. The first principle deals with respect for patient autonomy, explained Dr. Paul S. Appelbaum of the division of psychiatry, law, and ethics at Columbia University, New York.

"Although there's been a clear assumption until now ... that it's up to the doctor to decide whether the police speak to the patient, we would like to suggest a shift of conceptual framing--that in the general case, this ought to be the patient's decision" after he or she is informed of the medical risks of delay or stress inherent in interrogation, said Dr. …

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