When the Police Come Calling

The police are more-or-less a permanent fixture in every Emergency department. They bring in the drunks, the suicidal, the psychotic, the homeless and yes, the criminal, who have either sustained injuries as a result of their activities, or else have developed sudden (and convenient) cardiac symptoms upon their arrest. Most of us in Acme Regional’s ED will cooperate with the police to the point of expediting whatever they need us to do, which usually means filling out the Form 1 or medically clearing the patient. At the same time, most of are pretty clear that ED nurses and physicians are not an extension of the Police Service: police objectives and those of health care, to state the obvious,  are not the same.

It isn’t exactly mistrust. It’s more a wariness. There are ethical and legal issues involved. We cannot, for example, divulge patient information, so there is the constant dance of the police asking for information they know we won’t give them.  Come back with a subpoena, we tell them. They try anyway.

Then there is this: what do when the police bring in someone who, well, they’ve been beating on. It isn’t common, I should emphasize, but it isn’t so rare that it excites comment either. The police will say (nudge, nudge) the patient fell on the pavement while being arrested. Or banged his head while getting into the cruiser. Or the wall hit his face. Which may even be partly true. The patient usually says nothing at all.

So what do we do about it? Approximately nothing. We might document the injuries, in case there are  legal problems down the road. Or not. We are definitely not going to make any allegations about misuse of force. Who wants to travel that road, full of traps and pitfalls and paper by the mile plus, of course, the undying enmity of the local cops? I have seen a few pretty egregious cases, and we did exactly that — nothing. As well, I suppose many of us don’t want to second guess the police: I mean, who knows how things really go down, right? And we say, didn’t he deserve it anyway?

But how does this make anyone accountable? Including ourselves? And don’t we have a legal system in place to adjudicate innocence and guilt, and administer punishment?

It’s a moral swamp. And having thought about it long and hard, I’m not clear what, if anything, that can be done about it in practical terms. ED staff are not the guardians of the guardians. So we document. Poor excuse, I know.

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  1. #1 by edwin on Thursday 07 June 2012 - 1227

    This is not something new. From 1984 http://www.youtube.com/watch?v=-QfdHPoU300

    This post is too important to leave without comment. First things, you just did something very important by commenting on the situation. It is in silence that things like this happen and get worse. It is through exposure that police brutality will end.

    Ideally, you should deal with the issue in the same way that you would deal with a woman who appears to have been battered by her husband, or any other crime that comes to your attention. As I don’t work in the medical field, I don’t know what that would be.

    I think that a policy at the hospital level would be the best way of dealing with the problem. I wonder if such examples of brutality leave hospital workers potentially libel where it is clear that someone was beaten, and nothing was done. Documentation not only helps the patient, I think.

    By all means, keep documenting – it sounds to me like an excellent response. A photo or two might really help. Don’t short change the documentation. (Witnessing is always very important) Perhaps a hint to a defense attorney – or an interview with the patient – how did you get these injuries – without the police in listening range.

    “And we say, didn’t he deserve it anyway?” Perhaps it is true, but we did not deserve to have our legal system soiled in that manner. While individuals may deserve much or worse, we, as a society deserve a better legal system and a better law enforcement system. What we do for the worse of society, we end up doing for everyone.

  2. #2 by torontoemerg on Thursday 07 June 2012 - 2359

    Yes exactly. Thank you for your lengthy reply. I think the most frustrating thing (for me anyway) is the sense of powerlessness to effect change. But you are exactly right on the importance of witnessing.. . .

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