Occasionally, law enforcement officers provide security in EDs, serve as emergency responders, arrive to investigate crimes, or bring inmates for medical treatment. Regardless of the reason, “the presence of law enforcement in the ED presents unique and complex legal and ethical considerations,” says Sandra M. Douglas, JD, a partner in the Richmond, VA, office of Hancock Daniel.
ED providers are busy assessing patients and making treatment decisions, while at the same time considering hospital policies regarding law enforcement. “This distorts the typical provision of patient care. This can interfere with patient care [and] create privacy and security issues,” Douglas says.
Because of the complexity of the situation, Douglas recommends ED providers consult hospital security, risk management, legal counsel, or leadership for guidance on policies and applicable laws.
The presence of law enforcement can agitate some patients, or cause others to withhold information over fears the information will be disclosed to police. It creates a situation where state or federal privacy laws can be violated. “The patient may not be in a position to make decisions regarding their medical and legal needs during emergency care,” Douglas explains.
This puts the provider in the position of trying to protect the patient’s privacy and autonomy. “ED providers should document in detail the circumstances surrounding any permitted disclosure to law enforcement,” Douglas says.
ED policies on law enforcement presence should make patient health the priority. “With the exception of extreme risks to public safety, such as in the case of an active shooter, law enforcement should not be able to interview a patient until the treating provider has determined that the patient is medically stabilized,” Douglas says.
Hospitals also face possible legal exposure if they fail to ensure the safety of staff or patients. That includes keeping their patients safe from other patients and visitors. “Whenever there is a potential threat to the safety of staff or patients, it is incumbent on the hospital to either de-escalate the situation through their own security personnel or, if the hospital does not have its own security personnel, to involve local police authorities,” says Heather A. Tereshko, principal at Philadelphia-based Post & Schell.
Some EDs have put policies in place to prevent patients and guests from entering the hospital with deadly weapons. “When a patient cannot be subdued by ED staff, the ED staff are putting themselves at risk for injury and harm, and should defer to law enforcement who are most often better equipped to deal with a violent patient,” Tereshko says. Emergency clinicians should not interfere with the hospital security personnel’s or law enforcement’s response to a violent patient. “It could result in the ED provider being charged with an obstruction or interference crime, even though the ED provider may argue that they were simply trying to help defuse the situation,” Tereshko adds.
The presence of law enforcement can agitate some patients, or cause others to withhold information over fears the information will be disclosed to police. It creates a situation where state or federal privacy laws can be violated. Emergency clinicians should consult hospital security, risk management, legal counsel, or leadership for guidance on policies and applicable laws.
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