Reporting Suspected Rioters, Medical Defense Union Advises UK Physicians

Posted by taznetwork at 2:33 AM . Wednesday, August 24, 2011

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Over half of UK doctors have been advised by The Medical Defence Union (MDU) regarding when they can report a patient to the authorities following the riots and looting in cities across England this month.

Although many people have been arrested after being traced by published CCTV images of them, the search for suspects is most likely to persist in the following weeks and doctors may be approached by the authorities for information. The MDU believes this raises questions of when it is suitable for doctors to disclose information without patient consent. Doctors, however, may believe that a patient has taken part in the disorder, possibly because he or she has visited the surgery with unexplained injuries, such as cuts, or because they have confessed their involvement during a consultation.

MDU medico-legal adviser, Dr Yvonne McCombie said:

"While doctors' existing duty of patient confidentiality is central to the doctor-patient relationship, doctors can justifiably disclose information about patients if it is in the public interest. However, doctors don't take this step lightly and members often contact us for advice about their ethical obligations in these situations.
Doctors need to use their judgment to weigh the seriousness of patients' actions against the potential damage to their trust of breaching their confidentiality which may perhaps deter them from consulting a doctor in future. The GMC1 says that information can be disclosed if it is likely to assist in the prevention, detection or prosecution of serious crime. Meanwhile, the NHS Confidentiality Code of Practice2 says that breaching confidentiality can be justified in the case of suspected crimes that threaten serious harm to public order or involve substantial financial gain or loss but may not be warranted in cases of theft, fraud or damage to property where loss or damage is less substantial.
In this context, if a patient is suspected of offenses likely to cause injury, such as throwing missiles, robbery or arson, doctors may feel justified in disclosing information or reporting their suspicions. However, doctors who are in any doubt should first seek specific advice from experienced colleagues or from their defense organization."

Here are the crucial points of the MDU's advice: Doctors who decide to share information with police should do so quickly. The patient's name and address should be the minimum needed for this purpose, rather than their full medical history. In the case that it may not be practicable to seek patient consent or tell the patient if it would undermine the purpose of the disclosure, doctors should document their reasons for disclosing information without consent and why they have not informed the patient. There are sometimes situations when doctors are legally obliged to disclose information about a patient, such as in response to a court order. If this is the situation, doctors are advised to seek specific medico-legal advice right away. Should the patient be a child, the disclosure of confidential information may be justified in the same manner as with an adult, if the doctor believes the child is involved in behavior that could potentially put them or others at risk of serious harm. This again needs to be weighed against the possible damage to the doctor-patient relationship. Doctors who find out that a young child patient rumored to be out alone late at night, might consider whether this suggests they are at risk of neglect or abuse and may want to get advice from the local child protection agency. Written by Grace Rattue
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