The GMC notification in GSW is not something we can argue - we must
report all GSWs and will be in breach of the GMC regulations if we do
not. There is NO requirement formally to report any other assault or
injury except in the circumstances that were agreed between BAEM and
ACPO which I trust all emergency units abide by. These include breaking
patient confidentiality either by reporting an incident or giving
medical details against the patient's wishes in the greater public good,
and I would advise any doctor contemplating this to talk to their
medical director, Caldicott guardian and defence society before wilfully
doing so. Requests made under the Data Protection Act will not be
honoured - the officer must provide evidence that the information sought
is in the investigation of a serious arrestable offence.
The Consultant involved may make that disclosure after due
consideration.
It can thus be seen that the medical director of your Trust has
incorrectly interpreted the guidance, and you can perhaps assist in
redrafting it correctly.
Best wishes
Rowley.
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Rocky
Sent: 17 October 2004 13:42
To: [log in to unmask]
Subject: Re: Stabbings
I'm afraid I disagree here. If someone has been shot , it is almost
inevitably a deliberate act by someone else, or a self-inflicted suicide
attampt, pretty well invariably successful. Thus, there has been a
serious crime committed because virtually all GSWs are potentially life
or limb-threatening. In addition, handguns are illegal (apart from
under the most stringent conditions) so another crime has probably been
committed, by posession of the gun. Furthermore, shootings often happen
in the course of a robbery or another crime so there may be three
different crimes involved. I do not think there are any circumstances
when it is right to withold information from the police about GSWs. I
do not know of one single occasion in Belfast in the last thirty years
or so when the police were not involved and, in practice, they usually
know anyway. As far as stabbings go, I thnk a deliberate stabbing by
another person falls into the same category as GSWs. Again, in
practice, the police often know from someone else. I believe, if a
serious crime has been involved, the police have a right to know and we
have a duty to tell them. Stabbings are usually serious crimes. If the
wound is self-inflicted, I do not think we need to inform the police at
all unless the patient explicitly asks us to do this. So I do not think
there is any real difficulty here and I do not think there is any chance
that a court would find against a doctor who told the police about
either a GSW or a stabbing because they believed there had been a
criinal offence. Sorry for being long-winded. Cheers, Rocky.
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----- Original Message -----
From: "JONES Lewis, Locum Consultant - A&E"
<[log in to unmask]>
To: "Laurence Rocke" <[log in to unmask]>
Sent: Friday, October 15, 2004 3:22 PM
Subject: Re: Stabbings
I'm of the same opinion as Steve here if it is a murder / attempted
murder inquiry then the police will be involved as consent is not an
issue. If the "victim" is still able to give consent i.e. not dead or on
a ventilator then they have every right to withold their medical
information form the police. Lewis
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of Steve Moore
Sent: 15 October 2004 15:14
To: [log in to unmask]
Subject: Re: Stabbings
Duty of a doctor is to maintain patient confidentiality isn't it? This
might be affected if you think the patient has committed a serious
arrestable offence, but sounds like this directive concerns the victim.
I guess the powers that be think this might help develop clues regarding
perpetrators and we all have sympathy with that but the principle
remains.
Would you tell the police about victims of domestic violence without
their consent? I would play this one with a straight bat.
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