I disagree with you Vic, your intentions are correct but informing the
Police protects the public from the perpetrator (alleged) which is arguably
more significant than the woman from the inconvenience of Police interviews.
Informing the Police in no way commits a person to court and cross
examination. If she refuses to support the prosecution, it will be unlikely
to reach court. As you know I do a lot of forensic work, and would argue
that by contacting the Police you will be giving this lady access to
specialist forensic medical teams which may include forensic gynaecologists
but more frequently forensic physicians, and depending on locality
counselling/ victim support and an appointment for STDs, screening and post
coital contraception plus consideration of PEP.
In fact if she doesn't need PEP, it may be more satisfactory to refer to
Police (with consent) immediately and make no attempt to examine her for
fear of contamination and weakening forensic evidence.
What you are dealing with is handling disclosure of a vulnerable adult and
she may never try to disclose again if we screw up!! Remember rape is
punishable by life imprisonment for a reason, it's the same sentence as
murder - would you hesitate reporting a distressed daughter who confides
that she has just smothered her elderly aunt at home, whom you knew to be
living in pain from terminal cancer...
Don't let another Ian Huntley loose on our society. Imagine if this victim
was just the tip of the iceberg, the police could be alerted to a
psychopath, even if on this occasion they were unable to prosecute. Don't
assume the police will handle it very badly and the whole thing will be
awful and do talk to your MDO!!
Best wishes
Jeremy
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Vic
Sent: 19 June 2005 20:00
To: [log in to unmask]
Subject: Re: Rape & confidentiality & ED vs GP
You think Nitroprusside will work!
I'm sorry but I disagree with informing the Police without her consent. The
woman has just had her privacy and autonomy violated by one man and you have
the arrogance and audacity to think you have the right to do it a second
time?
You MUST let her decide whether she wants to face humiliation of a cross
examination in Court, and you have NO right to initiate the pressures that
will be applied by the Police if she does not want to press charges.
She has to make the right decision and she needs the handling that persuades
people to make painful decisions all professional people have to use. That
she will need time to make that decision, we are all, thank God, in
agreement over
Vic Calland
(I would have preferred an oral beta blocker to a Nitroprusside infusion..)
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Simon Odum
Sent: 19 June 2005 09:22
To: [log in to unmask]
Subject: Re: Rape & confidentiality & ED vs GP
You're a very sensible doc, Jel!
Seriously though - if we leave Vic on the Nitroprusside infusion for a few
days - as I understand the GMC guidelines we have a duty to report violent
crime if we feel there is a risk to the public.
Just after yesterday's posts I was talking to a barrister about this, and
her reply was very interesting. Apparently a senior judge has recently
incensed the Bar by stating that rape is not a violent crime. Maybe an
altered guideline is in the offing to specifically cover such offences.
However the "cry for help" theme is what my barrister friend seized on. The
Asian communuity see us as responsible professionals (if only they could see
this list sometimes!) and this lady could easily have been asking us to call
the police for her, even if she didn't say so in so many words. Having had
my conversation with my friend, I have to backtrack now and say that I very
likely WOULD call the police in future if this kind of case arises. Maybe
that is because I now feel on firmer legal ground, but I will still be
cautious.
Still entails spending 2-3 hours with the patient though. Don't have a
problem with that. Just the state of the ED when I get back out on the shop
floor, as Peter was saying earlier.
Simon
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]]On Behalf Of Peter Cutting
Sent: 17 June 2005 08:43
To: [log in to unmask]
Subject: Re: Rape & confidentiality & ED vs GP
Jel,
That fence must catch you in a very sensitive area from time to time though?
Peter
>>> [log in to unmask] 08:36:12 17/06/2005 >>>
Peter Cutting wrote:
> Thanks for all your thoughts.. I was particularly impressed by the GP vs
ED side spat.. always good for a giggle..
See me, my insurance category is GP with Emerg - because I work as both
an emerg doc and a GP - so I can choose to stand on whatever side of
whichever argument whenever I choose :) :)
(fortunately, no longer in the UK though)
Jel
________________________________________________________________________
Doctors.net.uk e-mail is protected from spam and viruses
Doctors.net.uk - the network of 114,000 UK doctors
_______________________________________________________________________
|