Sunday, February 16, 2014

Why would police have to search a hospital patient?

From The Ethicist:
My emergency unit handled a man who had been shot in the leg in the early hours of the morning. The trauma surgeons refused to have him transferred to the ward for wound management because they believed the victim would be pursued by his assailants, thereby posing a safety risk to staff members and patients. The police in the E.R. declined to pat down the injured man for weapons, as they were not legally empowered to do so. The man was retained in emergency for 12 hours. The emergency unit, which has an open-door policy for all comers 24/7, would most likely be the first place that assailants would look for an injured man. Are there ethical ramifications with the transfer of violent risk?
I was surprised that the letter-writer was focused on whether the police could pat down the injured man, because it seems to me like the medical professionals could undress him (and thereby disarm him) or otherwise determine what he's carrying in the course of medical care. I don't know how medically ethical this is (which is probably why it wasn't mentioned in the Ethicist column), but from a purely logistical perspective it seems perfectly feasible.

He's been shot in leg, so it's perfectly reasonable to remove his pants. And people usually remove their footwear as part of removing pants. They could then put him in a hospital gown so he's not sitting around undressed, and logistically they'd probably have to remove, at a minimum, all but his bottom layer of shirts - perhaps all his shirts.  If the hospital gown isn't necessary, they could also ask him to take his jacket/sweater/everything but t-shirt off  to take his blood pressure or something.

Once he's down to a t-shirt and undies they'll probably be able to tell if he's carrying a weapon.  And if they can't, they could do the "put the stethoscope on the patient's chest and have the patient breathe deeply" thing, which will allow them to lift the patient's shirt enough to see if there's anything underneath.

And all that's before we even get into the possibility of checking the patient's body for more wounds, which seems like something you might do when treating a patient who's been in a gunfight! Or x-raying a gunshot patient to verify the location of all the bits of bullet.

If the patient isn't searched by police officers and instead simply receives medical care from medical professionals, he's more likely to perceive the hospital as a safe place where there's no threat to him.  And the police in the ER would hopefully be able to keep out the people who are trying to kill the patient, so the patient would have no reason to draw any weapons he might have on him.

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