Concepts health leaders need to know when interacting with police
I am often asked by health leaders what to do when police arrive and need information about patients.
Police officers and police departments are important community partners for health care organizations. As citizens, we all rely on the police to protect us and enforce the laws. It is vital to the success of all health care organizations that you have a constructive and appropriate relationship with your local police force.
Here are six points health leaders need to know and think about when interacting with police:
1. Safety trumps privacy. In Ontario, our laws support health care organizations, clinicians and leaders calling police if there is an imminent significant risk of serious bodily harm to an identifiable person or group. As shorthand to help people remember, I call this “safety trumps privacy.” If there is a serious situation, someone’s life is at risk, and calling police is the best way to respond to that risk of harm – call police. The health privacy law, the Personal Health Information Protection Act, and cases that have gone to court support the “duty to warn” and the concept that these serious cases override general privacy obligations.
2. However, there is also a “general limiting principle” when reporting these serious situations to police. The principle has two parts: (1) if you do not need to share identifiable health information with police to make your report – don’t share the health information; and (2) if health information is necessary to the report, only share the minimal amount of identifiable health information that will fulfill the purpose – don’t share more than is necessary. For example, if you need to call police because there was a physical altercation on your premises – you can report what was witnessed in the altercation, but usually not the health histories of each of the people involved because their health histories are not necessary to the report to police. Then follow point number three below.
3. Abide by the law. You must share personal health information with police if you are required by law to do so. For example, if there is a court order or other court document that requires you to share information with police, you must do so. Police may also be authorized to collect information by the coroner to complete a coroner’s investigation. If that is the case, ask for a copy of the coroner’s directions. Another way you may be required by law to report is if a statute requires you to do so. For example, in Ontario, hospitals are required to call police if they are treating a person for a gunshot wound. However, that law does not extend to primary care offices, long-term care homes or community health centres for example.
4. Do you have consent? You can always share personal health information about a patient with police with the consent of that patient (or the patient’s substitute decision-maker if the patient is incapable of consenting).
5. Police have a job to do – it is their job, not yours. If and when you call police to respond to a crisis or criminal act, know that they have a job to do. They may do that job differently than you would. Sometimes they will not act. Sometimes they will, in your view, “overreact.” Sometimes they will not be as concerned about activity as you are. Sometimes they will take stronger action than you would have wanted. When police are on-site at your organization, health leaders can make suggestions, requests and ask questions of police officers – but don’t be surprised if they cannot share information with you or if the outcome isn’t what you imagined when you called for help.
6. Your front-line staff feel ill-equipped to manage these situations. When dealing with police, emotions run high. There is a natural tendency to want to cooperate and assist police in their investigations. Front-line administrative and clinical staff should not be making calls about what information to release to police or arranging interviews. They should be trained on who to call in your team when police arrive and to advise police that a supervisor, administrator on-call or executive will be able to respond to their queries.
Here are some additional resources that may help you navigate issues of police and health care:
- CMPA, Physician Interactions with Police
- Healthy Debate, Improving handoffs between police and emergency departments
- CMHA, Creating a police hospital transition framework for Ontario
- CNO, Police access to information