If you're ever contacted by the police, in most cases there will be no need for concern. But before responding to any contact, it's important to think about why you might have been approached.
Perhaps the most common and familiar reason for the police to contact a doctor is to request factual information about a patient. This might relate to a crime or other offence where the patient was either the alleged perpetrator or the victim.
Factual witness
The importance of medical confidentiality is well-known. It is mentioned in the Hippocratic oath and the Declaration of Geneva, as well as in regulators' guidance:
However, medical confidentiality is not absolute, and there will be circumstances when disclosing information about patients is permitted or even required.
Disclosure is permitted, and will usually be straightforward, if the patient has given consent. It is reasonable to ask the police if they have sought and obtained consent, and, if not, if they are prepared to do so - or, alternatively, if they are happy for you to seek consent.
This is unlikely to be problematic where the patient is the victim of the alleged offence. But if the patient is the alleged perpetrator, approaching them for consent could prejudice an ongoing investigation. The police will usually explain if that is the case.
In the absence of consent, you should consider if the disclosure is required by law - for example, if you have been given a valid court order - or if there is a public interest in disclosure that outweighs both the patient's own private interest in their information remaining confidential, and the wider public interest in there being a confidential medical service.
Whether disclosure is in the public interest will vary from case to case, but factors which you will wish to consider will include:
- the seriousness of the alleged offence
- whether the police would be able to obtain the same information from another source
- if the patient is the alleged perpetrator, whether they are in custody (and thus not a risk to anyone else).
Remember, the onus is on the law enforcement officer to give you enough information to justify any disclosure.
If you do choose to disclose information without consent, you should disclose the minimum amount of information relevant and necessary for the particular purpose. It's also important to carefully record what information you have disclosed and your justification for doing so. Similarly, if you declined to disclose information, you should carefully record your reasons.
Medical confidentiality is not absolute, and there will be circumstances when disclosing information about patients is permitted or even required.
Coroners/procurators fiscal
The police can help with investigating cases that have been reported to the coroner or procurator fiscal - for example, by taking statements relating to the death - but this doesn't mean a crime is suspected.
It will usually be appropriate to share relevant information with the law when they are acting for the coroner/procurator fiscal. This could be by providing a written statement or by sharing the relevant medical records. For more information, see our guide to disclosing information to third parties.
Criminal matters
Of perhaps the greatest concern for doctors is the possibility that they will be contacted by the law in relation to a criminal matter where they, the doctor, are suspected of having committed an offence.
Of course, doctors might find themselves subject to investigation for matters independent of their professional role in entirely the same way as any other individual, and criminal investigations arising out of professional medical practice are much less common.
Sadly more common is that a doctor will face an allegation of having committed a sexual offence against a patient. Such allegations often relate intimate physical examinations, and it is important to be aware of and where possible comply with the relevant guidance on this, including the appropriate use of chaperones.
In the event of a doctor being arrested and detained, they should be made aware of their right to consult with a solicitor before they are interviewed. They are also entitled to have a solicitor present during an interview, and should be advised of this.
If there is any suggestion that a patient has approached the law raising concerns about your conduct that might prompt a criminal investigation, contact your defence organisation immediately.
In summary
Being approached by law enforcement is not unusual. The nature of their role is such that contact can provoke anxiety, but in most cases there is nothing to be concerned about.
Applying the same basic principles about confidentiality and disclosure to a request made by the police that you would apply to any other request will often help to resolve any concerns you may have.
Depending on the nature of the request and your working arrangements, it will often be appropriate to seek input from the person in your organisation responsible for dealing with requests made under data protection or freedom of information legislation.
If you're an MDU member and you need advice after being contacted by the police, remember that our medico-legal advisers are only a phone call away. Contact us here.
Dr Edward Farnan
Medico-legal adviser
Dr Edward Farnan
Medico-legal adviser
MB BCh BAO LLM FRCGP DGM DCH DRCOG
Dr Farnan graduated from Queen's University, Belfast, in 1995 and completed his GP training in Northern Ireland, practising as a principal in general practice in Armagh for 11 years. He also sat on a research ethics committee, and had a particular interest in clinical governance.
See more by Dr Edward Farnan