Today’s correspondent says:

[I am] a Registered Nurse and Medical First Responder for our community, I was recently dispatched to aid an elderly person who had fallen on the sidewalk. The call for help to our organisation came through by a passer-by who witnessed the fall. Upon my arrival, I encountered police officers who had stopped to assist the patient a few minutes before my arrival.

The police officers present insisted that I shouldn’t perform any assessments or treatments. They stated that an ambulance was on its way, and they preferred not to subject the patient to repeated questioning once the paramedics arrived. They continued to say that the patient is clearly conscious and breathing so there is no need for us to assess.

I attempted to explain the importance of a comprehensive assessment and treatment, emphasising the potential for underlying issues like hypoglycemia that might not be immediately apparent. I stressed that an imminent and thorough evaluation was critical to prevent any possible adverse outcomes. However, the police officer insisted that I refrain from treating the patient, despite the patient’s willingness to be assessed and not being in police custody.

My primary concern is whether the police officer had the authority to prevent me from providing necessary care. I also want clarification on where the “duty of care” lies in this scenario—whether it falls under my responsibility as the attending clinician.

The short answer is ‘no, the police do not have the authority to prevent you from providing care if the patient is happy to talk to you’.

The long answer is If the patient was objecting and wanted you to go away, the police may have some authority to remove you but otherwise no, the police do not have the authority to prevent you from providing care if the patient is happy to talk to you.  The police may have ‘preferred not to subject the patient to repeated questioning once the paramedics arrived’ but it was really nothing to do with them. The person was free to talk to whosoever they wanted.  And if the patient was not competent then reasonable care that was in the patient’s best interests could be provided.

On this statement of principle, I wish to observe that officious intervention cannot be justified by the principle of necessity. So intervention cannot be justified when another more appropriate person is available and willing to act; nor can it be justified when it is contrary to the known wishes of the assisted person, to the extent that he is capable of rationally forming such a wish. (In Re F [1990] 2 AC 1, emphasis added).

Police intervening to stop a health practitioner providing care sounds like Lord Goff’s ‘officious intervention’.

Having said that one has to remember the old-fashioned offence of ‘not show proper respect to police’. Not actually an offence on the statute books but one that often gets people into trouble. If the police really want you to leave, they may give you a direction (see for example Law Enforcement (Powers and Responsibilities) Act 2002 (NSW) (LEPRA) s 197).  The direction may not be ‘reasonable’ but if it’s given, and you don’t comply, you may be arrested (LEPRA s 99). A court may later agree with you that the conditions for making the order did not exist, or the order was not reasonable, or it did not justify an arrest but that’s a whole lot of trouble for your efforts.  So whilst police, ‘do not have the authority to prevent you from providing care if the patient is happy to talk to you’ they certainly have to power to require you to comply with their directions even if those directions are not justified or reasonable.  Discretion is often the better part of valour.

As for duty of care, everyone has a duty of care – it is not a question of finding one person with a duty.  As a health care professional who has come to the aid of a patient you have a duty to act reasonably in the circumstances. You do not have a duty to make their condition better, but you do have a duty not to, by your actions, make it worse.   The police will also owe a duty to take reasonable care and that may well be a duty not to stop a health professional intervening if that that professional would or could stop the patient’s condition getting worse.

If an ambulance arrived and the patient gets the care they need, and it turns out that assessment by the health care practitioner would not have made a significant difference to the outcome then the issue of ‘duty’ is fairly irrelevant. If there’s no damage the issue does not arise.

This blog is made possible with generous financial support from the Australasian College of Paramedicine, the Australian Paramedics Association (NSW), Natural Hazards Research Australia, NSW Rural Fire Service Association and the NSW SES Volunteers Association. I am responsible for the content in this post including any errors or omissions. Any opinions expressed are mine, and do not necessarily reflect the opinion or understanding of the donors.