We have been sent to a young man who has called us from a public phonebox, he has told our calltaker that he has been cutting his wrists.
As a point of general safety the police are sent to this job as well as rather obviously he could well be armed with something sharp.
We meet with the police who are also searching for the patient – they have already been up and down the street and can't find him so they declare 'area searched, no trace' and disappear off to do something else (it's been a very busy night for the both of our services).
We decide to have a further scout around and, because of our experience of peering into the dark while driving slowly, manage to find the patient standing in a pool of his own blood in the phonebox.
The rather large blade that he has used to hack his arm to pieces rather thankfully is on the floor a little way away from him – I'd already approached him, but if we worried about people stabbing us all the time we'd never get any work done. I pick it up and throw it into out sharps bin where all our used needles go.
We bandage up his shredded arm and chat to him in the back of the ambulance. He's obviously emotionally shaken and keeps asking if the police are going to shoot him. It takes us some time to explain that the police have already gone on to their next job in the queue.
He tells us that he is in fear of the police because there is a warrant out for his arrest, I ask him what for and he answers, “you name it I've done it'.
So, my questions to you, the way I see it there are three ways to answer them – legally, ethically and practically.
- Do we, as ambulance people tell the police that we have someone who is wanted for arrest, taking into account that we are supposed to be all about patient confidentiality?
- If you decide not to tell the police, is there a certain level of crime that you would tell them – for example if the patient were a child murderer would you tell them as opposed to shoplifting?
- In general, how far do you think we can we go against the patient's wishes when there are external pressures on us to do something (for example not reporting a domestic abuse case or not reporting a child abuse case)?
I'll tell you what we did, and why in a later post. Responses from police officers are especially welcome.