stabbing at a local high school

firecoins said:
actually Ido enjoy doctor/patient priveldges. I work as an extension of medical control...a medical doctor. I ask because I am on a need to know basis.
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No, actually you don't have doctor-patient privileges.

Legal privilege involves the right to withhold evidence from discovery and/or the right to refrain from disclosing or divulging information gained within the context of a doctor-patient relationship.

You may be called as an EMT at any time to testify or give a statement. You may also be questioned about how you obtained your information or your motives for obtaining such information.
 
VentMedic said:
No, actually you don't have doctor-patient privileges.

Legal privilege involves the right to withhold evidence from discovery and/or the right to refrain from disclosing or divulging information gained within the context of a doctor-patient relationship.

You may be called as an EMT at any time to testify or give a statement. You may also be questioned about how you obtained your information or your motives for obtaining such information.
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without a subpeona, I have no obligation to provide information to the police. I have to be subpoenaed to tesify. Even doctors can also be suboenaed to testify.
 
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firecoins said:
without a subpeona, I have no obligation to provide information to the police. I have to be subpoenaed to tesify. Even doctors can also be suboenaed to testify.
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And yes, you will have to divulge what you have been told. The doctor does not necessarily have to give up that information. If you tell the patient or represent yourself as having the same legal privileges, you are doing both you and the patient an injustice.

Legal privilege involves the right to withhold evidence from discovery and/or the right to refrain from disclosing or divulging information gained within the context of a doctor-patient relationship.
 
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VentMedic said:
And yes, you will have to divulge what you have been told. The doctor does not necessarily have to give up that information. If you tell the patient or represent yourself as having the same legal privileges, you are doing both you and the patient an injustice.

Legal privilege involves the right to withhold evidence from discovery and/or the right to refrain from disclosing or divulging information gained within the context of a doctor-patient relationship.
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I am obtaining information from patient for their medical treatment exactly like a doctor does. I often report to a nurse or doctor at the ER and give them the information I obtain. Cops are not entitled to that information simply because they are conducting an investigation. I will refer a cop to either speak to the doctor at the ER and/or the public information officer of my organization. In this specific case, the cops did not come to me nor did they need to come to me. If they need something, the patient and parents were cooperating with the cops. I have rarely had a problem with the cops. They know what they are doing.
 
From what I have seen here, Firecoins, you actually do have a problem with the police. When you become licensed as a doctor and admitted to the AMA, you may have Doctor/patient confidentiality protection. As an EMT, you do not. Referring the police to the ER docs or nurse in most cases would only delay the inevitible: the subpoena. My suggestion is that you limit your questions to those that are medically necessary and not the other details that are more anecdotal than required for your paperwork. Unless you are ALS, how much time do you think you will have to spend with the patient anyway?
 
jmaccauley said:
From what I have seen here, Firecoins, you actually do have a problem with the police. When you become licensed as a doctor and admitted to the AMA, you may have Doctor/patient confidentiality protection. As an EMT, you do not. Referring the police to the ER docs or nurse in most cases would only delay the inevitible: the subpoena. My suggestion is that you limit your questions to those that are medically necessary and not the other details that are more anecdotal than required for your paperwork. Unless you are ALS, how much time do you think you will have to spend with the patient anyway?
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umm no. I do not have a problem with the police.

The police will not receive patient information just because they ask. I have no problem testifying under a subpoena. No doctor has the power to fight a subpoena either. My question are already limited to whats medically relevant as been mentioned several times already. I need information from the patient and its needs to be done in such a fashion that their words will not be used against them . If the police have a problem with that, they can go to a judge and get a warrent. The D.A. can subpoena me. That is fine. Thats what the legal process is for.
 
The discussion of "special relationships" between patient and dr/care provider are actually highly variable by state. The federal standard is pretty wishy-washy and just makes references to common law and generally accepted practice in terms of a physician privilege.

NY apparently has a fairly broad privilege - covering not only "those licensed to practice medicine" but also nurses and dentists. A quick perusal of a couple of court cases from that state suggest to me that an EMT would be considered a "medical professional" (the repeatedly used language of the court here: http://64.233.169.104/search?q=cach..._0113.htm+CPLR+§4504&hl=en&ct=clnk&cd=1&gl=us ) and be be covered by privilege.

Of course that applies only to medically relevant information - but the court also took a fairly broad look at that in the case above.

I have never been able to find any really good case law regarding privilege with prehospital care providers - my suspicion is that that is more due to a lack of ambulance-types challenging subpoenas.

The issue just doesn’t seem to have been addressed by the courts, and the possibility of extending the privilege to EMT's etc. seems to have been ignored by most legislatures, which makes asserting either that there is or is not privilege for EMT's very shaky.
 
Like has been stated before, an EMT does not have "Doctor patient privileges"; yes, we represent physicians but we are not licensed as a physician and are only covered by him by delegated practice and authority.

The patient initial contract of care was the EMT, not the physician even though by proxy.

Sure, one can refuse to give information because of privacy regulations in which all health care providers should be performing. There are certain information I will give or general information, that is required for safety and public information. This supersedes patient confidentiality.

R/r 911
 
firecoins said:
umm no. I do not have a problem with the police.

The police will not receive patient information just because they ask. I have no problem testifying under a subpoena. No doctor has the power to fight a subpoena either. My question are already limited to whats medically relevant as been mentioned several times already. I need information from the patient and its needs to be done in such a fashion that their words will not be used against them . If the police have a problem with that, they can go to a judge and get a warrent. The D.A. can subpoena me. That is fine. Thats what the legal process is for.
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So, given that you would (as if you had a choice) testify at a depo under subpoena, why would you withhold information from a police officer? If you were treating a patient for a gunshot or knife wound and they told you that the guy next door did it, you would keep that information to yourself unless compelled by a court order? I'm trying to understand your objections, since you are part of the investigation just by being on the scene. Do you feel that you would be violating HIPPA laws, or doctor/patient confidentiality?
 
jmaccauley said:
So, given that you would (as if you had a choice) testify at a depo under subpoena, why would you withhold information from a police officer? If you were treating a patient for a gunshot or knife wound and they told you that the guy next door did it, you would keep that information to yourself unless compelled by a court order? I'm trying to understand your objections, since you are part of the investigation just by being on the scene. Do you feel that you would be violating HIPPA laws, or doctor/patient confidentiality?
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If the suspect is my patient, I would not turn over information to cop if he simply asked. The cop would need to go through proper channels to get information. The reason being that in aquiring relevant patient information, the patient may reveal incriminating information but is necessary for medical treatment. The exception being that the information reveals a threat to the health and well being of other people.

If the victim of a crime told me information about the suspect and it was clear the victim would not be charged in a crime, that is a different scenario. You advise her to tell the cops. If the cops are not already on the scene, you can have them meet you at the hospital so the patient herself can tell the cops herself. (Cops are dispatched to all 911 calls in my area.) You as an EMT may be called as a witness in this case so you probably will get subpoeaned anyway.

Its my understanding there are mandatory reporting laws that require that all assaults be reported by the ER.

In the the scenario in the original post, the suspect had already been in custody. It was not clear if the victim would be charged with anything herself. She did not reveal anything incriminating about herself to me anyway. The victim did fully cooperate with the police with her mother's permission. She was not charged with a crime.
 
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Sometimes I think you have an inflated sense of your responsibilities. You would make the police jump through hoops rather than just cooperate. Are you protecting your patient or exercising some imagined power that you, as an EMT, believe you are afforded? Why should you care whether or not the victim may be charged with a crime? You're there to plug up holes and get them to a real doctor. Just as time is important in administering medical treatment, it plays a big role in solving crimes.
 
jmaccauley said:
Sometimes I think you have an inflated sense of your responsibilities. You would make the police jump through hoops rather than just cooperate. Are you protecting your patient or exercising some imagined power that you, as an EMT, believe you are afforded? Why should you care whether or not the victim may be charged with a crime? You're there to plug up holes and get them to a real doctor. Just as time is important in administering medical treatment, it plays a big role in solving crimes.
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What hoopes are the cops jumping through?

First, the name of a suspect is not something I would even ask because it isn't relevant to her treatment. I am not a cop. I am not solving crimes. Clearly I DONT have an inflated sense of responsibilities. I ask only medically relevant information. I ask what happaned so I knwo the injuries. I get nice little summary and I move on from there.

Second, if a victim can ID her attacker to me, 99.9% of the time, she already told cops. Therefore I don't need to tell them a second time. I am called after the fact by the cops more times than not. In the unlikely event she IDs an attacker to me and for some reason not to the cops, I would alert cops that she has identified a suspect under the assumption such a person is a threat to the general public.

If I am responding to a violent criminal event, I let the cops arrive first. If this event is in the past, the cops are already there. There going to have more information than I have to begin with and usually will se most of my assesment. Its unlikely I will find something out they don't already know.

Third, If I have a patient that is a suspect in a crime, its not my job to interrogate him. That is the job of police. Its my job to treat him. I have certain information I need to collect to do that. I am not interested in anything not medically relevant. If he says some incriminating that does not put my safety or that of the public in danger, it doesn't warrent calling the cops.

What is it that I am going to find out that the cops aren't going to find out though normal investigations? Not much.
 
let try and be clearer I find I am repeating myself.

I need to know what happaned. I don't need to who did it and why they did it. Too much info. The cops are 99.9% of the time dispatched to the same scene I am. They are already asking those questions. My inital assessmen usually occurs in plain view of the officer. As I said, there is very little the cop is not going to know. Inside the confine of the rig I will ask the same question a second time to make sure I got accurate information. People may not tell the truth in front of the cops. People rarely talk about personal drug use in front of cops yet this is relevant information if anyone want to give medications to the patient.

I am not a cop. I am not conducting a criminal investigation. Rarely will I know something a cop doesn't already know. In the event that I do, my giving the PD info depends soley on the circumstances.

The call in the OP. Dispatch said the fight/stabbing was in progress. We let the cops get their first. The cops already had the suspect in custody. I am not sure anything I found out in the process of assessing my patient would have made any difference in any criminal investigation BUT I wanted the patient to be able to speak freely without fear that what she said would get her arrested. This way I could get all relevant information without fear. I was able to do this. Nothing mentioned on the call was incriminating as far I could tell. The news article mentions everything I found out.
 
Much better explanation this time around. Plus, it's sounds more reasonable than the "I won't tell the cops anything unless subpoenaed."
 
We are lucky here. One time rides in on all penetrating trauma and most other assault type calls where they may need to sort out who is who and what happened. If a pt. hits me up with something I think the cops may like I relay it. As long as it is not in the HIPAA realm I feel free. I hate bad guys as much as the next guy right?

Also...how much does one need to ask on that type of call anyway. Not a lot.

Egg
 
Wow, that's just insane. People need to just "chill" with the drama, especially in the high-school setting/environment. It doesn't take much for someone to get worked up just because someone called their mom ugly, or some crazy stuff like that.

This also shows that a need for security, or police presence at the school during times of dismissal is needed as well, not just during regular "school hours".
 
Someone correct me if I'm wrong please. HIPPA rules restrict the release of medical records. Does that mean it covers all of details surrounding an injury or assault? I don't think so, but I have had nurses and even some doctors (who appear as confused as me) reluctant to share anything about the patient. At any rate, my issue is when a first responder decides that they want to be the "good guy" in the eyes of a victim and show that they aren't "the man." Plug up the leaks, get them breathing and take them to the hospital. If you hear something that the police might be interested in, share it before someone else gets hurt.
 
jmaccauley said:
Someone correct me if I'm wrong please. HIPPA rules restrict the release of medical records. Does that mean it covers all of details surrounding an injury or assault? I don't think so, but I have had nurses and even some doctors (who appear as confused as me) reluctant to share anything about the patient. At any rate, my issue is when a first responder decides that they want to be the "good guy" in the eyes of a victim and show that they aren't "the man." Plug up the leaks, get them breathing and take them to the hospital. If you hear something that the police might be interested in, share it before someone else gets hurt.
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Considering that there are specific exemptions in HIPAA covering the release of PHI to law enforcement as it pertains to the victim or suspect of a crime, you are correct. I don't see where people are still having a problem with this. After all, mandatory reporting is something that is exempted from HIPAA also.
 
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