Emergency Physician Observations and Attitudes on Law Enforcement Activities in the Emergency Department

Abstract

Introduction: Law enforcement officers (LEO) interact with patients and clinicians in the emergency department (ED) for many reasons. There is no current consensus on what should comprise, or how to best enact, guidelines that ideally balance LEO activities in the service of public safety with patient health, autonomy, and privacy. The purpose of this study was to explore how a national sample of emergency physicians (EP) perceives activities of LEOs during the delivery of emergency medical care. Methods: Members of the Emergency Medicine Practice Research Network (EMPRN) were recruited via an email-delivered, anonymous survey that elicited experiences, perceptions, and knowledge of policies that guide interactions with LEOs in the ED. The survey included multiple-choice items, which we analyzed descriptively, and open-ended questions, which we analyzed using qualitative content analysis. Results: Of 765 EPs in the EMPRN, 141 (18.4%) completed the survey. Respondents represented diverse locations and years in practice. A total of 113 (82%) respondents were White, and 114 (81%) were male. Over a third reported LEO presence in the ED on a daily basis. A majority (62%) perceived LEO presence as helpful for clinicians and clinical practice. When asked about the factors deemed highly important in allowing LEOs to access patients during care, 75% reported patients’ potential as a threat to public safety. A small minority of respondents (12%) considered the patients’ consent or preference to interact with LEOs. While 86% of EPs felt that information-gathering by LEO was appropriate in the ED setting, only 13% were aware of policy to guide these decisions. Perceived barriers to implementation of policy in this area included: issues of enforcement; leadership; education; operational challenges; and potential negative consequences. Conclusion: Future research is warranted to explore how policies and practices that guide intersections between emergency medical care and law enforcement impact patients, clinicians, and the communities that health systems serve.

Law enforcement in the trauma bay: a survey of members of the American Academy for the Surgery of Trauma

“…This corresponds with the results of a recent survey of emergency medicine physicians, who prioritized staff and public safety most highly in navigating these interactions. 16 This indicates then when clinicians think about LEO presence, they may be focused on issues outside of the core patient-centered mission of healthcare. Consistent with patient perspectives in previous research, 8 9 11 many respondents found LEOs' presence a detriment, by disrupting clinical care, causing emotional distress to patients, or leading patients to minimize symptoms or withhold medically pertinent information that could pose legal risks.…”

Clinicians' experiences of caring for people brought in by police to the emergency department: A qualitative interpretive study

“…Thus, police presence may impact on access to relevant care structures such as staffing and delay time-sensitive ED processes. Recent evidence has identified that the conflicting priorities between police and ED clinicians may lead to compromised clinical care (Khatri et al, 2023), which can then impact on patient outcomes. Additionally, patients who have an involuntary assessment order (compared to those without an involuntary assessment order) are more likely to encounter outcomes such as a prolonged ED stay (Trivedi et al, 2019;Wardrop et al, 2022a).…”