Court: Impaired man’s conversation with EMT after crash not privileged

[TheMowingMonk]

good point, statement withdrawn. Well I am trying to remember what the law would do about you like finding them in possession of drugs if the cops didn't search them thoroughly enough isnt that something you are still suppose to tell the cops about?

 

[JPINFV]

Personally, if I find drugs on a patient I'm either going to ignore it or deposit it in the nearest trash can. I generally don't care for prohibition.

 

[Hepinghand]

What's your opinion here?

I disagree firmly that the medic was not acting under the supervision or direction of a physician, and that's why he was not covered under the doctor patient privelege.

I acknowledge the moral dilemma that the medic was dealing with, but I think he was mistaken by reporting the drug use to the cops. If they had suspicion, which they should have, they could subpoena drug tests and not have the testimony of the medic be the key to their case.

I totally agree with you.

 

[HotelCo]

It's still a meaningful precedent, set by people who are obviously pretty ignorant of how EMS systems work. Either we are a *para*medic, operating under the umbrella of the medical director, or not.

If not, it could be a real breakthrough for our profession.

How aren't we working under the license of a physician? A courts failure to understand the structure of the system, won't change the system.


Sent from my iPhone using Tapatalk

 

[MasterIntubator]

Personally, if I find drugs on a patient I'm either going to ignore it or deposit it in the nearest trash can. I generally don't care for prohibition.

Im not going to jail or loosing my job for anyone. I have reported, and will continue to report any findings on my surveys. Let alone the irresponsible move of throwing away to where someone else could gain access to it and injure themselves. Now that would be negligent, and probably many more big words I can't pronounce.

 

[DrParasite]

The issue i have with this is that if one state court makes this decision, others courts can use it as a precedent in future decisions. Not only that, but if you tell me that anything a patient tells me CAN be used against him, than we get seen as officers of law enforcement, and our patients have good reason to hold stuff from us, stuff that would prevent us from treating them properly.

Patient confidentiality, doctor/patient, and lawyer/client rules exist to allow full disclosure between the service provider and the person being provided the service. removing that privilege from the prehospital provider has the potential to be detrimental to future patient care.

 

[CAOX3]

Im not going to jail or loosing my job for anyone. I have reported, and will continue to report any findings on my surveys. Let alone the irresponsible move of throwing away to where someone else could gain access to it and injure themselves. Now that would be negligent, and probably many more big words I can't pronounce.

To the police?

Why?

Then again I've bren doing this job long enough that the fear of litigation or the fear of losing my job never enters into the thought process.

If I wanted to be a cop I would have taken the test.

 

[MasterIntubator]

Yup... to the police. We work closely with the police, and if I find something and cover it up ( ignoring it, throwing it away, or otherwise destroying evidence ), Im just as guilty.... especially if it ever comes up as a question or investigation. Ever get accused by a criminal and get sent to court, trying to tarnish your reputation, the police and anyone elses life they can ruin? They usually have nothing to loose at that point..... why not take some more folks out? I have, but all of my documentation, reporting to law enforcement and paper trails, have cleared crap like that.
I have no issues going to court, have testified and written many depositions on cases like this... on things I have seen or found on assessment in my care, on scene or in the rig. It gets reported, and documented.

I would wonder why anyone would even consider ignoring it or not reporting it. To me... thats wrong, and immoral. Maybe one day a special circumstance may present itself causing me to think about it, but I really doubt it. Im going to do the right thing and have trust in a system that has my back with everything I do.

I really don't think that will happen in a my couple years to retirement. Maybe some of you work for some wacked out systems.... and you don't play nice with law enforcement. Kinda makes me feel proud to be part of a system where the law enforcement and fire rescue support each other in everything they do.

 

[MasterIntubator]

I was thinking... scenario based....

If I was on the scene of a situation and the cops are there ( as they usually are in any questionable call ), I would report to the officer if I found anything prior to us leaving the scene. If enroute, I report the findings to the ED staff, and to their security. It all gets documented.

If the pt reveals info enroute - or out of the presence of law enforcement - it gets documented and passed on as medically relevant info to hospital staff.

Pt telling me something vs having physical evidence are handled a little different. It does not really matter too much if they reveal it or not, symptoms and assessment will lead the treatment... even in polypharms. ( although it helps speed things up... it doesn't slow me down too much. ). They can clam up and not talk, which is cool with me. I'll figure it out.

Are those scenarios kinda on track of what you would do? Or am I still the black sheep on this one?

I'm really trying to understand it....

 

[usalsfyre]

Yup... to the police. We work closely with the police,

We work very closely with local law enforcement (probably more so than the FD). They also understand OUR function is not law enforcement.

and if I find something and cover it up ( ignoring it, throwing it away, or otherwise destroying evidence ), Im just as guilty.... especially if it ever comes up as a question or investigation.

"Covering it up" and not calling the cops are two different issues. Especially in the case of something like drugs, outside of finding a kilo of coke or heroin on the patient, the ones around here would rather NOT be involved.

Ever get accused by a criminal and get sent to court, trying to tarnish your reputation, the police and anyone elses life they can ruin? They usually have nothing to loose at that point..... why not take some more folks out? I have, but all of my documentation, reporting to law enforcement and paper trails, have cleared crap like that.

Can't say I've heard of this being common in any way. But the way you label "criminals" is slightly concerning, they're all "patients" regardless of legal status, and at the point your speaking of having contact with them they fall in the "accused" category.

I have no issues going to court, have testified and written many depositions on cases like this... on things I have seen or found on assessment in my care, on scene or in the rig. It gets reported, and documented.

No problem with documenting findings in the appropriate place. Yes our charts are discoverable. However contacting law enforcement directly violates the patient's trust, and interest (remember, we're patient advocates).

I would wonder why anyone would even consider ignoring it or not reporting it. To me... thats wrong, and immoral.

I find it morally and ethically suspect that anyone would report things they find out because they are granted access to parts of people's lives that are normally hidden due to their need for medical care. This makes EMS job harder (patients are less willing to be honest) more dangerous (patients will go to further extremes to hide minor criminal activity from EMS if they think it will be reported) and discourages those that are not entirely on good terms with the law from calling EMS (patients suffer). None of which is acceptable in my mind.

Maybe one day a special circumstance may present itself causing me to think about it, but I really doubt it. Im going to do the right thing and have trust in a system that has my back with everything I do.

Your choosing your "system" over the patient.

I really don't think that will happen in a my couple years to retirement. Maybe some of you work for some wacked out systems.... and you don't play nice with law enforcement. Kinda makes me feel proud to be part of a system where the law enforcement and fire rescue support each other in everything they do.

Like I said, we get along great, and support each other. They understand our roles are different, and that the documentation will be accurate and complete. They don't generally ask us. Outside of mandated reporting categories, I don't go to LE with anything unless it involves violence against another person. They will generally find out anyway.

Our number one role is health care. Being a patient advocate goes along with this. Letting any "public safety" role you have distract you from that is, in my eyes, failing your patients and profession.

 

[JPINFV]

Im not going to jail or loosing my job for anyone. I have reported, and will continue to report any findings on my surveys. Let alone the irresponsible move of throwing away to where someone else could gain access to it and injure themselves. Now that would be negligent, and probably many more big words I can't pronounce.

Why are finding drugs on a patient a "pertinent finding" if the patient is not intoxicated?

 

[JPINFV]

I would wonder why anyone would even consider ignoring it or not reporting it. To me... thats wrong, and immoral. Maybe one day a special circumstance may present itself causing me to think about it, but I really doubt it. Im going to do the right thing and have trust in a system that has my back with everything I do.

What's wrong and immoral is a country that decides for a supposively free population what they can or cannot put inside their own body. There's a reason why the 18th amendment was followed by the 21st amendment and it wasn't just because legislating via constitutional amendment is an enormously stupid act in its own right.

Also, what is immoral about drug use? To argue that drug use on its own is immoral regardless of legal status should follow that other drugs, such as alcohol and tobacco, are just as immoral and should share the same legal status as other drugs.

 

[CAOX3]

Yup... to the police. We work closely with the police, and if I find something and cover it up ( ignoring it, throwing it away, or otherwise destroying evidence ), Im just as guilty.... especially if it ever comes up as a question or investigation. Ever get accused by a criminal and get sent to court, trying to tarnish your reputation, the police and anyone elses life they can ruin? They usually have nothing to loose at that point..... why not take some more folks out? I have, but all of my documentation, reporting to law enforcement and paper trails, have cleared crap like that.
I have no issues going to court, have testified and written many depositions on cases like this... on things I have seen or found on assessment in my care, on scene or in the rig. It gets reported, and documented.

I would wonder why anyone would even consider ignoring it or not reporting it. To me... thats wrong, and immoral. Maybe one day a special circumstance may present itself causing me to think about it, but I really doubt it. Im going to do the right thing and have trust in a system that has my back with everything I do.

I really don't think that will happen in a my couple years to retirement. Maybe some of you work for some wacked out systems.... and you don't play nice with law enforcement. Kinda makes me feel proud to be part of a system where the law enforcement and fire rescue support each other in everything they do.

We play fine with police, they understand we have a job to do and part of that is not disclosing sensitive information.

How do you expect to to treat patients when you constantly betray the trust by running to the cops with flapping your gums? Im only concerned with whats in the best interest of the patient not how this might affect my working relationship with the police.

I don't dispose of anything on scene, I'm also not jamming up some twenty year old for the rest of his life because he made a poor decision and tripped walking down the street with weed in his pocket so my cop buddies will wave to me in the coffe shop or I'm confused about the role I play

 

[Aidey]

What's wrong and immoral is a country that decides for a supposively free population what they can or cannot put inside their own body. There's a reason why the 18th amendment was followed by the 21st amendment and it wasn't just because legislating via constitutional amendment is an enormously stupid act in its own right.

Also, what is immoral about drug use? To argue that drug use on its own is immoral regardless of legal status should follow that other drugs, such as alcohol and tobacco, are just as immoral and should share the same legal status as other drugs.

The problem is that for now, drugs are still illegal.

I've been in the hypothetical situation you guys are talking about. I ended up handing the drugs over to the cops in order to cover my arse. Officially they didn't ask where I got them, although they knew because we had just been on scene together. My concern in these situations is protecting myself. The last thing I need is to be the last person documented as having illegal drugs. I'm not going to waste narcs without anyone around, why would I do it with other controlled substances?

 

[281mustang]

I would wonder why anyone would even consider ignoring it or not reporting it. To me... thats wrong, and immoral. Maybe one day a special circumstance may present itself causing me to think about it, but I really doubt it. Im going to do the right thing and have trust in a system that has my back with everything I do.

What specifically is immoral about not reporting drug use to LE?

Instead of just reacting think about the consequences of your decisions. Incase you haven't noticed our system is structured around lobbyists, not ethics or stastics or anything else.

Do you know how much prision guard unions just in the state of California spend to "reform" our drug laws and keep their jobs? Do you know how much it costs to imprision an inmate, how overcrouded our prisions are, how far our courts are backlogged, or the financial state of most local governments? And what good is this going to do exactly? Piss off an addict that will still continue using? Ruin the future of a college kid that is already 60k in debt from school loans? MAYBE even indirectly cause a couple future deaths after word gets out that Medics are now 21st century LEOs minus the gun and plus a drug box.

The world thanks you and your noble actions to bring those that break the law to justice. Some patient advocate you are.

 

[281mustang]

* overcrowded, not overcrouded. Damn this forum and it's lack of edit features.

 

[MediMike]

I don't dispose of anything on scene, I'm also not jamming up some twenty year old for the rest of his life because he made a poor decision and tripped walking down the street with weed in his pocket so my cop buddies will wave to me in the coffe shop or I'm confused about the role I play

Agreed. Patient and confidentiality comes first. If I get asked verbally regarding the presence of an ETOH aroma I invite the officer to smell him/herself if they like. I couldn't care less if the cops like me, if they understand what my job entails then they won't have a problem with it. I document things well enough that, like was mentioned above, once it is subpoenaed they will find the picture painted. And in regards to finding illegal substances ON the patient themselves, I will inform the ED staff and that is all. I'm not playing Dudley DoRight of the RCMP here trying to get my patient in trouble.

Now on to the original topic. I believe that the confidentiality entailed in Pt/Dr and Pt/Attorney relationships should without a doubt be extended to EMS. Hell I thought it was.

 

[firetender]

The guy had a cut leg!

What are you, a cop or an EMT? (Question for everyone) It might be something to think about, as I see some here have.

The information that you deal with and document and relay TO THE APPROPRIATE MEDICAL FACILITY, while performing in a well-defined (and medically sanctioned, NOT independently functioning, I might add) job description is anything pertinent TO the injury.

Whatever the victim (which is what he was, thanks to the medic) did after the initial injury -- with the exception perhaps of the facts of how he may have exacerbated the trauma in question -- is irrelevant to any medical intervention or reportage that may need to occur.

Is it too hard to decide what info is medical and what is not?

One is patient care, the other is law enforcement. If there are any questions, the legal system has ways to place the medic in a courtroom to get them answered.

In this case, the medic sought out a LEO to share privately disclosed information about things irrelevant to patient care. There was NO presence of illegal substances, so the medic had nothing to turn over to the appropriate authority.

Even at that, the medic would be within his rights to simply hand over the offensive substance to an LEO WITHOUT saying a word! YOU have the right to remain silent, remember that, and you're not there to add trauma of any kind to trauma.

According to Nancy Caroline's Emergency in the Streets

Without question, our first duty as EMS providers is to do no further harm. As the Latin phrase (which is thought to have originated with Hippocrates) states "Primum non nocere" First, do no harm.

 

[Too Old To Work]

The court appears to have got this one right under applicable Nevada law. It's binding in Nevada only, and other courts in other states may well decide the exact opposite. Remember also that this ruling is not restricted to drug cases only, it applies to any criminal activity.

If you are treating a person for a leg fracture and he tells you he fell out a window after raping a woman, what do you do? You are not obligated to tell the police about that, but you are not prohibited from doing that either.

 

[HotelCo]

Even at that, the medic would be within his rights to simply hand over the offensive substance to an LEO WITHOUT saying a word

and then you're in possession of an illegal substance.

Do you really think a LEO wouldn't be able to figure out where the substance came from?


Sent from my iPhone using Tapatalk