Staff at UK hospitals should tell police when patients present with serious knife wounds even if this is against the patient’s wishes, says a senior police officer.
Alfred Hitchcock, the acting assistant commissioner for London’s Metropolitan Police and the Association of Chief Police Officers’ national lead officer for knife related crime, made the request on the Channel 4 News programme. His call came after a fresh spate of violence in England among teenagers and young adults over the late May bank holiday weekend, which included several knife attacks and the fatal stabbing of an 18 year old man.
“If there are knife wounds that are clearly inflicted as a result of a serious incident then it should be notified to us,” Mr Hitchcock later told the BMJ. “In the way we get gunshot wounds reported to us by hospitals, it seems sensible that hospitals could report knife wounds to us as well.”
But the BMA is concerned that any blanket rule might damage the doctor-patient relationship. “Doctors are very willing to cooperate with the police to tackle knife crime. However, doctors do not want to be compelled to report all knife wounds and therefore breach patient confidentiality,” a spokesperson said. “There has to be an element of flexibility which would allow doctors to act in their patient’s best interests while protecting the public.”
However, Mr Hitchcock argued that the protection of the individual and society outweigh rights to privacy and data protection.
The General Medical Council is due to revise its guidance on doctors’ reporting of knife wounds, with consultation due to start in September. It currently advises that for gunshot wounds doctors report to the police all patients as soon as they arrive at hospital. New guidance might take into account the strict legal regulation of gun ownership and that knife wounds can originate unintentionally, a council spokeswoman said. “Knife wounds are often the result of domestic or workplace accidents, in which the police would not have the same interest.”
Mr Hitchcock dismissed fears that victims with knife wounds might avoid presenting to hospital, saying that although they should be reported they “may not wish to cooperate with us . . . That’s their right.”
Current GMC guidance on patient confidentiality permits personal information to be disclosed without the patient’s consent and “in exceptional cases” if patients have withheld consent “where a failure to disclose information would put the patient, or someone else, at risk of death or serious harm [or if it] may assist in the prevention, detection, or prosecution of a serious crime” (www.gmc-uk.org/guidance).
Most US states require doctors to report gunshot wounds in presenting patients, and many states require doctors to report knife wounds. However, these laws can endanger victims of domestic violence or discourage them from seeking medical care if they fear police involvement, said Esta Soler, president of the Family Violence Prevention Fund. “In our experience, in domestic violence cases these laws do more harm than good.”
Jacqui Smith, the UK home secretary, called for medical staff to share information about patients with stab wounds in her tackling violence action plan in February. And last October the Association of Chief Police Officers called for doctors to report patients who have been violently assaulted.
Some UK hospitals routinely pass anonymised data on patients who present to hospital with knife wounds to police, in pilot schemes in London, Merseyside, and south Wales.