Managing Law Enforcement Presence in the Emergency Department: Highlighting the Need for New Policy Recommendations

Abstract

Background: The Emergency Department (ED) is the portal of entry to the health care system for a large percentage of patients. This is especially true for victims and perpetrators of interpersonal violence. Frequently, law enforcement personnel (LEP) accompany patients to the ED or seek access to patients during their ED stay or subsequent hospitalization. The time-sensitive nature of both emergency care and criminal investigation motivates both health care personnel and LEP, and can lead to potential conflicts of interest regarding access to patients in the ED.

Objectives: We hope to examine the relationship among patients, providers, and LEP in the ED, and the potential impact these interactions have on patient care. This article presents a review of the relevant literature and policy consideration as well as provides guidance on the development of such policies for EDs.

Discussion: Hospitals, EDs, and trauma resuscitation rooms are highly regulated environments, but LEP largely fall outside the ethical and institutional guidelines of health care institutions. Many potential areas of conflict exist when LEP are present in the ED that can have detrimental effects on patient care, provider liability, and LEP efficacy. Patients' perceptions of collaboration between ED personnel and LEP can compromise emergency patient care.

Conclusion: There is a need for hospital policies to govern interactions among patients, emergency health care providers, and LEP in the ED.

Keywords: Emergency Department (ED); Trauma Informed Care (TIC); chain of custody (COC); emergency medicine (EM); ethics; evidence collection; jurisdictions; law enforcement personnel (LEP); police; privacy.