Legal/ethical question

[bullmedic]

Well I guess I am in the minority. Absolutely I report this to the police. Absolutely I note it in my report. I am a public servant and I am here to protect the whole public I serve not just the one seizing individual. Who is he selling this stuff to, what other activities is he involved in? Who knows? Not me. But, what I do know is that these activities are illegal and that these activities can put other peoples lives in danger. The neighbors, the kids down the street, my family as they drive by this apartment when a looped up guy pulls out of the lot and hits someone. If a patient does not want to trust me and tell me of their drug use that is fine. That is a decision that is to their detriment. Again I am concerned with the whole community not just one individual.

[akflightmedic]

The information does NOT belong in your report. It has nothing to do with the patients condition.

You want to report it fine, but the point being made is if you were not a public servant, you would not have the trust or ability to enter into their private domain and make this discovery. What if you went to a patient for a rectal bleed and he told you it is because he was having anal sex? Look up your state laws and you will be surprised when you see the number that outlaw sodomy. Sodomy is a crime! Would you report this as well? Your only legal obigations to report are child abuse and elder abuse. You are required to report those. The rest are reportable if you so choose. It is definitely an ethical question and there is no right or wrong, however sometimes you need to step out of the box and look at the whole picture, not just one small narrowminded portion.

[BEorP]

Right, but the reverse of that is do you never report anything? License plates of injury hit-and-runs, a house down your block dealing drugs to neighborhood kids, someone breaking into your neighbor's car, recognizing a murder suspect from a wanted poster. Some you might, some you might not. So, even if you're in EMS, I think there's still a sliding scale.

I'm not saying to necessarily report it in this scenario, but whatever your decision, it should be based on a personal sliding scale. I don't think it's best for the community to refuse to report simply because you're not required.

It's different when it's something you find out from access you had while treating a pt

[BEorP]

Well I guess I am in the minority. Absolutely I report this to the police. Absolutely I note it in my report. I am a public servant and I am here to protect the whole public I serve not just the one seizing individual. Who is he selling this stuff to, what other activities is he involved in? Who knows? Not me. But, what I do know is that these activities are illegal and that these activities can put other peoples lives in danger. The neighbors, the kids down the street, my family as they drive by this apartment when a looped up guy pulls out of the lot and hits someone. If a patient does not want to trust me and tell me of their drug use that is fine. That is a decision that is to their detriment. Again I am concerned with the whole community not just one individual.

If a pt admits to using heroin to you, are you going to tell the police also?

I sure hope not...

[Dustdevil]

Might I give an unofficial, off the record heads up to the local cop on the beat about it? Sure. I watch out for him. He watches out for me. But I bloody well am not making a "report" of what I saw. Depending on how relevant any given circumstances are to a patient's condition, I may or may not make note of it in my PCR. However, the PCR is privileged info that is not legally shared with law enforcement, so it would not be brought to their attention.

And minus 5 for using radio codes. :roll:

[strippel]

I'm with Dust on this one. I would not report it. That could turn into a legal nightmare for you, and your department. Not to mention, if they are trafficking... could lead to danger....

I might mention it to the police in passing. I have done that before. But, it has no legal basis in your chart. I would make reference to the patient using drugs, that is relevant to his care. Maybe even to paraphernalia.

If you tell the police, they would need an official statement, and then they would have to get a search warrant. Would you want to be called into court to testify against them? Or, how would you feel about them sending in a SERT team with a warrant, then finding nothing because it was all cleaned up.

I am all about watching each others backs, but.. That is why our police try to respond on medical calls. They help EMS, and can do some looking around.

[ptemt]

TJ83,

What is the worst thing that could happen for you.........perhaps the dealers decide that you "know too much" and have become a "threat to their operation."

If any of the IM Force are caught or killed.....the Secretary will disavow any knowledge of your actions. :shock:

[Charlie 3]

Reporting this would be preventitive medicine.

Drug trade adds to all kinds of bad things like prostitution, drug abuse, homelessness, and theft.

I think I probably would have keyed up the radio and asked for PD on scene, then they would have been obligated to do something about it, but probably could not have arrested the pt.

[flight-lp]

Reporting this would be preventative medicine.

Drug trade adds to all kinds of bad things like prostitution, drug abuse, homelessness, and theft.

I think I probably would have keyed up the radio and asked for PD on scene, then they would have been obligated to do something about it, but probably could not have arrested the pt.

You have a postictal seizure patient that needs to be transported. You would be negligent in your care waiting on scene for law enforcement. Plus if they arrive after you depart the scene, they can not enter the premises without a warrant. Your job is to treat your patient, not play "CSI" in the apartment. I wouldn't document any illicit drug use unless the patient tells you he used. The ER will know after toxicology is obtained. But as far as the "powders, syringes, and paraphernalia" goes, you cannot make an assertion to their usage and you cannot test the substances to determine their chemical composition. Therefore, until such actions are done and done by the people who need to do it (i.e. Law Enforcement), they are of no concern to you. Any statements that you make, oral or written, subjectively attempting to claim the presence of drugs can be grounds for dismissal of charges if they are not made with sound evidential proof. Leave it be, focus on your patient!

[MedicRN]

PCR = 'Patient found in postictial state. White powder in baggies and a green leafy substance in bags noted near patient. Syringes also noted. Several large stacks of cash noted on table.'

No determination as to the contents of anything is made or asserted with the above statement. It is an objective observation of the surrounds when you found the patient.