Advice line dilemma - serious assault

An ST1 doctor was treating a female patient who had been admitted to ITU with a serious head injury. The police arrived on ITU and claimed that the patient, a gang member, had been involved in a violent incident and had seriously assaulted another female.

The police asked for the patient's name and address as well as information about her current condition. When the ST1 hesitated, they told her that she had a statutory duty to disclose these details under s29(3) of the Data Protection Act, which allows information to be disclosed for the 'prevention or detection of a crime'. Due to her injuries, the patient was unable to consent to disclosure. The doctor still felt uncomfortable about providing this information and called the MDU for advice.

MDU advice

... confidentiality is central to the trust between doctors and patients...

The doctor asked the MDU adviser whether she was required, or even allowed, to disclose this information to the police. The adviser referred her to the GMC guidance on confidentiality and explained that confidentiality is central to the trust between doctors and patients and should normally be respected. The adviser emphasised that the doctor's first priority was to discuss the request for disclosure with the treating consultant with overall responsibility for the patient. The adviser also suggested that the trust Caldicott Guardian should be made aware of this situation and be involved in the decision-making process.

In general, the adviser explained, no personal information should be disclosed to a third party such as a solicitor, police officer or officer of a court without the patient's express consent, unless it is required by law or can be justified in the public interest.

The adviser stated that there were other issues to consider in this case.

• Currently the patient could not consent to disclosure as she lacked capacity; this may be temporary so the doctor could advise the police that consent would be sought once the patient had regained consciousness and capacity if possible.
• If this was not possible and the police wanted to investigate a serious crime, then disclosure may be justified in the public interest to protect others.
• If seeking consent puts the doctor or anyone else at risk of harm, disclosure without consent might be possible but the doctor would have to be prepared to justify her decision. 
• The member was advised that although s29(3) allows you to disclose information in certain circumstances without fear of prosecution under the Data Protection Act, it does not displace the professional and ethical obligations imposed upon you as a doctor by the GMC, i.e. it is permissive rather than mandatory.

The member was advised of the importance of documenting in the notes all discussions and decisions regarding this disclosure and to inform the patient of their decision, if it was safe to do so.

The doctor later contacted the MDU again and said that the consultant had decided to disclose the information to the police in the public interest. They had documented that, although the patient was currently not a risk to others, she could be when discharged and they could not rule out that she might abscond.