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Doctors must report knife injuries to police under new GMC guidance

BMJ 2009; 339 doi: http://dx.doi.org/10.1136/bmj.b4004 (Published 29 September 2009) Cite this as: BMJ 2009;339:b4004
  1. Clare Dyer
  1. 1BMJ

    Doctors should report knife injuries to the police despite the general obligation to keep patients’ information confidential, says new guidance from the General Medical Council.

    Currently doctors are required to report gunshot wounds to police, but the revised guidance, which comes into force on 12 October, requires them for the first time also to report attacks with a knife, blade, or sharp instrument, whether the patient is an adult or a child.

    Doctors should report incidents quickly but should not disclose the patient’s identity with the initial report, the guidance says. They must ask patients whether they are willing to talk to the police. But even where the answer is no a doctor may disclose the patient’s identity and other confidential information to police if it is probable that a serious crime has been committed or other people are at risk.

    “We are not asking doctors to force patients to speak to the police, but we are asking them to pass on information which will help the police to help protect patients, the public, and staff from risks of serious harm,” said Henrietta Campbell, former chief medical officer in Northern Ireland, who chaired the GMC’s working group on confidentiality.

    Even where knife injuries to children are accidental they may raise child protection issues, and doctors need to consider whether to report to the appropriate agencies, the guidance says. Doctors who believe that a child patient—or any patient who lacks capacity—may be a victim of abuse or neglect, and who believe that disclosure would be in the patient’s best interests or necessary to protect others from a risk of serious harm, must report this to a responsible authority.

    The guidance also says that where a patient is given a diagnosis of an illness, such as an inherited cancer, that points to a likelihood or certainty of the same illness in a blood relative, a doctor may be justified in disclosing that fact to the relative at risk.

    Most patients will agree to sharing of health information to family members who could therefore take preventive action, doctors are told, but there may be cases where disclosure is warranted even if the patient refuses consent.

    The Medical Defence Union estimated that nearly a fifth of calls from members for advice involve issues of confidentiality and disclosure of information.

    Dilemmas raised by members of the union included whether to reveal a patient’s name and address to police who have found a practice appointment card at a crime scene and whether to tell the Driver and Vehicle Licensing Agency about a patient who refused to stop driving a lorry after experiencing a blackout.

    Both situations are tackled in the GMC’s new guidance, which also advises doctors on responding to media criticism, raising child protection concerns, and disclosing information for insurance, employment, or benefit claims.

    Notes

    Cite this as: BMJ 2009;339:b4004

    Footnotes

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