are physicians obligated to report a crime the patient was victim of?

by Marjorie Lakin 9 min read

How Should Physicians Make Decisions about Mandatory Reporting …

32 hours ago  · What to consider before reporting. Before reporting suspected violence or abuse, the Code says physicians should: Inform patients about requirements to report. Obtain the patient’s informed consent when reporting is not required by law. Exceptions can be made if a physician reasonably believes that a patient’s refusal to authorize reporting ... >> Go To The Portal


Of the 37 million visitors to emergency rooms in the United States in 1999, 7 percent had injuries related to intentional violence. 1 Certain kinds of violent acts, such as child abuse and dog bites must be reported to police in the US; in some states, physicians are required to report domestic violence and alcohol-related car accidents. 1, 2 Not all violent acts must be reported by emergency room personnel, however, and the police are often not notified.

Full Answer

Should physicians decide whether to report suspected abuse?

The fact that it is often difficult to decide whether to report suspected abuse does not negate one's professional and legal responsibility to protect children by doing so. Physicians are not responsible for determining whether maltreatment occurred, only for reporting reasonable suspicion.

When does a hospital have to report a patient to law enforcement?

(1) A hospital shall report to a local law enforcement authority as soon as reasonably possible, taking into consideration a patient's emergency care needs, when the hospital provides treatment for a bullet wound, gunshot wound, or stab wound to a patient.

Can a medical facility require an adult victim to report an incident?

B) No medical facility or licensed health care provider may require an adult victim to report the incident in order to receive medical treatment. C) (i) Evidence will be collected only with the permission of the victim. Mandatory Reporting of Non-Accidental Injuries  3

What is a physician’s responsibility for determining whether maltreatment occurred?

Physicians are not responsible for determining whether maltreatment occurred, only for reporting reasonable suspicion. The reporting decision is complicated by ambiguous definitions that vary across disciplines and by cultural differences in acceptable parenting practices.

In which situation may a healthcare provider refuse to disclose protected health information to law enforcement individuals?

The HIPAA privacy rules (45 CFR § 164.501 et seq.) generally prohibit healthcare providers from disclosing protected health information to law enforcement officials without the patient's written authorization unless certain conditions are met.

Are physicians accountable to their patients for their actions?

In addition to being held accountable by patients, as physicians, we hold ourselves accountable for outcomes. Doctors are trained to remain analytical, objective, and stoic even in the face of difficult situations. Complications are treated as unanticipated clinical challenges.

Are doctors allowed to withhold information from patients?

Except in emergency situations in which a patient is incapable of making an informed decision, withholding information without the patient's knowledge or consent is ethically unacceptable.

What are the exceptions to doctor-patient confidentiality?

Other legal exceptions to a breach of doctor-patient confidentiality include: Medical treatment of injuries that could relate to criminal conduct (e.g., gunshot wounds, drunk driving, hit and run). Disclosures to the patient's health insurance company for the purposes of getting insurance coverage for treatment.

Who are doctors accountable to?

All doctors are accountable to the GMC for their conduct and the decisions they take. Good medical practice (2013) sets out the principles which should underpin their professional work and against which their conduct may be judged.

What is physician accountability?

State licensing boards and the legal justice system protect the medical profession and the public from patently bad doctors.

What is intentionally withholding information?

When we deliberately withhold or conceal information from each other, we are doing something called “knowledge hiding,” an action that can take several different forms.

Are there exceptions to full disclosure in medical field?

Exceptions to such disclosure do exist, namely, the “therapeutic privilege,” which permits the physician to withhold information from the patient or to seek consent from an appropriate surrogate when provision of such information would be so detrimental that the result would be counter-therapeutic and would bring about ...

Do doctors have to tell patients everything?

Doctors are only required to make disclosures which are mandated by law but they do not need to disclose every possible risk or medical alternative. The general standard which is applied is that if a reasonable doctor would disclose the information, then a doctor is obligated to disclose the information.

In what cases can the medical data of the patient be disclosed?

It can be disclosed to the parents or the legal guardian of the patient where the patient is not of legal age or mentally incapacitated; and if the patient is of legal age, then, the information can be disclosed with his right to choose the person to whom the medical information should be communicated.

When can a doctor break patient confidentiality?

Doctors can breach confidentiality only when their duty to society overrides their duty to individual patients and it is deemed to be in the public interest.

Who holds the physician/patient privilege?

The patient holds the privilege – which means that the patient is the only one who can waive it – but in a legal proceeding either the doctor or the patient may assert it.

What are the responsibility of patients and doctors in shared decision making?

While physicians have the responsibility to provide health care services to patients to the best of their ability, patients have the responsibility to communicate openly, to participate in decisions about the diagnostic and treatment recommendations,"1,3 and to adhere to follow or engage in the agreed-upon treatment ...

What are the responsibilities of patients and doctors in shared decision making?

The essential steps include first informing patients of the need for a decision, then explaining the various facts involved; after which, it is important to elicit patients' preferences and goals. Once the treatment options and outcomes important to patients are identified, an actual decision can be made.

How do you deal with toxic attending?

I've made a list of five strategies to keep in mind during these scenarios.Take It With A Smile. If you happen to become the target of an angry attending, don't get angry. ... Stay Focused. ... If You Make a Mistake, Own Up To It. ... Stay Professional. ... Keep The End in Mind.

How are surgeons held accountable?

Patients trust their doctors to act responsibly and they trust state medical boards to hold their doctor accountable if they can't maintain accepted standards of competence.

What to consider before reporting suspected violence?

What to consider before reporting. Before reporting suspected violence or abuse, the Code says physicians should: Inform patients about requirements to report. Obtain the patient’s informed consent when reporting is not required by law.

How many victims of trafficking had contact with a health professional?

The authors noted research showing that 88% of victims had contact with a health professional while being trafficked, but none were identified or offered help in getting out of their situation during the medical encounter.

What is the abuse in the exam room?

Patients in your exam room may be experiencing one of a number of forms of abuse—domestic violence, human trafficking or other violence— and identifying those being abused can sometimes be tough.

Can a physician make exceptions to patient privacy?

Exceptions can be made if a physician reasonably believes that a patient’s refusal to authorize reporting is coerced and therefore does not constitute a valid informed treatment decision. Physicians should also protect patient privacy when reporting by disclosing only the minimum necessary information.

Do you have to see one on one for a trafficked patient?

Dr. Ravi said it is also important to establish a policy—even putting it in writing in the exam and waiting rooms—that says a patient needs to be seen one-on-one for part of the visit. Trafficked patients may come in with a man or woman who is trafficking them; sometimes that person could even be a relative.

How long does it take to report a hospital incident in Louisiana?

The report must be made within 24 hours of the incident.

What is toxicology test?

If a physician has cause to believe that a newborn was exposed in utero to an unlawfully used controlled dangerous substance, the physician shall order a toxicology test upon the newborn, without the consent of the newborn’s parents or guardian, to determine whether there is evidence or prenatal neglect.

Does a summons or arrest warrant have to be executed prior to admission to the hospital?

the law enforcement agency has certified in writing that the patient has been issued a summons or arrest warrant for an offense, but as a result of the need for emergency medical care, the warrant has not been executed prior to admission to the hospital.

Do you have to report an incident to a hospital?

No hospital may require a person to report the incident in order to receive medical attention. La. R.S. 40:2109.1. Victim does not wish to report. If the victim does not wish to report the incident to law enforcement officials, the victim must be examined and treated as a regular emergency room patient.

Why do physicians discuss cases with a knowledgeable colleague?

Physicians reported that discussing the case with a knowledgeable colleague helped them decide whether or not to report suspicious injuries. The clinician's past experiences with CPS. Clinicians who believed that CPS involvement would result in a negative outcome for the child or family were less likely to report.

Why is it so hard to document the number of children who are maltreated annually in the United States?

The number of children who are maltreated annually in the United States is difficult to document because: (1) definitions vary across tribal, state, and federal jurisdictions; (2) the standards and methods of collecting data vary considerably; and (3) many cases go unrecognized and unreported [5].

How to report child abuse?

The level of suspicion required to report suspected abuse is not clearly defined. But, with the knowledge that physicians tend to underreport suspected abuse, the following recommendations are made to increase physicians' confidence in making appropriate reports: 1 Obtain continuing education regarding child maltreatment. Routinely seeking out local and national opportunities for continuing education related to child abuse and neglect can help you maintain a current understanding of child maltreatment. 2 Know reporting laws. Familiarizing yourself with the reporting laws and to whom reports should be made in your state (i.e., CPS or law enforcement) can lessen the ambiguity in the reporting process. 3 Consult with colleagues. Establishing collaborative relationships with colleagues to consult with regarding difficult cases can assist in the decision-making process. Physicians in private practice who do not have colleagues readily available may want to create a referral process with local agencies that have teams who make these decisions. 4 Know your local CPS staff. Forming relationships with your local CPS staff members can facilitate an open line of communication and establish a better sense of the guidelines used by the agency.

What is child abuse?

Physical abuse is any physical injury to a child that is not accidental and may involve, but is not limited to, hitting, slapping, beating, biting, burning, shaking, ...

What is emotional abuse?

Emotional and psychological abuse exposes a child frequently and repeatedly to behaviors that impact his or her psychological well-being, including blaming, threatening, yelling at, belittling, humiliating, name calling, pointing out faults, withholding emotional support and affection, and ignoring a child. In some cases, exposure ...

What is sexual abuse?

In sexual abuse, an adult or older child engages a child in sexual activities such as fondling, intercourse, oral-genital stimulation, sodomy, observing sexual acts, viewing adult genitals, and looking at, watching, or engaging in pornography.

What are the physical injuries that a child may have?

As a result of these actions, a child may have bruises, broken bones, burns, or internal injuries that document the occurrence, as well as imprints of the specific object used to inflict the injury (e.g., belt buckle, hand, and knuckles). In sexual abuse, an adult or older child engages a child in sexual activities such as fondling, intercourse, ...

What is the mandated reporting for domestic violence in North Carolina?

Mandated reporting is for child abuse and neglect.

What is mandated reporting?

Mandated reporting is for child abuse and neglect. For adults the law is clear that when a doctor suspect domestic violence they are to ask the patient if their partner or care giver, family member or friend is harming them.

What is the number to call for domestic violence?

They are mandated to inform the domestic violence victim about the resources available to them, including providing them the number to the National Domestic Violence Hotline - 1-800-799-SAFE. I believe that this is following the principle that only the victim may know when it is truly safe for them to leave.

What is domestic violence in Florida?

To further expand this definition under Florida law: “Domestic Violence Battery is defined as any actual and intentional touching or the intentional causing of bodily harm to another person when the person is a ‘family or household Member’.”.

What does "at risk" mean in DCFS?

At risk can refer to observing one parent being harmed by another family member including an adolescent child. It is not always a male partner. Violence in the family is genderless.

How much is the penalty for domestic violence?

The penalties may include a fine of $1,000.00 in addition to up to a year in jail followed by twelve months probation. Additionally, as this crime is considered so serious, a person convicted of domestic violence will always have a criminal record as their record can never be expunged or sealed.

Do police convict people?

Police don't convict anyone of anything. The prosecutors convict a defendant based on evidence (produced, among other things, by police sometimes) and argument. In that case, many domestic violence cases are proven entirely on the back of testimony by the victim.

What is the duty to warn in healthcare?

A health care provider’s “duty to warn” generally is derived from and defined by standards of ethical conduct and State laws and court decisions such as Tarasoff v. Regents of the University of California.

What is HIPAA notification?

HIPAA permits a covered health care provider to notify a patient’s family members of a serious and imminent threat to the health or safety of the patient or others if those family members are in a position to lessen or avert the threat. Thus, to the extent that a provider determines that there is a serious and imminent threat ...

Does HIPAA protect against physical harm?

Thus, to the extent that a provider determines that there is a serious and imminent threat of a patient physically harming self or others, HIPAA would permit the provider to warn the appropriate person (s) of the threat, consistent with his or her professional ethical obligations and State law requirements.

What happens if a therapist fails to take reasonable steps to protect the intended victim from harm?

“If a therapist fails to take reasonable steps to protect the intended victim from harm, he or she may be liable to the intended victim or his family if the patient acts on the threat ,” Reischer said.

Should clients withhold anything from their therapist?

“Clients should not withhold anything from their therapist, because the therapist is only obligated to report situations in which they feel that another individual, whether it be the client or someone else, is at risk,” said Sophia Reed, a nationally certified counselor and transformation coach.

Can a therapist report a patient's intent to harm someone else?

A therapist may be forced to report information disclosed by the patient if a patient reveals their intent to harm someone else. However, this is not as simple as a patient saying simply they “would like to kill someone,” according to Jessica Nicolosi, a clinical psychologist in Rockland County, New York. There has to be intent plus a specific identifiable party who may be threatened.

Do therapists have to disclose information in court?

For instance, Reed noted that even if a wife is cheating on her husband and they are going through a divorce, the therapist has no legal obligation whatsoever to disclose that information in court. The last thing a therapist wants to do is defy their patient’s trust.

Do you have to report child abuse to a therapist?

“If a client experienced child abuse but is now 18 years of age then the therapist is not required to make a child abuse report, unless the abuser is currently abusing other minors,” Mayo said.

Case

Commentary

Disclosing Protected Health Information

  • In 1996, the federal government passed the Health Insurance Portability and Accountability Act (HIPAA) to standardize the expectations of patient confidentiality surrounding protected health information (PHI), which comprises any health care information that can be linked to a specific individual, such as diagnostic or treatment information . With this increased regulation came increased sanctions for violations and physicians’ growing con…
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Counseling Patients About Firearm Safety

  • Despite their importance in risk assessments, firearms can be a difficult and anxiety-provoking topic for physicians, particularly when they are not personally familiar or comfortable with guns. In such situations, physicians must consider how the firearm might affect their risk assessment. Depending on their personal experience with guns, physicians might have varying levels of concern about or comfort with the implications of …
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When Is Reporting Required?

  • Physicians also face the difficult task of deciding whether or not the situation constitutes enough of a risk to breach the patient’s confidentiality. In many cases, physicians might choose to tell the patient, as Dr. B did, that the information will be shared with another party. However, in situations in which this information might further agitate or anger the patient, physicians might decide not to disclose that they are reporting in the interest of thei…
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Conclusion

  • Physicians might be faced with difficult legal and ethical decisions in cases in which patients appear at risk of violence or suicide, particularly when firearms are involved. Discussions about the risks of firearms should be approached collaboratively so as not to diminish patient rapport. Additionally, physicians should be cognizant of when they ...
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