Last month in the state of Utah, US, an ER Nurse was arrested by police for not taking a blood sample from an unconscious patient. The patient was a suspect in a motor vehicle collision, and police wanted to know if the suspect had been under the influence of drugs or alcohol.
Taking blood samples from patients is a daily occurrence for every ER Nurse, but there are strict policies and procedures that must be followed to protect the rights of the patient. Ordinarily, verbal or written consent is obtained by the Healthcare Professional to obtain a blood sample. The results of the blood sample will help the Healthcare team determine a diagnosis, or rule one out. On occasion, a patient may not be awake enough to give their consent. In these circumstances, Healthcare Professionals will treat the patient taking their best interest as a priority. This means assuming the patient would want to be treated. This includes the diagnostic tests to determine what is wrong with the patient. The College of Physicians and Surgeons of Ontario determine "treatment" to be the following:
“Treatment is defined in the HCCA as anything that is done for a therapeutic, preventive, palliative, diagnostic, cosmetic or other health-related purpose, and includes a course of treatment, plan of treatment, or community treatment plan.”
Providing treatment to a patient in an emergency situation can be given without consent. ER staff is faced with this situation daily. In these situations, treatment can be provided immediately, as per the College of Nurses Practical Guidelines if the patient is:
“Incapable with respect to treatment, a substitute decision-maker is not readily available, it is not reasonably possible to obtain a consent or refusal from the substitute, and a delay will put the person at risk of sustaining serious bodily harm”
None of these situations allow for Healthcare Professionals to perform any form of treatment unless there is a valid consent, an emergency situation, or as we will discuss, a warrant. It is generally common practice for Healthcare Professionals to take diagnostic test in relation to alcohol or drug levels if a patient comes to the ER unconscious. This may determine the reason for the patient being unconscious, therefore, this being in the best interest of the patient to take such test. As an ER nurse, I developed close working relationships with the officers who would come into the ER with patients. On occasion, I was asked to provide them with results from patients in similar situations that brought the patient into the Utah hospital. Even though you may be tempted to help the police out, do not do it. Providing police, or anyone for that matter, confidential information regarding your patient is a breach of hospital policy, a breach of professional practice guidelines, and a breach of the Personal Health Information Protection Act (PHIPA). This will not prevent the police obtaining the information, as long as they follow the correct procedures. To do this the police will obtain a warrant under the Criminal Code, section 256(1) which states the following:
256. (1) Subject to subsection (2), if a justice is satisfied, on an information on oath in Form 1 or on an information on oath submitted to the justice under section 487.1 by telephone or other means of telecommunication, that there are reasonable grounds to believe that
(a) a person has, within the preceding four hours, committed, as a result of the consumption of alcohol or a drug, an offence under section 253 and the person was involved in an accident resulting in the death of another person or in bodily harm to himself or herself or to any other person, and
(b) a qualified medical practitioner is of the opinion that
(i) by reason of any physical or mental condition of the person that resulted from the consumption of alcohol or a drug, the accident or any other occurrence related to or resulting from the accident, the person is unable to consent to the taking of samples of his or her blood, and
(ii) the taking of samples of blood from the person would not endanger the life or health of the person,
So by placing a quick phone call to a Justice, who are available 24/7, a warrant can be obtained. If the proper procedure is not followed, this could lead to the evidence not being used in court. So if you think you are helping, think again. It can lead to the case being thrown out and placing the Healthcare Professional’s career in jeopardy.