There are two important questions that a physician should ask in dealing with a police officer in a medical care setting: Is the patient in custody? Is there a court order involving medical care? If the patient is not in custody, the police officer is a third party, with no right to information about the patient or the medical care. Medical information may become available to the officer later through a court action for the medical records, but that does not allow the officer to question the physician without the express permission of the patient. If the patient is unable or unwilling to give permission, the officer should be politely but firmly shown the door.

If the patient is in custody, the officer still has no right to consent to or know about the patient’s medical care beyond the specific requirements of the state’s laws. Being under arrest increases the importance of the patient’s right of privacy. The physician must be careful not to interfere with the officer’s duties, just as the physician should not allow the officer to interfere with the patient’s medical care. If privacy is required for the medical examination, the patient’s dignity should be protected as much as possible consistent with preventing the patient’s escape. The physician should not interfere with actions that are necessary to maintain custody of a conscious and potentially dangerous prisoner.

Court-ordered medical care is different from care requested by a peace officer. A police officer does not have the right to overrule a patient’s decisions on medical consent; a court does. A physician who is presented with a valid court order to do something to or for a patient may either honor the order or get a lawyer to fight the order. Physicians who are routinely involved with court- ordered care should be well versed in the procedures. The emergency physician in the county hospital may be routinely ordered to do drug testing on specific prisoners. This physician or the nurses who work there regularly may know the forms and the judges’ names and have no problem with honoring the order. The physician in a private hospital who is presented with an unusual order should contact the hospital attorney or someone in the court system for a clarification of the order.

Some medical records are protected even from court orders, but these are usually in the custody of agencies that know the extent of their authority to withhold records. Venereal disease control programs frequently receive subpoenas for medical records that are protected from subpoena by state law. The judge in a divorce proceeding may not know about the law protecting these records or may have authorized that subpoena as one in a large group. The public health program will routinely request that the subpoena be quashed. A physician in public health or drug rehabilitation who deals regularly with protected records must view the possibility of spending some time in jail on a contempt citation as an occupational hazard. The physician who does not deal with these matters frequently should consult an attorney when presented with a court order.