Generally physicians have a responsibility to report violent or suspicious injuries—all gunshot wounds, knifings, poisonings, serious motor vehicle injuries, and any other wounds that seem suspicious—to the local law enforcement agency. The legal assumption is that anyone who has knowledge that a crime may have been committed has a duty to report the possible crime to the police. If the patient is brought to the hospital in the custody of the police or from the scene of a police investigation, the physician may safely assume that the police have been notified. In all other cases, the physician should call the police and make the report.

Such injuries should be reported despite the wishes of the patient. The patient who has been shot escaping from the scene of a crime will be more interested in the wound’s not being reported than the patient who is embarrassed about mishandling a gun while cleaning it. Some states have made domestic violence a reportable offense. In states where such reporting is not required, the physician should determine if battered spouses or partners may be reported under general violent injury laws. This is very important because of the high probability that the victim will be severely injured or killed eventually. In some cases, the couple will have made up by the time the stitches are in and the X rays are read. This should not stop the physician from reporting. In others, the victim will be too terrified to complain. If the woman who came in saying her husband cut her now claims she injured herself cooking, the injury must be reported nevertheless. Domestic violence is one of the most dangerous areas of police work, and the rate of repeat violence is very high. Medical care providers should not try to handle these cases privately in emergency rooms.