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should have access to a patient. What these principles
mean and questions to ask oneself to ensure they are
being applied correctly are as follows:
• The principle of autonomy refers to the patient’s right to
make decisions regarding his or her own medical care
without being influenced or coerced by outside parties.
Is the patient actually under arrest or in police custody,
or are the police simply accompanying the patient with
the intent to question him or her? What are the local
laws with regard to these patients?
•Benevolence refers to the physician’s responsibility to
prevent “deliberate, unnecessary, or avoidable harm
to patients.” 25 Does the police presence impede the
patient’s care or violate their trust or privacy?
• The principle of beneficence requires that the physician have a positive impact on the patient’s health. Is
the presence of law enforcement benefiting the patient
in some way?
•The principle of justice delineates that all patients
should be treated equally regardless of their personal
or financial situation. Is the patient receiving the same
care and being treated with the same respect that any
other person arriving in the trauma bay would expect
to receive?
After these initial concerns are addressed and the
basic ethical principles are considered in each unique
situation, the surgeon must further ask if staff or
public safety concerns are sufficiently compelling
to potentially violate the patient’s best interests and
allow law enforcement to proceed with questioning.
Only after assessing each of these variables can the
surgeon determine who should have access to the
patient and truly provide the most ethical medical
care possible. ♦
REFERENCES, CONTINUED
