Physicians in a variety of clinical settings, including emergency departments, may need to interact with police seeking information and evidence as part of an investigation or inquiry.
This article offers advice for physicians when interacting with police, including their responsibility to maintain the confidentiality of patient health information, and their duty to report to law enforcement or other authorities in specific circumstances. Physicians who work in hospitals should verify whether their institution has a policy concerning interactions with police and sharing patient information.
If safety is at risk, contact police without delay. For more information, see the article “The office safety plan.”
Confidentiality and privacy
Physicians should generally refrain from disclosing information about patients to the police or any other third party unless the patient provides their consent.
There are a few exceptions when the disclosure of patient information is permitted, or required, without patient consent. For example:
- When the physician receives a search warrant or court order.
- When the physician receives a request from the police investigating an alleged crime and it is considered appropriate in the circumstances to do so.
- When the physician has reason to believe there is an imminent risk of serious bodily harm or death.
Search warrants
A search warrant grants the police broad legal authority to search for and seize evidence. Before disclosing or permitting the police access to patient information in response to a search warrant:
- Inspect the warrant. Only the information listed in the warrant should be disclosed.
The police may contact you before a search warrant is issued. As this may be an attempt to gather information for obtaining the search warrant, refrain from disclosing patient information prior to the search warrant being issued.
Subpoenas
In most jurisdictions, a subpoena or summons is a command for the physician to attend a criminal or other court proceeding. A subpoena alone is not sufficient reason to disclose patient information before attending the proceeding.
- Unless the patient has given you specific authority to disclose the records in advance, bring the records with you to the proceeding as indicated in the subpoena, and release the relevant contents only when the court or tribunal so orders.
Police investigations of patients
In the absence of consent or other legal authority, do not disclose information about a patient even when a patient is under arrest or otherwise being detained. Your duty of confidentiality also applies to patients who are deceased, unconscious, or impaired beyond having the capacity to consent.
If you receive a request for information about a patient who is suspected of criminal activity or dangerous behaviour toward others:
- You may respond to questions about the patient's health only if presented with valid legal authority compelling disclosure (e.g. statutory requirement, search warrant, or court order).
- You do not have a duty to provide patient information to the police concerning suspected prescription fraud. The exception is if the police’s questions do not require you to disclose the patient's personal health information, such as asking you to verify whether a prescription in the possession of the police is authentic (e.g. whether the handwriting and signature are those of the physician).
In some provinces and territories, physicians may be legally required to disclose personal health information when police are conducting a criminal investigation. In other jurisdictions, physicians may have discretion on whether to disclose patient information without consent in these circumstances. When you have such discretion, keep in mind your duty of confidentiality and the facts of the case.
- When disclosing patient information to police or any third party, document in the patient’s medical record the fact that you disclosed patient information, what information you disclosed, and the information you relied on to make the decision to disclose.
Blood samples
The Criminal Code allows for the taking of blood samples in certain situations, such as for the police to confirm a person’s blood-alcohol content. Such circumstances are distinct from where a blood sample is taken without consent to guide care in medical emergencies.
When a blood sample is obtained under the Criminal Code or a court order, the individual would be obligated to submit to a blood sample. If the individual refuses, physicians should not attempt to obtain a blood sample without their consent.
If physicians are presented with a warrant for a blood sample (issued by a justice of the peace under specific legal conditions where the individual is considered unable to give consent), then physicians (or qualified technicians) are required to obtain and provide to police the sample based on the warrant and not on the basis of consent by the patient. However, there may be exceptions, such as:
- The patient’s condition has changed since the warrant was initially requested, and the person is now considered able to provide consent.
- Taking the sample could endanger the person’s health.
- The physician has a "reasonable excuse" 1 for refusing to take the sample.
For more information, see CMPA’s Medico-legal handbook for physicians in Canada.
Duty to report to the police
Gunshot and stab wounds
In British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Québec, Nova Scotia, Newfoundland and Labrador, and Northwest Territories, hospitals and healthcare facilities must report gunshot wounds to the police. In British Columbia, Alberta, Saskatchewan, Manitoba, Newfoundland and Labrador, and Northwest Territories, this reporting obligation also includes stab wounds.
The obligation to report such incidents typically falls to the institution, not the individual physician, though in some provinces and territories, this could also include private medical offices and clinics.
Deaths
All provinces and territories have legislation that requires anyone, including physicians, to report certain deaths, including those that the person has reason to believe are violent, suspicious, or unexplained.
The nature and circumstances of deaths that must be reported varies from province to province. While most legislation requires the report to be made to the chief coroner, several provinces allow the report to be made to police.
Physicians under investigation
In the course of their medical practices, physicians may become the subject of police investigations, such as for alleged sexual assault, narcotic fraud, or billing issues.
- When receiving a request from police, you should decline to make any statements or respond to questions until you have received advice from CMPA or your personal legal counsel.
Keep in mind, any statements or documents provided to the police can be used as evidence in subsequent proceedings, and physicians are still expected to maintain the confidentiality of patient health information.
Contact CMPA
Contact CMPA if you are a CMPA member and have questions or concerns about your obligations to provide information to police.
More information
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An example of a “reasonable excuse” for a physician to refuse to take a blood sample might be the absence of informed consent, that is, when a “competent individual” declines to give consent to their blood being drawn.
