Inform the patient she does not believe him and that she has to report her suspicions to the police, then contact the police and give them the patient's details?
Dr MacDonald is a consultant in emergency medicine at a busy district general hospital. She has been treating a 19 year-old man with a stab wound to the abdomen.
Dr MacDonald is speaking to Craig, the paramedic who brought the patient in. When briefing Dr MacDonald earlier, Craig said the patient had told him that he had accidentally stabbed himself with a knife.
He's still insisting that he stabbed himself accidentally. Where did you say you picked him up?
Under the railway arches down by West Hill multi-storey. He was phoned in by an anonymous caller. Nobody else was on the scene when we arrived.
...and you said there'd been some other incidents in that area recently?
Three other stabbings in the last fortnight, two of them serious. Seems fairly likely to me that it's gang-related. So I guess you have to tell the police do you? But if the patient doesn't want you to and he says it was an accident...well, patient confidentiality and that...
He's adamant that he doesn't want to involve the police, but I don't see what else I can do. I don't want to scare him away...stop him and others like him from seeking treatment in the future.
12. If it is probable that a crime has been committed, the police will ask for more information. If practicable, you should ask for the patient's consent before disclosing personal information unless, for example, doing so:
13. If the patient refuses consent or cannot give it (eg because they are unconscious), you can still disclose information if it is required by law or if you believe disclosure is justified in the public interest.
14. Disclosures in the public interest may be justified when:
15. If there is any doubt about whether disclosure without consent is justified, the decision should be made by, or with the agreement of, the consultant in charge or the healthcare organisation's Caldicott or data guardian.
16. You must document in the patient's record your reasons for disclosing information without consent and any steps you have taken to seek their consent or inform them about the disclosure, or your reasons for not doing so.
(Confidentiality: reporting gunshot and knife wounds (2017) paragraphs 12-16)