Best practice guidelines for evaluating patients in custody in the emergency department

Abstract Patients in custody due to arrest or incarceration are a vulnerable population that present a unique ethical and logistical challenge for emergency physicians (EPs). People incarcerated in the United States have a constitutional right to health care. When caring for these patients, EPs must...

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Main Authors: Samantha Chao, William Weber, Kenneth V. Iserson, Rebecca Goett, Eileen F. Baker, Sarayna S. McGuire, Paul Bissmeyer Jr., Arthur R. Derse, Nishi Kumar, Jay M. Brenner
Format: Article
Language:English
Published: Elsevier 2024-04-01
Series:Journal of the American College of Emergency Physicians Open
Subjects:
Online Access:https://doi.org/10.1002/emp2.13143
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author Samantha Chao
William Weber
Kenneth V. Iserson
Rebecca Goett
Eileen F. Baker
Sarayna S. McGuire
Paul Bissmeyer Jr.
Arthur R. Derse
Nishi Kumar
Jay M. Brenner
author_facet Samantha Chao
William Weber
Kenneth V. Iserson
Rebecca Goett
Eileen F. Baker
Sarayna S. McGuire
Paul Bissmeyer Jr.
Arthur R. Derse
Nishi Kumar
Jay M. Brenner
author_sort Samantha Chao
collection DOAJ
description Abstract Patients in custody due to arrest or incarceration are a vulnerable population that present a unique ethical and logistical challenge for emergency physicians (EPs). People incarcerated in the United States have a constitutional right to health care. When caring for these patients, EPs must balance their ethical obligations to the patient with security and safety concerns. They should refer to their institutional policy for guidance and their local, state, and federal laws, when applicable. Hospital legal counsel and risk management also can be helpful resources. EPs should communicate early and openly with law enforcement personnel to ensure security and emergency department staff safety is maintained while meeting the patient's medical needs. Physicians should consider the least restrictive restraints necessary to ensure security while allowing for medical evaluation and treatment. They should also protect patient privacy as much as possible within departmental constraints, promote the patient's autonomous medical decision‐making, and be mindful of ways that medical information could interact with the legal system.
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spelling doaj-art-8ed6030c7f104d5692048b4fa20fa5cd2025-08-20T01:58:34ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522024-04-0152n/an/a10.1002/emp2.13143Best practice guidelines for evaluating patients in custody in the emergency departmentSamantha Chao0William Weber1Kenneth V. Iserson2Rebecca Goett3Eileen F. Baker4Sarayna S. McGuire5Paul Bissmeyer Jr.6Arthur R. Derse7Nishi Kumar8Jay M. Brenner9Department of Emergency Medicine Michigan Medicine Ann Arbor Michigan USADepartment of Emergency Medicine Rush University Chicago Illinois USADepartment of Emergency Medicine The University of Arizona Tucson Arizona USADepartment of Emergency Medicine Rutgers New Jersey Medical School Newark New Jersey USARiverwood Emergency Services, Inc Perrysburg Ohio USADepartment of Emergency Medicine Mayo Clinic Rochester Minnesota USADepartment of Emergency Medicine Orange Park Hospital Jacksonville Florida USACenter for Bioethics and Medical Humanities and Department of Emergency Medicine Medical College of Wisconsin Milwaukee Wisconsin USACollege of Law Loyola University New Orleans New Orleans Louisiana USADepartment of Emergency Medicine SUNY‐Upstate Medical University Syracuse New York USAAbstract Patients in custody due to arrest or incarceration are a vulnerable population that present a unique ethical and logistical challenge for emergency physicians (EPs). People incarcerated in the United States have a constitutional right to health care. When caring for these patients, EPs must balance their ethical obligations to the patient with security and safety concerns. They should refer to their institutional policy for guidance and their local, state, and federal laws, when applicable. Hospital legal counsel and risk management also can be helpful resources. EPs should communicate early and openly with law enforcement personnel to ensure security and emergency department staff safety is maintained while meeting the patient's medical needs. Physicians should consider the least restrictive restraints necessary to ensure security while allowing for medical evaluation and treatment. They should also protect patient privacy as much as possible within departmental constraints, promote the patient's autonomous medical decision‐making, and be mindful of ways that medical information could interact with the legal system.https://doi.org/10.1002/emp2.13143autonomycarceralcustodyincarceratedlaw enforcementprison
spellingShingle Samantha Chao
William Weber
Kenneth V. Iserson
Rebecca Goett
Eileen F. Baker
Sarayna S. McGuire
Paul Bissmeyer Jr.
Arthur R. Derse
Nishi Kumar
Jay M. Brenner
Best practice guidelines for evaluating patients in custody in the emergency department
Journal of the American College of Emergency Physicians Open
autonomy
carceral
custody
incarcerated
law enforcement
prison
title Best practice guidelines for evaluating patients in custody in the emergency department
title_full Best practice guidelines for evaluating patients in custody in the emergency department
title_fullStr Best practice guidelines for evaluating patients in custody in the emergency department
title_full_unstemmed Best practice guidelines for evaluating patients in custody in the emergency department
title_short Best practice guidelines for evaluating patients in custody in the emergency department
title_sort best practice guidelines for evaluating patients in custody in the emergency department
topic autonomy
carceral
custody
incarcerated
law enforcement
prison
url https://doi.org/10.1002/emp2.13143
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