Synopsis

In this vignette the action takes place in the Emergency Department. A resident physician is taking a history from a patient who presents with a possible fracture after falling over a fence. During the interview the patient reveals that he was being chased and injured his leg when he landed. Immediately after the encounter, the resident receives a phone call from the police asking for information about the patient’s clinical condition.

As you watch, focus on:

• The patient’s narrative – how the resident elicits the circumstances of the fall and assesses the injury.
• Ethical and legal considerations – the resident’s response to the police request, including confidentiality, consent, and duty to disclose.
• Clinical decision‑making – the initial assessment of a possible fracture and any immediate management steps taken before the call.

Confidentiality

Patient confidentiality is a fundamental principle in healthcare, ensuring that information shared by patients in the context of treatment is kept private unless there is a valid reason to do otherwise. This trust is essential: it encourages open communication, supports accurate diagnosis, and maintains the therapeutic relationship. When requests come from external bodies – such as the police – the duty of confidentiality must be carefully balanced with legal, ethical, and public interest obligations.

Confidentiality can be broken in certain situations, but only under specific conditions. First, if the patient gives explicit consent, information may be shared. Second, there must be a legal requirement or statutory obligation — for example a court order or law that mandates disclosure. Third, disclosure could be justified if there is a public interest strong enough to override confidentiality: for instance, to prevent serious harm, protect vulnerable individuals (such as children or those lacking capacity), or to prevent or detect serious crime. Importantly, any breach must be necessary and proportionate, and only as much information as needed should be disclosed.

When police request patient information, healthcare professionals should assess: whether there is consent; whether a law requires or permits disclosure; whether the requested information is relevant and limited; and whether delaying for legal advice or involving senior colleagues is needed. Proper documentation of decision-making is crucial.

By maintaining confidentiality wherever possible, healthcare professionals protect patient autonomy and trust. But knowing when disclosure is legally or ethically justified ensures they act responsibly, protect others, and uphold their professional duties.

Discussion Points

• Confidentiality – when can you break it?
• Can you break confidentiality in context of police requests? Do you have to break it for all police requests?
• In the case of court order requests – what information is acceptable to share?

External Resources

• Sharing information with the police – NHS England guidance
• Disclosures for the protection of patients and others – GMC
• Can I disclose information to the police? - Medical Protection