What powers are available to officers when a detainee refuses medical treatment?

22 April 2020

Not reviewed after the date of publication

Question:

A detainee in custody confirms they have swallowed drugs and a health care professional is not available. They refuse assessment and any medical treatment but are deemed to have mental capacity. Is there a power to force them to have treatment?

Answer: 

Ultimately when a person in custody who is deemed to have capacity refuses medical treatment the police do not have any powers to force them to have treatment. The medical staff would not be able to treat a person without their consent and the detainee does have a right to refuse treatment.

The custody officer must ensure the provisions of PACE Code C are complied with in regards to clinical treatment and attention, specifically paragraph 9.5 onwards. For example, when the custody officer has been made aware of the swallowing of drugs, they must call an ambulance immediately in the absence of a health care professional.

The custody officer must follow force policies / procedures and any further advice given by the healthcare professionals in regards to caring for the detainee. Following a review of the detainee's risk assessment, the likely outcome following refusal of treatment will be to arrange for the detainee to be placed under higher level observations and a requirement to rouse, a level 2 observation is the minimum acceptable level for detainees who are under the influence of alcohol or drugs.

Paragraph 9.15 also states what should be recorded on the custody record when any decisions regarding medical treatment are made:

'9.15 A record must be made in the custody record of:

a) the arrangements made for an examination by an appropriate health care professional under paragraph 9.2 and of any complaint reported under that paragraph together with any relevant remarks by the custody officer.

b) any arrangements made in accordance with paragraph 9.5;

c) any request for a clinical examination under paragraph 9.8 and any arrangements made in response;

d) the injury, ailment, condition or other reason which made it necessary to make the arrangements in (a) to (c), See Note 9G

e) any clinical directions and advice, including any further clarifications, given to police by a health care professional concerning the care and treatment of the detainee in connection with any of the arrangements made in (a) to (c), See Notes 9E and 9F;

f) if applicable, the responses received when attempting to rouse a person using the procedure in Annex H, See Note 9H,

9.16 If a health care professional does not record their clinical findings in the custody record, the record must show where they are recorded. See Note 9G. However, information which is necessary to custody staff to ensure the effective ongoing care and well-being of the detainee must be recorded openly in the custody record, See paragraph 3.8 and Annex G, paragraph 7.'

We would therefore advise that the custody officer makes a record of all efforts made to provide the detainee with medical treatment and records any information that has been given from the medical professionals with regards to the risks of refusing hospital treatment.

Further information regarding monitoring, observations and caring for detainees can be found on the following College of Policing link:

https://www.app.college.police.uk/app-content/detention-and-custody-2/detainee-care/

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