‘Cleared’ as mud. communication between health services and police: risks to detainees in police custody

Abstract

In Victoria, a significant proportion of forensic medical officer caseload includes attending police stations to assess fitness for police interview of detainees in police custody. Detainees may be particularly vulnerable if they have existing medical conditions, require medications, are at risk of substance withdrawal, or have sustained recent trauma during their alleged offence or arrest. There may be a delay until they can be assessed by custodial healthcare staff if they are transferred to a remand centre. Detainees in police custody are entirely reliant on police custodians to activate health seeking channels to facilitate medical assessment, and to reactivate healthcare channels if the detainee’s clinical situation changes. A series of near miss incidents with regard to detainee safety are presented, identified at the time of fitness for police interview assessment by forensic medical officers, in which detainees had been reportedly already ‘cleared’ medically. The concept of medical ‘clearance’ is discussed, and the inherent misunderstanding of this as a static and binary state, including the role of the forensic medical officer in facilitating communication between the health care and criminal justice systems.