Abstract
Worldwide, there is a high risk of medical complications or death in police custody. This risk is often increased by unclear legislation, a lack of clearly defined responsibility and medical examination standards. Any solution to these problems requires as a very basis the systematic analysis of the medical examinations that determine whether a person is fit to be detained in custody. We analysed a total of 3,674 medical records on fitness for custody, taken from two large German towns (Halle/S and Bremen). The examined individuals were predominantly males or of a younger age. The indication in the majority of cases was acute alcoholic intoxication or drug withdrawal syndromes. Traumata and internal or mental diseases were also quite frequent. For approximately 50% of all cases, fitness for custody was declared on certain conditions. Only 39.8% were found to be unconditionally fit for detention in custody. In just under 10% of the cases, the person was found unfit for custody. These cases concerned mainly persons with psychological symptoms and advanced alcohol or drug withdrawal syndromes. We were able to show that the recent introduction of new police custody regulations in Halle/S had a significant influence on the medical decision on fitness for custody. Our detailed assessment has provided us with the basis to develop solutions for the improvement of medical care in police custody. The focus lies here on the organisation and legal regulation of the medical aspects of custody but also on policing and medical work.
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References
Payne-James JJ (2000) History and Development. In: Stark MM (ed) A physician’s guide to clinical forensic medicine. Humana Press, Totowa, pp 1–14
Editorial (1993) Three-faced practice: doctors and police custody. Lancet 341:1245–1247
Mc Kinnon I, Grubin D (2010) Health screening in police custody. J Forensic Leg Med 17(4):209–212
Heide S, Kleiber M, Hanke S, Stiller D (2009) Deaths in German police custody. Eur J Public Health 19:597–601
Chariot P, Martel P, Penneau M, Debout M (2008) Guidelines for doctors attending detainees in police custody: a consensus conference in France. Int J Leg Med 122:73–76
Heide S, Stiller D, Kleiber M, Henn V (2005) Ärztliche Beurteilung der Gewahrsamstauglichkeit—Probleme mit dem Föderalismus. Dtsch Med Wochenschr 130:1648–1652
Heide S, Krüger M, Kroke S, Kleiber M, Stiller D (2011) Gewahrsamstauglichkeitsuntersuchung-Ärztliche Pflicht und rechtliche Verantwortung. Gesundheitswesen (in press)
Pedal W (2001) Die ärztliche Gewahrsamsfähigkeitsuntersuchung. Ärzteblatt Sachsen-Anhalt 12:48–50
Greiner A (1999) Der Tod in der Polizeizelle. Die Polizei 90:281–285
Kiesecker R (1999) Arzt und Gewahrsams-/Haftfähigkeit. MedR 2:51–57
Heide S, Stiller D, Kleiber M (2003) Zur Problematik der Gewahrsamstauglichkeit. Dtsch Ärztebl 12:791–794
Weber B (2006) Medizinische und rechtliche Probleme des Polizeigewahrsams. Dissertation, University of Heidelberg
Ogloff J, Warren L, Tye C, Blaher F, Thomas S (2010) Psychiatric symptom and histories among peo ple detained in police cells. Soc Psychiatr Epidemiol. doi:10.1007/s00127-010-0256-5
Gregory M (2007) Characteristics of drug misusers in custody and their perceptions of medical care. J Forensic Leg Med 14(4):209–212
Blaauw E, Lulf RE (1999) Police custody detainees and forensic medicine: use of medical resourrces in the cell block. Med Law 18:645–651
Roberts G, Roberts J, Patton HF, Patton M, Megson K, Murphy R (2006) A qualitative and quantitative survey of Forensic Medical Examiner workload in the Northumbria Police Force area October 2002–January 2003. J Clin Forensic Med 13(1):1–8
Carter J, Mayhew J (2010) Audit of hospital transfers January to March 2006 from Sussex police custody. J Forensic Leg Med 17(1):38–40
Payne-James JJ, Geen PG, Green N, McLachlan GM, Munro MH, Moore TC (2010) Healthcare issues of detainees in police custody in London, UK. J Forensic Leg Med 17(1):11–17
Heide S, Kleiber M, Wilhelms E, zur Nieden K, Stiller D (2007) Änderungsbedarf bei neuer Polizeigewahrsamsordnung. Ärzteblatt Sachsen-Anhalt 3:16–18
Fischer L (2005) Gewahrsamstauglichkeit und Unterbringung alkoholisierter Personen. Ärzteblatt Mecklenburg-Vorpommern 6:197–200
Busuttil A, Wallace NW (1991) Medication in police custody. J R Soc Med 83:566–568
Norfolk GA, Stark MM (2000) Care of Detainees. In: Stark MM (ed) A physician’s guide to clinical forensic medicine. Humana Press, Totowa, pp 149–178
Bundeskriminalamt (2010) Polizeiliche Kriminalstatistik 2009. Wiesbaden, 57. Ausgabe
Ochmann A, Berghaus G (1968) Fehldiagnose Trunkenheit. In: Dotzauer G, Hirschmann J (eds) Fehldiagnose Trunkenheit. Schattauer Verlag, Stuttgart, p 15
Copeland AR (1984) Deaths in custody revisited. Am J Forensic Med Pathol 5:121–124
Segest E (1987) Police custody: deaths and medical attention. J Forensic Sci 32:1694–1703
Norfolk GA (1998) Death in police custody during 1994: a retrospective analysis. J Clin Forensic Med 5:49–54
Giles HG, Sandrin S (1992) Alcohol and deaths in police custody. Alcohol Clin Exp Res 6:670–672
Blaauw E, Vermunt R, Kerkhof A (1997) Death and medical attention in police custody. Med Law 16:593–606
Johnson HRM (1982) Deaths in Custody in England and Wales. Forensic Sci Int 19:231–236
Stark MM, Gregory M (2005) The clinical management of substance misusers in police custody—a survey of current practice. J Clin Forensic Med 12:199–204
Best D, Havis S, Payne-James JJ, Stark MM (2006) Near miss incidents in police custody suites in London in 2003: a feasibility study. J Clin Forensic Med 13:60–64
Tiainen E, Penttila A (1986) Sudden and unexpected deaths in police custody. Acta Med Leg Soc (Liege) 36:281–292
Chan TC (2006) Medical overwiev of sudden in-custody deaths. In: Ross DL, Chan TC (eds) Sudden deaths in custody. Humana Press, Totowa, pp 9–14
Pedal I (2003) Todesfälle bei der Festnahme exzitierter Personen: Zum Stand der Diskussion. In: Saternus KS, Kernbach-Wighton G (eds) Fixierung erregter Personen. Todesfälle in Klinik und Gewahrsam. Schmidt-Römhild, Lübeck, pp 25–35
Greenberg N, Lloyd K, O'Brien C, McLver S, Hessford A, Donovan M (2002) A prospective survey of section 136 in rural England (Devon and Cornwall). Med Sci Law 42(2):129–134
Heide S, Henn V, Kleiber M, Dressler J (2010) An avoidable death in police custody? Am J Forensic Med Pathol 31(3):261–263
Heide S, Kleiber M, Stiller D (2009) Strafprozessuale Folgen bei Todesfällen im Polizeigewahrsam. Gesundheitswesen 71:226–231
Lieske K, Püschel K (1986) Todesfälle in der Ausnüchterungsambulanz. Blutalkohol 23:289–294
Elsing C, Schlenker T, Stremmel W (2001) Haft- und Gewahrsamsfähigkeit aus internistischer Sicht. Dtsch Med Wochenschr 126:1118–1121
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Heide, S., Stiller, D., Lessig, R. et al. Medical examination of fitness for police custody in two large German towns. Int J Legal Med 126, 27–35 (2012). https://doi.org/10.1007/s00414-011-0557-6
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DOI: https://doi.org/10.1007/s00414-011-0557-6