1. Anderson, Maija DNP, RN
  2. Bailey, Mary DNP, RN, APN


Abuse of patients in the custody of law enforcement officials is not acceptable.


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In late summer 2005 a police officer in Chicago was charged with aggravated battery and official misconduct after a hospital surveillance video showed him beating an intoxicated patient who was shackled to a wheelchair while waiting for ED treatment. The police had been called when the patient was "not cooperating with hospital staff," according to the January 19, 2006, Chicago Sun-Times. In November 2006 the patient was awarded $125,000, and the Chicago Police Department was seeking to fire the officer.

Figure. Maija Anders... - Click to enlarge in new windowFigure. Maija Anderson
Figure. Mary Bailey... - Click to enlarge in new windowFigure. Mary Bailey

This is just one example of an excessive use of force, which the International Association of Chiefs of Police defines as "the application of an amount and/or frequency of force greater than that required to compel compliance from a willing or unwilling subject." According to the Bureau of Justice Statistics, such force resulted in 1,095 arrest-related deaths by law enforcement officers between 2003 and 2005.


Despite media reports of excessive use of force, health care professionals have been resoundingly mute on the topic. Nurses care for patients whose injuries may be the result of such abuse, but while they're mandated to report abuse in children and the elderly, there is no systematic protocol for responding when patients are hospitalized because of excessive use of police force. We suggest, therefore, that the care of such patients should parallel the care provided to victims of other types of violence. This is a complex issue; children, the elderly, and victims of domestic violence who are receiving treatment typically haven't been accused of committing crimes themselves. The nurse must be the patient's advocate regardless of what that person has been accused-or convicted-of.


The Student National Medical Association and the American Public Health Association (APHA) have taken positions against police brutality; the APHA has urged the "training of health and mental health personnel in the identification of victims of police brutality and an appropriate means of reporting such events." Perhaps nursing can follow suit.


Consider taking the following actions:


* Talk with colleagues. What is an appropriate use of force? What is excessive?


* Provide education on the excessive use of force, nurses' responsibilities, and how to report such incidents.


* Collaborate with correctional facilities, police departments, hospitals, and clinics to establish protocols for responding to such incidents.


* Host joint information sessions with community members and law enforcement officials; nurses are trusted by both groups and are therefore well-suited to this task.



But before the issue can be resolved, nurses need to honor their legal, moral, and ethical obligation to be their patients' advocates. Input from nurse ethicists and attorneys who work with this population would be valuable. Since nurses in many different practice settings see this form of abuse, why shouldn't they be involved in reporting and preventing it? Nursing takes a stand on many other issues. Why not this one?