When working on the resolution with fellow PACEP members, Drs. Werley and Savino “noticed a clear dichotomy regarding our experiences with law enforcement among us from those who practice in more urban settings to those that practice in a more small town or rural environment,” said Dr. Werley. Those perspectives prepared them for the detailed debate that ensued at the Council Meeting.

There was concern that the second part of the resolution—that ACEP encourage law enforcement to stay with any patient they choose to bring to the ED who poses a risk to the safety of themself or others until a disposition has been determined or the physician determines assistance is no longer needed—did not reflect the collaborative relationship needed with law enforcement. Those testifying acknowledged that this is a complex problem that affects emergency physicians and patients, and highlighted the practical, regulatory, and legal challenges associated with implementing this resolution. There was additional debate about hospitals taking more responsibility for the safety of staff and patients.

The telemedicine aspect of the resolution “brought up concerns that it could turn into a slippery slope, and we may be asked to do other evaluations for law enforcement,” said Dr. Savino, so it was agreed to remove that part.

The resolution prompted a lot of discussion about the institution’s role in keeping its employees safe, which illuminated the safety resources available to large, urban EDs compared to smaller hospitals.

“I was surprised that some perceived [our resolution] as anti-law enforcement, which was never the intent. I have had great experiences with law enforcement in my career,” Dr. Werley said. “But just like hospitals have various resources based on size and location, the same can be said for a small town with only one or two officers on duty versus a city with a much larger police force.”

After much debate, this resolution was referred to ACEP’s Board of Directors. “We knew it might be contentious when we wrote it, but felt it was worth discussing because it impacts so many of us,” said Dr. Werley. “I’m glad it generated so much discussion because it demonstrated to the Board the importance of this issue.” Both Drs. Savino and Werley were comfortable with the resolution’s outcome, saying they felt confident that the Board had heard both sides of the discussion and would be able to explore the additional nuances of the issue.