Alcohol and deaths in police custody

Study on Evaluation of Knowledge, Attitude, and Practice of Sri Lankan Traffic Police Officers Related to Examination of Drunk Drivers, in Two Most Populated Districts of Sri Lanka

Introduction:

Driving under the influence (DUI) of alcohol is one of the substantial predisposing factors for mishaps among road users. A traffic police officer will be the first authoritative personnel a drunk driver encounters in the legal system. The absence of accurate skills and knowledge of these officers impedes the structuring of legal procedures and may lead to miscarriage of justice.

Objective:

To assess the knowledge, attitude and practice of Sri Lankan traffic police in handling and managing an alleged case of driving under influence of alcohol.

Methods:

This was a descriptive cross sectional study carried on a sample of 384 traffic police officers attached to the districts of Colombo and Gampaha, through a questionnaire.

Results:

Out of 384, only 75 of police officers knew the correct preliminaries to perform before administering a breathalyzer test. 79.7% knew the correct instructions for using a breathalyzer, but only 3.4% knew the colour changes of the breathalyzer. Significantly poor attitude was observed among the police officers, regarding the importance of producing a drunk driver for medico-legal examination ( P = 0.001) Only 222 (57.8%) answered correctly that a drunk driver needs to be subjected to a medico-legal examination as early as possible. Significantly poor practice and attitude was observed in officers with longer service duration but no significant association was observed between ranks of officers and attitude and practice ( P = 0.199).

Conclusions:

The results of our study demonstrate that the knowledge attitude and practice on efficiently handling a case of DUI among traffic police officers is poor, even though all of them are engaged in DUI duties irrespective of their service duration. The need for continuous professional development programmes was highlighted.

Retrospective analysis of 172 cases of custodial deaths in China between 1999 and 2016: forensic experience in China

Custodial deaths refer to the death of an individual who is in prison, a detention center, or a police station. The present study aims to retrospectively analyze cases of custodial deaths examined at Tongji Medico Legal Expertise Center in Hubei (TMECH). A total of 172 out of 5853 cases were screened at TMECH from January 1999 to December 2016. Male preponderance was observed in 172 cases (male-female ratio: 5:1). Natural deaths accounted for the majority (70.93%), followed by suicide (16.28%), accidents (3.49%), homicides (4.65%), and undetermined causes (4.65%). The most common natural cause was cardiovascular disease. Custodial deaths occurred more frequently in prisons and detention houses than in police cells (63%, 63%, and 46%, respectively). Among the 172 cases, 105 deaths occurred after resuscitation failure despite the individual being sent to the hospital. The average age across cases was 36.3 years, and 90% of the deceased were aged under 50 years. Since there is no officially reported data regarding the prevalence of causes and manners of custodial deaths in China, our analysis contributes to enhancing the understanding of such deaths in central China and serves as a reference for law enforcement to develop a prevention program to reduce incidents of mortality in custody.

In custody deaths of men related to mental illness and substance use: A cross-sectional analysis of administrative records in Ontario, Canada

Highly publicized incidents of in-custody deaths have drawn attention to the well-being of individuals who are held in custodial settings and have contributed to questions surrounding the role played by mental illness and substance use. The data for this descriptive study consist of administrative records from the Office of the Chief Coroner of Ontario. Section 10(4) jury verdicts filed from January 1, 1996 through December 31, 2010 were drawn for analysis. The final sample includes 478 males who died while in custody. Logistic and multinomial regressions were conducted to assess how a history of mental illness and substance use is related to deaths in custody and how those deaths vary across custodial jurisdictions. Approximately half of all deaths in custody occurred among those with a history of mental illness or substance use and those deaths disproportionately occurred in local police or provincial custody, compared to those held in federal custody. Further, the joint effects of a co-occurring history of mental illness and substance use were found to be statistically significant with the strongest effects observed in local police custody. The results from this study underscore concerns surrounding the well-being of individuals with a history of mental illness or substance use and who come into contact with the criminal justice system. With more offenders presenting with complex mental-health and substance-use problems, the implications for local police become apparent in the context of developing policies and practices directed towards preventing deaths.

Deaths in police custody

Deaths in police custody often attract a huge amount of public interest and are frequently associated with controversy related to causation. While systematic investigations of deaths in police custody are currently available for countries in Europe, North America and Australia, the different inclusion and exclusion criteria and the lack of a uniform definition limits their comparability. Rates of death vary by age and gender with some similarities across different countries and continents. The male dominance is essentially due to the fact that around the world women are much less frequently taken into police custody than men. Similarly, in the U.S., the most common cause of custody death was natural illness and disease progression such as heart disease and cancer; along with high rates of suicide deaths. In most European countries there is a considerable dominance of non-natural deaths. The causes of death are dominated by alcohol, drugs and medications, but suicide, injury and trauma are also common. Deaths in custody require careful investigation to determine causality as well as culpability when appropriate. While many deaths may not be preventable, some are. Further systematic research of this issue, including detailed analyses and investigations of such cases, is necessary to develop general and specific preventative measures to reduce the risk of death in the custody population.

Can deaths in police cells be prevented? Experience from Norway and death rates in other countries

PURPOSE

To describe the changes in death rates and causes of deaths in Norwegian police cells during the last 2 decades. To review reports on death rates in police cells that have been published in medical journals and elsewhere, and discuss the difficulties of comparing death rates between countries.

METHODS

Data on deaths in Norwegian police cells were collected retrospectively in 2002 and 2012 for two time periods: 1993-2001 (period 1) and 2003-2012 (period 2). Several databases were searched to find reports on deaths in police cells from as many countries as possible.

RESULTS

The death rates in Norwegian police cells reduced significantly from 0.83 deaths per year per million inhabitants (DYM) in period 1 to 0.22 DYM in period 2 (p < 0.05). The most common cause of death in period 1 was alcohol intoxication including intracranial bleeding in persons with high blood alcohol levels, and the number declined from 16 persons in period 1 to 1 person in period 2 (p = 0.032). The median death rate in the surveyed Western countries was 0.44 DYM (range: 0.14-1.46 DYM).

CONCLUSION

The number of deaths in Norwegian police cells reduced by about 75% over a period of approximately 10 years. This is probably mainly due to individuals with severe alcohol intoxication no longer being placed in police cells. However, there remain large methodology difficulties in comparing deaths rates between countries.

Medical examination of fitness for police custody in two large German towns

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.

Alcohol related conditions represent a major psychiatric problem in emergency departments

BACKGROUND

Alcoholism represents a huge socioeconomic burden in most developed societies.

METHODS

In order to determine the impact of conditions associated with alcohol abuse on emergency care, in 2002 all patients with alcohol related pathology presenting to the emergency department (ED) of a large urban university hospital in Germany were assessed.

RESULTS

Of 2194 patients seen by psychiatrists in the ED, the 613 cases associated with alcohol abuse represented the largest diagnostic group (30.7%). Within this group, alcohol intoxication was the most frequent diagnosis (71.4%). Patients with an alcohol related condition needed treatment by different medical specialities and required diagnostic procedures significantly more often and consequently stayed significantly longer in the ED than patients with other psychiatric presentations.

CONCLUSIONS

The generally underestimated problem of alcohol abuse in Germany demands an excessive amount of manpower and resources in EDs, where a high yet expensive standard of care is provided. Against this background, how far this burden can be reduced, both in EDs and in society in general, is discussed.

The role of forensic medical examiners and their attitudes on delivering brief alcohol interventions in police custody

BACKGROUND

Many drunken detainees are not receiving alcohol treatment, so the forensic medical examiner (FME) might be the only healthcare professional they see. This paper explores the possibility of British FMEs delivering brief alcohol interventions in custody suites.

METHOD

Twenty-five FMEs and 15 police officers were interviewed, using semi-structured interviews and a snowball sampling approach.

RESULTS

The main concerns expressed by FMEs regarding brief alcohol interventions were around role legitimacy, the suitability of the location and the state of the detainee. Several FMEs suggested that all drinkers would benefit from some intervention, especially young binge drinkers, drink drivers and those detained for domestic violence.

DISCUSSION

These findings suggest that FMEs generally require a clearer understanding of the effectiveness of brief interventions, and the wider public health implications of such 'low demand' alcohol interventions.

Assessment and management of individuals under the influence of alcohol in police custody

Individuals taken into police custody are commonly under the influence of alcohol. Some of these individuals are dependent on alcohol and suffer from withdrawal symptoms. Morbidity and mortality in this group is high, and deaths have been recorded in police custody. There are no specific guidelines on the assessment and management of individuals under the influence of alcohol taken into police custody. This article outlines the clinical features, assessment, investigations and management of these individuals based on a review of the literature.

Correctional nursing practice

This study explored the nature and problems of nursing practice in correctional settings using qualitative field research methodology. Data were collected through participant observation at three men's state prisons and one city jail and included informal interviews and conversations of varying length and depth with 40 nursing staff members. Data analysis was accomplished through the constant comparative methodology and dimension analysis of grounded theory. Custody personnel's recognition, evaluation, and acceptance of judicially mandated health care varied across settings and formed a toleration continuum with two types (contentious and considered) located at polar ends and a third (acknowledged) in a central position. Correctional nurses' conceptions of nursing were categorized as limited, expanded, or other-directed. The three types of toleration provided differing contexts for correctional nursing practice. Interactions between custody and health care staff occurring within each toleration scene differentially influenced the degree to which the three conceptions of nursing prevailed.