Doctors' attendance with arrestees in police custody: Physicians' representations

Police custody is detention in response to a suspicion of crime. In France, it lasts less than 24 h, in most cases. According to French law, any individual placed in police custody may, at the individual's request, be examined by a doctor. The doctor decides whether the detainee's state of health is compatible with detention in a police station. Our objective was to assess the attending physicians' representations of police custody and medical intervention in this setting. In this study, physicians were asked to report on their own practice in custody and the way they perceived arrestees. We conducted face-to-face semi-structured interviews with 22 physicians who attended arrestees in police custody. For some doctors, the doctor-patient relationship is unconventional because arrestees may want to cheat them and because doctors feel that they have minimal duties that are limited to keeping arrestees alive. Most doctors consider the conditions of examination markedly unsatisfactory, similar to the material conditions of detention in police cells. Some physicians are reluctant to describe traumatic injuries so that they do not appear to support the arrestees over the police. Although all doctors determine whether a detainee is fit to be detained in police cells, the rationale for this decision differs from one physician to another. Physicians consider a medical prescription legitimate when it fits with their own representation of the needs of arrestees. Physicians delimit the framework of their relationship with arrestees and restrict the requests that they consider acceptable. They have limited knowledge of the conditions of detention and show little interest in this matter. Physicians manifest a simplistic, usually negative view of the individuals that they examine in custody. However, some are aware of the deleterious effects of custody conditions on arrestees.