I am a volunteer with St John Ambulance (NSW) and an interesting scenario came up at our training. We’re responding to an unconscious patient (suspected drug overdose) at a musical festival. There is no one else with the patient that knows him, so we are unable to ascertain his identity for the completion of our patient record and/or handover to paramedics.

The question is: are we allowed to go through the patient’s wallet/personal items to look for some sort of ID?

The nature of the patient’s injuries here are irrelevant, ie it doesn’t matter if they’re unconscious due to a suspected drug overdose, head injury or unknown causes.  The relevant principle is the principle of necessity. Remember that any touching no matter how slight may be a battery, but as Lord Goff said in Collins v Wilcock [1984] 3 All ER 374 at 378 ‘so widely drawn a principle must inevitably be subject to exceptions’.  One exception is the principle of necessity that justifies the provision of medical treatment to those that cannot consent.  Again it was Lord Goff who said, In Re F [1990] 2 AC 1:

… to fall within the principle [of necessity], not only (1) must there be a necessity to act when it is not practicable to communicate with the assisted person, but also (2) the action taken must be such as a reasonable person would in all the circumstances take, acting in the best interests of the assisted person.

His point was that this doctrine was not just a doctrine of emergency, but of necessity.  Is it necessary, ‘acting in the best interests of the assisted person’ to look for ID? I can imagine that it could be.  You may need to search them:

  1. To locate and take care of their personal items, wallets, phones, keys etc are likely to get lost in treatment and transfer so collecting them together is in the person’s best interests;
  2. To remove items from pockets that are going to cause discomfort or further injury eg to stop them lying on their phones, keys etc and this again is in their best interests.
  3. To find a more complete history of the patient, you may find identifying material that reveals a relevant medical history that causes you to review the original diagnosis eg you believe they have a suspected drug overdose and you find further drugs that may add evidence to confirm your suspicions but equally you may find evidence that they are in fact diabetic, or epileptic or have some other condition that makes you rethink your working diagnosis. Provided the search is for that purpose and not, say for law enforcement, then again it is an action taken in their best interests.
  4. Finding ID will, as my correspondent first raised, allow the first aiders to complete their patient record and if they hand that to the paramedics it will allow the records to be held together. If the St John record has no name on it, then at some point someone is going to question who does it relate to and if they can’t positively link it to a patient it becomes less than useless.   Ensuring that there is a complete record to contribute to continuity of care will also be action taken ‘in the best interests of the assisted person’.

There is probably also a common law right to search the person to protect the first aider ie to locate things that may be on the person that could injure the first aider such as sharps or weapons.  In saying that I’m drawing (in my mind) an analogy with the common law powers of police to search a person on arrest (Clarke v Bailey (1933) 33 SR(NSW) 303).  That’s not a clear parallel but I think it could be argued.

Certainly you will want to find out if a person has sharp items in their pockets as they pose a risk to the patient as well as the first aider, but that can’t justify searching their bag to look for weapons or other sharps or just to satisfy your curiosity.

Conclusion

You can search a person who cannot consent to treatment, and go through their wallet and personal items provided the action is ‘reasonable’ and your motivation is to find information you need to act in their best interests.   You might collect their personal items together and go through their wallet to find ID and any medical history, but having done that you stop.  There is no need to try to access their phone or go through their bag to see what else you can find.