Public Health

How policing can benefit from medicine’s evidence-based approach

Tanya Albert Henry , Contributing News Writer

Both police officers and physicians often face high-pressure situations in which they must make time-sensitive, life-or-death decisions and “it may benefit law enforcement to borrow some of the strategies and practices that the medical profession uses to ensure that its members provide safe and effective care,” says an AMA Board of Trustees report whose recommendations were adopted at the November 2021 AMA Special Meeting.

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“The AMA is strongly invested in the betterment of public health and remains committed to advocating for actionable reform to eliminate excessive police violence in historically marginalized communities,” said AMA Trustee Willie Underwood III, MD, MS, MPH. “We value the opportunity to contribute the scope of the AMA’s expertise to the national conversation on policing—especially as it relates to improving the health of our patients and the overall health of the nation.”

The AMA House of Delegates adopted new policy to:

  • Advocate efforts to implement evidence-based policing and the creation of evidence-based standards for law enforcement.
  • Advocate sentinel event reviews in the criminal justice system following an adverse event, such as an in-custody death.
  • Encourage further research by subject-matter experts on the issues related to the transfer of military equipment to law enforcement agencies, including the impact on communities, particularly those in minoritized and marginalized communities.
  • Support greater police accountability, procedurally just policing models, and greater community involvement in policing policies and practices.

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November 2021 AMA Special Meeting: 10 issues to watch

Evidence decision-making “bedrock”

In medicine, “evidence is a bedrock of clinical decision-making, but the same is not true in policing,” the Board of Trustees Report says. Law enforcement also does not have the standardization that medicine does, the report says.

“Unlike in medicine, where multiple governmental and nongovernmental entities set standards and guidelines for training and clinical practice, law-enforcement entities are not required to adhere to external standards, often resulting in fragmented and inconsistent policies,” says the board report.

While accreditation alone won’t prevent all negative events, the trustees’ report says it could be one tool for review and ongoing measurement. Also, it would be helpful for police to review sentinel events in the way that health care and aviation professionals do.

“A sentinel event review focuses not on assigning blame, but bringing together key community stakeholders to conduct a root cause analysis of all factors that led to a negative outcome and reforms that can strengthen the system to prevent recurrence,” the board’s report says. “The approach recognizes that failures are often systemwide and not the result of a single individual’s actions. The goal, therefore, is to enable systems changes in practice and culture.”

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Highlights from the November 2021 AMA Special Meeting

Accountability for individual police actions “is essential if police are to effectively and equitably protect all citizens and if police are to have legitimacy in the eyes of community members,” says the trustees’ report.

The new policy joins numerous other related AMA policies on topics such as law-enforcement procedures, the public health threat of racism, and police brutality as a manifestation of systemic racism. Other recent AMA actions include advocacy urging lawmakers to act on necessary policing reforms and a Board of Trustees pledge denouncing racism and police brutality.

Read about the other highlights from the November 2021 AMA Special Meeting.