- The law is there because it has to be there

The duty to avert criminal acts may involve making difficult choices, even for professionals such as doctors and teachers.

The purpose of the duty to avert criminal acts is to prevent abuse and violence. For medical personnel, the duty to avert criminal acts takes precedence over the duty of confidentiality.

For many who work in the healthcare sector, there is a difficult balance between protecting the patient and the requirements of the duty to avert criminal acts, and it is easy to think that you are protecting the patient if you do not report something that could have negative consequences. But is that the right choice?

Birgit Lie has been a doctor for many years. She is Head of Department at the Specialised Outpatient Clinic for Psychosomatics and Trauma at Sørlandet Hospital. Over the years in the national health service, she has had to make difficult decisions a number of times.

“Of course it is very difficult. If you have a patient with whom you build trust, reporting to Child Welfare Services or the police about something you have learned as their doctor can be perceived as a breach of trust. The patient could easily perceive it as a betrayal. At the same time, if you are going to treat trauma, you cannot succeed if the patient is exposed to ongoing trauma or abuse,” says Lie.

Throughout her career, Lie has participated in the development of several agencies and services, including the Norwegian Centre for Violence and Traumatic Stress Studies. As a doctor and a manager in the healthcare sector, Lie has first-hand experience of the dilemma of being in a situation where you must consider both a patient and a law that says that you must report what you know.

“What may sound difficult is actually quite simple. The law is there because it has to be there. We cannot allow doctors or other healthcare professionals to know that patients are being subjected to serious violence or abuse without trying to stop it. It would be an impossible situation if you had to decide what to do case-by-case. If you know that a person is the victim of a criminal act, then you have only one choice – and that is to report the offence,” says Lie.

Lie also points out that, in the psychiatric health service, there may be situations where a patient receiving treatment for traumas caused by abuse or having lived with violence over time is still being subjected to similar abuse.

“Then it is impossible to treat those traumas. It is quite simply impossible. So, in those cases, reporting is also necessary to be able to succeed in providing the health services the patient needs,” she says.

For many, the duty to avert criminal acts, and Section 196 of the Norwegian Penal Code, is a vague provision – but for Lie, the law is simple: Everyone, including professionals, has a duty to try to avert situations where someone is the victim of domestic violence, incest or the like.

“We have a law that is crystal clear, as I see it. It is something you just have to deal with,” she concludes.