In most instances health professionals will respond to any request for medical examination under the auspices of their general duty of care towards their patient particularly where they have a current involvement with the adult at risk and are fulfilling their duty to cooperate with Inquiries and Investigation in respect of that adult. This is most likely to be where the adult requires medical treatment for a physical illness or mental disorder or assessment of their physical or mental health.

In some situations a formal request for a medical examination under Section 9 of the Adult Support and Protection (Scotland) Act 2007 may be viewed as necessary by the Council Officer or the health professional to which the request is being made.

Section 9 states a medical examination may only be carried out by a health professional as defined under Section 52(2) as a:

• doctor
• nurse
• midwife

It is normally the case that doctors would carry out a medical examination, nurses and midwives would carry out an assessment of current health status.

Medical examination may be required as part of an investigation for a number of reasons including:

• the adult’s need of immediate medical treatment for a physical illness or mental disorder
• to assess the adult’s physical or mental health needs
• to assess the adult’s mental capacity
• to provide evidence of harm to inform a criminal prosecution under police direction or application for an order to safeguard the adult

The circumstances where medical examination should be considered include:

• sexual harm and where there may be physical evidence
• physical injury which the adult states was inflicted by another person
• explanation is inconsistent with injuries
• neglect and self-neglect, illness or injury or where there are concerns around self-harm and no previous assessment or treatment has been sought

Where a crime has been committed or where criminality is suspected, the Police should be contacted immediately to discuss how best to progress the investigation of suspected criminality. If the adult concerned has been injured, the priority must be their immediate health and welfare.  The police may arrange for a forensic medical examination to be carried out.  This will be undertaken in a sensitive and professional manner with due consideration given to the needs or requirements of the complainer. This is essential in order to ensure no evidence is lost and to allow a criminal investigation to begin.

If medical examination is required, wherever possible, all courses of action must first be agreed with the adult.  In situations of extreme risk or urgency the Council Officer may need to take immediate action, i.e. involve emergency services without prior consent.