We’ve all taken care of patients that either have a baseline condition or have sustained an injury that renders them unfit to drive. What issues need to be considered with regard to keeping them off the road?
There are a number of ethical and legal considerations. As a physician or other healthcare provider, you have three priorities. In order, they are:
- Duty to protect your patient
- Duty to protect the public
- Duty to maintain patient confidentiality
Note that the duty to protect the public supersedes the need to maintain confidentiality. However, if the patient knows that their confidentiality may be violated, they may be less likely to seek treatment, disclose key information, or trust you.
The ideal method of dealing with a driver whom you believe is unsafe is to have a frank discussion with them (and their family, if permitted) regarding why you think they should stop driving and the consequences of failing to do so. They should be encouraged to stop driving voluntarily, or self-report to the license bureau so they can be re-evaluated. It is also very important to encourage the family to support the decision and provide alternative transportation to meet your patient’s needs. Social services should be involved so that transportation alternatives and resources can be provided.
If your patient refuses to surrender their license or self-report for retesting, then you need to consider reporting them to the license bureau yourself. Before doing this you should exhaust all possibility that the patient will stop driving voluntarily. You must also be knowledgeable of your state laws so you know what kind of protections (if any) are given to you after reporting.
Tomorrow, I’ll give a state by state description of the applicable reporting laws and a sample letter to send to the license bureau. Click here to view.