DOCTORS TOLD TO INFORM ON PATIENTS

Drink and drug drivers must not be allowed to put the public's safety at
risk, says BMA

DOCTORS are being warned they must break patient confidentiality and turn
in drink-driving patients to the police or face disciplinary action
themselves.

Both the British Medical Association and the Medical and Dental Defence
Union of Scotland say GPs are becoming increasingly concerned about the
number of patients who are being treated for drink or drug problems but
still drive cars. A medical newspaper has even reported the case of an
anonymous airline pilot who was on powerful tranquillisers while flying
passenger jets.

The defence union, which acts as a legal advice centre for 20,000 members,
has recently recommended that patient confidentiality should not be
protected in cases where injury could result.

Dr George Fernie, legal adviser at the MDUS, contacted members after
studying 500 cases in his work as a surgeon with Strathclyde Police. He
said that if GPs and dentists did not report a patient who was driving
under the influence - and subsequently caused death or serious injury -
they faced possible action from the General Medical Council, which could
result in them losing their medical licences.

"One would not breach patient confidentiality lightly but we are clearly
answerable to the GMC," he said. "If somebody is driving under the
influence of drink or drugs the GP should speak to the patient first and
say they will report them to the authorities if they persist. But there are
difficulties with that. The patient may leave or, worse, become violent
towards the doctor.

"GPs must not put their own safety at risk and in those circumstances would
be justified in reporting the patient without their knowledge. We know of
patients who are being treated for drink or drugs who even drive away from
the surgery car park. If a doctor knows that a patient is endangering the
public it may be appropriate to pass on that information. It is also not
about when a patient seeks help for drug or drink abuse. It is also when
they are coming off a drug - they can be just as much a danger driving then
too. It is a dilemma for doctors. If you had not responded in a
professional way and somebody died, you would have that on your conscience
- - as well as possibly problems with the GMC."

Dr Brian Potter; Scottish Secretary of the BMA, agreed with the advice
being circulated by the MDUS. "Confidentiality should only be broken in
circumstances where a third party may be hurt. If a GP is in possession of
such information he should pass it on he said. "An increasing number of
doctors are reporting their patients, but in a way it reflects the increase
in drug and drink abuse in society."

Sheila MacLean, Professor of Medical law and ethics at Glasgow University
gave her backing to the controversial proposals. "This plan is an extension
of the rule that doctors can breech confidentiality if there is an issue of
public interest at stake," she said. "In this case there is a powerful
argument. The death and harm that could be caused by someone driving under
the influence of drink is very much in the public interest.

"Many would agree that it is wrong for someone, who is breaking the law and
could go out and kill another person, to hide behind confidentiality."

However, MacLean said the downside of the proposals could be a decline in
the number of patients coming forward for dependency because of fears that
doctors could report them.