2 hours ago The doctor call the police (and the DEA) to report the theft and suggest possible suspects. A psychiatrist has a patient in crisis at his office. Patient attacks psychiatrist and threatens staff. Someone will be on the phone with 911. And finally, the coroner will contact police when the report on his patient is complete. >> Go To The Portal
When determining whether to report a patient’s medical condition that may impair driving, physicians may have to weigh conflicting guidelines: a professional obligation to report and a legal requirement to maintain confidentiality, even in the face of danger to the public. Where obligated to report, physicians must do so.
For a number of reasons, physicians should be restrained in reporting to authorities drivers with a mild or moderate increase in driving risk. First, this degree of added risk is on the same order as other conditions where reporting is not considered professionally or legally appropriate, e.g., benzodiazapine use.
New York is a state that offers no statutory imperative for physicians to report a suspected impaired driver to the authorities. Generally, physicians may not divulge medical information about their patients to others without patient consent unless otherwise provided by law, e.g., suspected child abuse, and wounds from bullets or knives.
The DMV must notify the impacted driver in writing of its final decision. Under California law, doctors are required to report anyone to the DMV who suffers from any medical or mental condition that may impact his/her ability to drive safely. What is a doctor’s duty to report medical conditions to the DMV?
Physician reporting of demented drivers may have little effect on their driving, if the demented person does not comprehend the implications of loss of licensure. For demented patients, responsibility for driving cessation falls on other persons, such as the next-of-kin or legal guardian.
In most situations, your doctor can't stop you from driving. In fact, there's no way to enforce a doctor's advice not to drive. But share with your doctor any concerns you have about near misses on the road. That may lead to some advice that can help you be a safer driver.
The HIPAA privacy rules (45 CFR § 164.501 et seq.) generally prohibit healthcare providers from disclosing protected health information to law enforcement officials without the patient's written authorization unless certain conditions are met.
A breach of confidentiality occurs when a patient's private information is disclosed to a third party without their consent. There are limited exceptions to this, including disclosures to state health officials and court orders requiring medical records to be produced.
“The therapeutic privilege permits physicians to tailor (and even withhold) information when, but only when, its disclosure would so upset a patient that he or she could not rationally engage in a conversation about therapeutic options and consequences”.
Importantly, the only way the police can demand clinical records is by way of a search warrant, so unless there is a warrant you do not have to release the health information.
In general, HIPAA allows for PHI disclosures to law enforcement in the following situations: If there is a court order, warrant, subpoena, or other administrative request. To identify or locate a suspect, fugitive, material witness, or missing person.
The GMC does not define serious crime in its guidance but refers to examples given in the NHS's Confidentiality Code of Practice. These include murder, manslaughter, rape, kidnapping, and child abuse or neglect causing significant harm.
Q: Will my doctor tell my parents what we talked about? A: Your doctor will keep the details of what you talk about private, or confidential. The only times when your doctor cannot honor your privacy is when someone is hurting you or you are going to hurt yourself or someone else.
A doctor or health care provider can't talk with your parents or guardian about your medical care unless you agree (but there are exceptions, see below). If you are considered capable of making your own medical decisions, then you have a right to doctor-patient confidentiality.
One of the recommendations to reduce medication errors and harm is to use the “five rights”: the right patient, the right drug, the right dose, the right route, and the right time.
Research shows that it happens rather often. Eleven percent of 1,800-plus physicians recently surveyed by Massachusetts General Hospital admitted to having lied to a patient in the preceding year, and 55 percent said they'd described a prognosis to a patient in a more positive light than was medically accurate.
Doctors are only required to make disclosures which are mandated by law but they do not need to disclose every possible risk or medical alternative. The general standard which is applied is that if a reasonable doctor would disclose the information, then a doctor is obligated to disclose the information.
In addition to professional ethical standards, most States have laws and/or court decisions which address, and in many instances require, disclosure of patient information to prevent or lessen the risk of harm.
Under these provisions, a health care provider may disclose patient information, including information from mental health records, if necessary, to law enforcement, family members of the patient, or any other persons who may reasonably be able to prevent or lessen the risk of harm. For example, if a mental health professional has a patient who has made a credible threat to inflict serious and imminent bodily harm on one or more persons, HIPAA permits the mental health professional to alert the police, a parent or other family member, school administrators or campus police, and others who may be able to intervene to avert harm from the threat.
Note that, where a provider is not subject to such State laws or other ethical standards, the HIPAA permission still would allow disclosures for these purpose s to the extent the other conditions of the permission are met.
There are two groups. The first consists of common recreational drugs and the specified limits for these have been set at a low level. They include cannabis, cocaine, MDMA, LSD, ketamine, heroin/diamorphine metabolite and methylamphetamine.
It's already an offence to drive while impaired by drugs under a section of the Road Traffic Act. This is the case regardless of whether or not the medications are prescribed, and this offence remains in force alongside the drug-driving offence.
The limits have been set by the government in conjunction with scientists and medical experts. It is anticipated that the vast majority of patients taking therapeutic doses of prescribed medication should not have blood levels over the specified limit for these medications.
If a patient is stopped and investigated by the police for drug-driving, they can raise a medical defence if they are taking the medication for therapeutic purposes, and in accordance with the prescriber or supplier's advice and any accompanying instructions included in the medication pack.
The legislation shouldn't affect the way you prescribe the medications in question. You will already be advising patients about the risks and side effects of medications.
Patients may ask for a report if they are stopped, tested and found to have exceeded the specified limit for a medication. Some may also request a report as evidence they are prescribed the medication, to keep with them in case they're stopped.
Not necessarily, although you may decide to audit the records of patients on the relevant medications to see if advice on driving while taking the medications is already being documented.
Reporting by Physicians of Impaired Drivers and Potentially Impaired Drivers
For a number of reasons, physicians should be restrained in reporting to authorities drivers with a mild or moderate increase in driving risk. First, this degree of added risk is on the same order as other conditions where reporting is not considered professionally or legally appropriate, e.g., benzodiazapine use. Second, the burdens of loss of driving privilege may be out of proportion to threat to personal and public safety. Third, physician-as-policer is of questionable long-term, net benefit to patients. Patients may avoid health services in these circumstances. This avoidance would limit physicians' effectiveness in caring for such patients and, by corollary, preclude physician involvement in driver safety. Physicians should educate patients about relevant conditions which impair driving, and be attentive to increases in disability over time. For example, a patient with cataracts should be educated as to its early effects on night vision. A patient declining treatment for sleep apnea should be counseled about the increased driving risk associated with the untreated condition. Where driving risk is profound and the patient refuses to cease driving, physicians should contact the licensing agency. The marked and immediate risk to patient and public safety outweigh the potential consequences of reporting on the future care of patients.
In 1997, the American Medical Association (AMA) resolved to study physicians' legal and ethical obligations with respect to reporting physical and medical conditions which may impair a patient's ability to drive and to investigate the potential legal liability to which physicians may be exposed as a result of caring for patients with these physical and medical conditions . The Council on Ethical and Judicial Affairs (CEJA) of the AMA was assigned responsibility and its report (I-1-98) concluded that the problem of impaired drivers illustrates the fundamental conflict between the responsibility physicians have to individual patients and their responsibility to society. The CEJA report included the following points:
Physicians may be sued by their patients if they fail to counsel their patients on the dangers of driving associated with certain medications or medical conditions. Physicians may also face legal action by victims of motor vehicle accidents caused by their patients if the court decides that the physicians could have foreseen the danger of their patients' continuing to drive. Physicians' legal responsibilities to report patients with certain medical conditions override their ethical responsibilities to keep patients' medical histories confidential.33
Some impaired drivers avoid their responsibility to cease driving due to emotional and logistical concerns of dependence and immobility. Physicians should consider family support in this life-event. Family members can provide emotional support to the patient, can reinforce the physician's concerns, can assist the patient in articulating his or her concerns, and can play an important role in developing strategies for patient safety and welfare. For example, family members can encourage the patient to have a needed cataract excision, may volunteer to transport the patient to occupation therapy sessions, and can offer rush hour and nighttime transportation to minimize patient exposure to adverse driving conditions.
The U.S. Federal Motor Carriers Safety Regulations , administered by the Department of Transportation, require most commercial vehicle drivers to be certified by a medical examiner. Should an accident occur, the physician who examined the driver may be found liable since such physicians' primarily responsibility is to the public. Some medical diagnoses, such as insulin-requiring diabetes mellitus, seizure disorders, and significant visual or hearing defects, are automatically disqualifying, no matter how well the disease is controlled. In spite of these seemingly stringent regulations, most certification examinations of commercial drivers are simple, and relatively few drivers are disqualified from driving a commercial vehicle such as a truck or bus.34
Patients who may be considered for revocation or limitation of driving privileges include patients with an ongoing or persistent impairment such as visual defects or dementia, or patients with a propensity for episodic disability such as epilepsy, cardiac dysrhythmias, or substance dependency.
The biggest fear people face when just thinking about admitting substance use to their doctor is consequences. Discomfort grows when a person is using an illegal substance. The biggest fear is being reported to the authorities. Thanks to doctor-patient confidentiality, this fear is often only as big as you make it. A doctor cannot discuss the information you share in confidence, and if they do, you can take legal recourse, even when admitting something like heroin or cocaine use.
It’s a Legal Concept: The doctor-patient privilege is a nationally recognized legal concept. It protects what a patient and their doctor discuss from being used against the patient in a court of law , even if the patient confesses to a crime.
If you know you have a substance use problem, it’s time to talk to your doctor, even if the drug (s) you’re using are illegal. The point of talking to your doctor is to seek and obtain the kind of treatment that will help you stop abusing drugs and end your addiction. Your doctor can help you find the right treatment.
The oath serves as a sort of moral guide , and medical practitioners must abide by a code of ethics. While doctor’s view patient-physician confidentiality as a fundamental tenet of their code of ethics, they are bound to abide by it within the constraints of the law. Harm Must be Reported: By law and ethics, a doctor must report severe bodily injury.
Your doctor can help you find the right treatment. Your options are not limited, and your physician can connect you with professionals and community resources dedicated to supporting you. From substance abuse counseling programs to prescription support, there have never been more evidence-based options for treating substance abuse and addiction.
If you choose to talk to your doctor about illegal substance use, you can , in most cases, rest assured that your conversation will remain confidential. You can read up on physician-patient privilege at Wikipedia, but here are the important highlights:
Should the relationship between substance abuse, addiction, and medical insurance stop you from getting help? No, but it might be something you’ll need to consider based on your circumstances before proceeding cautiously. Medical science has clearly identified substance use disorders as viable medical conditions that are, for many, as unavoidable as diabetes or cancer. Could the manner in which these are treated by insurance companies change in the future? Perhaps, but until then, you’ll need to decide on what’s best for you.
The police have requested the medical records of a patient of mine who has been arrested. They said I must provide these under section 29 of the Data Protection Act (DPA).
The police have also asked me for details of the driver of the car that was involved in the accident. The Road Traffic Act 1988 allows the police to require information from anyone that may lead to the identification of the driver.
If a disclosure is required by law, you should only disclose information that is relevant to the request, and where practicable you should tell the patient about the disclosure. The police have asked me for a statement for the coroner following the unexpected death of a patient.
If you are approached by the police, stay calm and professional and remember to follow the basic principles of good medical practice and confidentiality, as set out by the GMC. Let the police know that you are keen to co-operate but that you also have your own professional obligations that you must follow. If you are unsure about the request, call Medical Protection for advice.
If you are the subject of a police investigation you should take legal advice as soon as possible, and if you are being interviewed under caution you are strongly advised to have legal representation. If the investigation arises out of your professional practice, contact Medical Protection before providing the police with a statement or attending for an interview.
This says that information can only be disclosed with patient consent, or if it is required by law, or if the disclosure is justified in the public interest.
But any approach from the police in the workplace can be stressful.
Only doctors are required by law to report medical conditions to the DMV. But other parties have the option to do so, including: law enforcement officers, judges, family members, friends, concerned private citizens, and. even the driver him- or herself (in a driver’s license application or during a visit to the DMV).
After receiving a report about a driver, the DMV will conduct an initial safety risk assessment of the driver.
do nothing (if the Department finds that the driver poses no safety risk), ask for further medical information, conduct a “ reexamination hearing ,” or. in rare cases, immediately suspend or revoke the person’s driving privileges. The DMV must notify the impacted driver in writing of its final decision.
The DMV will then review the DME. If it determines that the driver does not pose a safety risk, it will take no further action.
macular degeneration. These conditions are a common cause of driver’s license suspensions for elderly drivers. But drivers of all ages can be affected. Once the DMV receives a report from a physician regarding a driver’s inability to drive safely, it can take any of the following actions:
Most states require physicians to inform the DMV when they diagnose a patient with any medical or mental condition that may affect the person’s ability to drive safely.
This is an in-person evaluation to determine if a driver has the physical and mental skills to drive a car safely. The hearing takes place at a local California DMV driver safety office and it is conducted by a DMV hearing officer. The hearing officer may do any of the following after conducting the hearing:
Police don't always accompany the driver , which is part of the problem Green said. If an officer doesn't initiate a legal blood alcohol test, the results cannot be shared, he added.
Currently, police need to have a reasonable suspicion that a driver has been drinking in order to test them. Dr. Rob Green, a medical director at Trauma Nova Scotia where he researches conviction rates among injured drunk drivers, said often times, police officers are unaware a patient is drunk.
Furthermore, the number of people who come into the emergency department with alcohol in their blood is "enormous," Whatley told Lynch.
Pauls said there are laws in most provinces that oblige doctors to report drivers who are unsafe, for example, a patient that has seizures.