Health professionals have an ethical and legal duty to maintain patient confidentiality and build up a relation of trust with patients, since the latter do have to reveal a lot to the doctor with the express purpose of protecting their health and wellbeing.
Despite the great emphasis placed on patient confidentiality, there are certain cases in which the agreement can be breached, particularly when it comes to assessing the fitness to drive. The duty to maintain confidentiality can be legally disregarded in certain circumstances if it is in the interests of public safety.
According to a recent Fleetnews article, a new guideline has been set up by the GMC (General Medical Council), which is active in the UK and Northern Ireland. The guidance is that doctors must inform the DVLA, or DVA in Northern Ireland, if a patient continues to drive contrary to explicit medical advice. This direction is part of a public consultation on the GMC’s guidance on responsibility.
The strengthened guidance is part of a public consultation on the GMC’s core directives regarding confidentiality which relate to a doctor’s responsibility to balance their duties to patients with the well-being of the wider public—Doctors are often anxious about being criticized or prosecuted for disclosing information. According to the guidance, the primary aim should be protecting road users and the public generally, and doctors should only disclose a patient’s unfitness to drive as a last resort after encouraging the patient to do so results in a failure.
As far as the Republic of Ireland is concerned, the Irish Medical Council Guidelines provide for breach of confidentiality if the driver represents a risk to the safety of others, refuses or cannot inform the NDLS, fails to stop or adapt driving appropriately, and is not amenable to appropriate persuasion and discussion. The health professional should consider reporting directly to the NDLS in situations where the driver is:
•Unable or unwilling to appreciate the impact of their condition which is impacting on their fitness to drive;
•Unable or unwilling to take notice of the health professional’s recommendations;
•Continues driving despite appropriate advice and is likely to endanger the public.
According to Steve Gooding, director of the RAC Foundation, thirty-seven million drivers depend on the car for getting about and for those with serious medical conditions there is a real fear around losing their license.
“With the right treatment many illnesses will not lead to people having to hang up the keys. The worst thing motorists can do is ignore medical advice,” he said. “If they don’t tell the DVLA about something that impacts on their ability to drive safely then their GP will.”
