title: Confidentiality and the management of patients with epilepsy who fail to comply with doctor's advice not to drive: a survey of medical/legal opinions in Australia.
abstract: This study sought the opinions of a select group of professionals, trained in medicine and law concerning: professional privilege; management of patients who posed risks to society; and the legal charge to impose upon a patient with uncontrolled epilepsy who caused a fatality by driving contrary to medical advice. The second Academic Seminar of the Australian College of Legal Medicine was surveyed to define demographics and opinions. Of 23 respondents, 14 were trained in law and medicine, of whom eight had post graduate medical qualifications and seven had more than basic legal training; 20/23 supported professional privilege in medicine but 18/23 denied its absoluteness; 22/23 felt the doctor had a right to divulge information in the public interest. Only 14/23 (although still a majority opinion) felt this right was a duty and 6/23 refuted the same. When concerned regarding compliance not to drive, 7/23 would discuss it with family/friends in contravention of patient consent, 12/23 would report to the driving authorities where concern became fact, 13/23 would advise the patient that a report would be sent, 4/23 would report without the patient's knowledge and four would threaten but not send the report. In the case of a fatality consequent to non-compliance, 10/23 considered murder and 22/23 considered manslaughter charges to be appropriate. The majority supported professional privilege in the doctor/patient relationship but also supported the right or even a duty to report risks to society. Where a concern arose that a patient with epilepsy may drive contrary to advice, one-third of doctors would discuss with family/friends, without consent, one-half would report the patient to the driving authorities, while almost three-quarters would report the patient if concern was realised. Murder and manslaughter, serious charges, were deemed appropriate for patients who caused death by driving against medical advice.
authors.affiliation: Epilepsy Research and Services, Chatswood, NSW, Australia.
authors.forename: R G
authors.initials: RG
authors.lastname: Beran
mesh_terms: D001315:Australia; D001334:Automobile Driving / Q000331:legislation & jurisprudence* / Q000523:psychology; D003219:Confidentiality; D003625:Data Collection; D004827:Epilepsy / Q000523:psychology*; D004992:Ethics, Medical; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007258:Informed Consent; D008297:Male; D019221:Mandatory Reporting; D010349:Patient Compliance; D010817:Physician-Patient Relations