title: Should a psychiatrist report a bus driver's alcohol and drug abuse? An ethical dilemma.
abstract: Denial of alcohol or drug abuse, and of its possible consequences, can complicate medical and psychiatric care. We present the case of an HIV-positive bus driver with substance abuse who initially denied ongoing use of alcohol and of other drugs, but later admitted to both. The psychiatrist's duty to protect the patient's confidentiality, coupled with concerns about public safety, created an ethical dilemma. In discussing this dilemma we stress the importance of preserving confidentiality, both to facilitate treatment and also to further the safety of others.
authors.affiliation: SUNY Downstate Medical Center, Brooklyn, NY, USA. cpl@cpleeman.net
authors.forename: C P
authors.initials: CP
authors.lastname: Leeman
authors.forename: M A
authors.initials: MA
authors.lastname: Cohen
authors.forename: V
authors.initials: V
authors.lastname: Parkas
mesh_terms: D000437:Alcoholism / Q000523:psychology*; D003219:Confidentiality; D003617:Dangerous Behavior; D017007:Duty to Warn; D026690:Ethics, Clinical; D006679:HIV Seropositivity; D006801:Humans; D018986:Motor Vehicles; D009790:Occupations; D010817:Physician-Patient Relations; D012449:Safety; D019966:Substance-Related Disorders / Q000523:psychology*