Ethics of Clinical Decision-Making for Older Drivers: Reporting Health-Related Driving Risk.
The number of older drivers will continue to increase as the population ages. Health care professionals have the responsibility of providing care and maintaining confidentiality for their patients while ensuring public safety. This article discusses the ethics of clinical decision-making pertaining to reporting health-related driving risk of older drivers to licensing authorities. Ethical considerations inherent in reporting driving risk, including autonomy, confidentiality, therapeutic relationships, and the uncertainty about determining individual driving safety and risk, are discussed. We also address the moral agency of reporting health-related driving risk and raise the question of whose responsibility it is to report. Issues of uncertainty surrounding clinical reasoning and concepts related to risk assessment are also discussed. Finally, we present two case studies to illustrate some of the issues and challenges faced by health care professionals as they seek to balance their responsibilities for their patients while ensuring road safety for all citizens.
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University.|Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) - site Jewish Rehabilitation Hospital, Laval.
Barbara
B
Mazer
Faculté de médecine, École de réadaptation, Université de Montréal, and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR).
Maude
M
Laliberté
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University.|Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) - site Jewish Rehabilitation Hospital, Laval.
Matthew
M
Hunt
Faculté de médecine, École de réadaptation, Université de Montréal, and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR).
Josée
J
Lemoignan
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University.|Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain (CRIR) - site Jewish Rehabilitation Hospital, Laval.
Isabelle
I
Gélinas
School of Rehabilitation Science, McMaster University.
Brenda
B
Vrkljan
Department of Medicine and Rotman Research Institute, Baycrest Health Sciences; Research Department, Toronto Rehabilitation Institute, University Health Network.|Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto.
Gary
G
Naglie
Ottawa Hospital Research Institute, University of Ottawa.
Shawn
S
Marshall
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001334:Automobile Driving / Q000331:legislation & jurisprudence / Q000592:standards*; D002170:Canada; D000066491:Clinical Decision-Making / Q000941:ethics*; D003219:Confidentiality / Q000941:ethics; D005260:Female; D006304:Health Status; D006801:Humans; D008004:Licensure / Q000331:legislation & jurisprudence; D008297:Male; D010300:Parkinson Disease / Q000150:complications; D011369:Professional-Patient Relations; D018570:Risk Assessment / Q000379:methods
aging; assessment; clinical ethics; conduite automobile; driving; vieillissement; éthique clinique; évaluation