Sunday, August 31, 2014

Should ER doctors turn in suspected drunk drivers?

Last weekend the Toronto Sun ran a front page story and two full pages inside, on an ER doctor's experience and opinion.
The story was about a woman that had been taken to the ER and examined by that doctor.
"The patient, a woman in her 40s, had driven her car into the back of another automobile, causing significant damage to her vehicle and injuring the two occupants of the car she struck.
As I examined this woman, it became apparent to me she was likely under the influence of alcohol at the time of the accident. Her breath smelled strongly of liquor, her words were slurred, and her balance was unsteady. Speaking to the attending paramedics, I was informed police had not interviewed the woman at the scene and she had not yet been subjected to an alcohol breath test. Assessing the patient for injuries, I proceeded to order x-rays and CT scans, as well as lab tests to screen for alcohol and drugs of abuse."
The doctor's suggestion is that physicians be allowed to report suspected drunk drivers to the police in the interests of public safety, contrary to doctor - patient confidentiality. 

In this case the woman had the presence of mind NOT to permit blood tests, and even if they were done they could not be admitted as evidence because the law imposes a duty of confidentiality on physicians. In the article the doctor points out how this duty of confidentiality already has exceptions. His suggestion would simply add to the slippery slope that currently erodes doctor-patient confidentiality. Is it warranted? 

I would say no. In the case above, the actions of that woman, likely required police investigation because harm was done, people were hurt, property was damaged. So where were the police? That is their job. The issue should have been dealt with right there. 

Maybe there were witnesses (including the two that were injured) that could have testified that the woman was driving carelessly or even dangerously. Their encounter with the woman assuming they were able, would allow them to pursue a civil action against the woman, even if the woman wasn't charged. Careless and dangerous driving can be objectively observed. Both may cause harm, and appropriate penalties do exist. However, alcohol in the blood does not necessarily indicate impairment or result in careless or even dangerous driving. By allowing the doctor to hold or report the woman until police arrive just puts off what should have happened initially. When a traffic collision occurs and an ambulance is called, police should be there too.

I'm not in favour of drinking and driving, I doubt anyone is. Charging someone with a crime simply based chemicals present in their bloodstream is not reasonable in my opinion. That is what the doctor proposes and of course that already happens when police stop drivers and ask them to use a breathalyzer. But the police may have had cause for stopping that particular driver. The actions of that person, the way they are driving, that is what should be judged.

In Ontario police already have extraordinary powers with regard to alcohol consumption. All Ontario drivers are likely aware of The Ride Program, - the annual holiday police road block that assumes guilt by virtue of the time of year, and time of day. The statistics show that fatal collisions that have impaired drivers involved have been steadily decreasing over the years. Is that because of the Ride Program or is that because of all the advertising education that has occurred over the 26 years since Ride was initiated province wide? Its hard to know.

There are many reasons that could impair a person's ability to drive. Eating, drinking (alcohol), talking, texting, shaving, children in the back, putting on makeup, it's a long list. None of those are crimes in the right context. But if any of them causes a person to drive erratically or even dangerously resulting in a collision, that is potentially a crime, and that is what should be judged.     


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