Driving is freedom. We learn that when we are young, taking the wheel by ourselves for the first time. We are reminded of it years later, when physical or cognitive issues make driving more difficult, or when our doctors tell us that it may be time to stop. In those later years, freedom and safety often clash. At what point should an elderly driver turn over his or her keys? What role do doctors have to play in this important decision?
The American Medical Association (AMA) explores these questions in the recently updated AMA Physician's Guide to Assessing and Counseling Older Drivers. According to the guide, "To date, little organized effort in the medical community has been made to help older adults improve or maintain their driving skills." In fact, many physicians have had little guidance whatsoever on this topic.
The Physician's Guide offers advice about what physicians can do to assess, counsel and treat older drivers. It also discusses the competing legal and ethical duties that physicians face when their patients are too impaired to drive but refuse to stop.
Keeping Elderly Drivers Safe
Auto accidents are the number one cause of accidental death among individuals between the ages of 65 and 74 and the second leading cause of death for those over 74. Many of these accidents are preventable, caused by inattention, slower visual processing and failure to follow traffic signs. When cognitive, visual and motor skills prevent safe driving, what can doctors do to keep elderly drivers - and the public - safe?
The AMA states that physicians can assist in two important ways. First, they can identify diseases and provide effective treatment to keep older drivers on the road. Second, they can play a crucial role in determining whether older drivers are capable of driving safely and make recommendations when appropriate. This includes reporting patients to driver rehabilitation specialists and, when necessary, to their state's Department of Motor Vehicles (DMV).
When Patient Confidentiality Clashes With Public Safety
Unfortunately, reporting a patient to the DMV comes with its own set of concerns, the most important of which is patient confidentiality. Physicians have competing legal duties:
•· Duty to protect patients: A doctor's first responsibility is to his or her patients and their health and safety.
•· Duty to maintain patient confidentiality: Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), physicians have a duty to keep patient information confidential. The only exception to this rule is where public interest or the patient's own interests make it necessary to disclose the information.
•· Duty to protect the public: Doctors are in a unique position to protect the public from health-related accidents. In some U.S. states, doctors can be held liable for third-party injuries caused in part by their actions (such as failure to warn of a medicine's side effects
Doctors must weigh the value of each of these ethical duties when deciding whether to report a patient for unsafe driving. Reporting and failing to report can both lead to consequences. On one hand, breaching patient confidentiality can forever tarnish the relationship between a doctor and his or her patient. On the other hand, failing to report a public safety issue puts the public at risk and could - in some states - make the doctor liable for an accident caused by his or her patient.
Physician Reporting Guidelines in Colorado
Every state has different reporting guidelines that provide some guidance for physicians who must decide whether to report their elderly patients for unsafe driving. In Colorado, physicians are not required to report to the DMV, but it is encouraged. Furthermore, physicians are not legally liable for providing written medical opinions. Doctors can freely choose to report or not to report.
The AMA's Guide suggests that doctors can "reduce the impact of breaching patient confidentiality" by only providing enough information to show that the patient could be an unsafe driver and by documenting all information provided. Doctors should also explain to the patient that the choice to report is an ethical choice.
What to Do if You Were Injured by an Elderly Driver
Driving is freedom, but in an orderly society freedom has limits. There comes a time when some freedom must be relinquished to protect the safety of the driver as well as the public.
If you were injured in a Colorado auto accident caused by an elderly driver, contact an auto accident lawyer near you to discuss your legal options.
