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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.
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References 7 · Cited by 13
Research works printed but not linked: 5
- Appelbaum, 1985, Tarasoff, and the clinician, Am J Psychiatry, 142, 425, 10.1176/ajp.142.4.425 · DOI
- Binder, 1996, Application of the Tarasoff ruling and its effect on the victim and the therapeutic relationship, Psychiatric Services, 47, 1212, 10.1176/ps.47.11.1212 · DOI
- Krumholz, 1991, Driving and epilepsy, JAMA, 265, 622, 10.1001/jama.265.5.622 · DOI
- 2000, Public policy statement on reporting of patient information related to fitness for driving or other potentially dangerous activities, J Addictive Diseases, 19, 125
- 23 F.Supp. 2d 167, United States District Court (D. Connecticut 1998) as discussed in Lamb MJ: Divergent opinions regarding the Tarasoff-type duty-a double bind. Rx for Risk 2000;8(1):1, 4–7.
Metadata
- Authors
- Leeman, C. P., Cohen, M. A., & Parkas, V.
- Affiliations
- SUNY Downstate Health Sciences University (US)
- Corresponding author
- Leeman, Cavin P
- ORCID
- Cohen, Mary Ann
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2001-11
- Volume
- 23
- Issue
- 6
- Pages
- 333-336
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2028514577
- Cited by
- 13
- References
- 7
- Citations by year
- 2019: 1 · 2013: 1
- FWCI
- 2.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- duty to warn, confidentiality, alcohol abuse, drug abuse, people living with HIV, public safety, professional ethics, bus drivers, occupational safety
- MeSH terms
- Alcoholism, Confidentiality, Dangerous Behavior, HIV Seropositivity, Humans, Occupations, Physician-Patient Relations, Safety, Duty to Warn, Motor Vehicles, Substance-Related Disorders, Ethics, Clinical
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- Leeman, C. P., Cohen, M. A., & Parkas, V. (2001). Should a psychiatrist report a bus driver’s alcohol and drug abuse? An ethical dilemma. General Hospital Psychiatry. https://doi.org/10.1016/s0163-8343(01)00161-x
