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Is it any of your doctor’s business whether you text and drive?

by Dominic Wilkinson

"Absolutely!" is the answer of Boston physician Amy Ship writing in the New England Journal of Medicine, and interviewed over at the LA Times blog. She includes questions about seatbelts and phone use while driving in her routine questions for patients

Dennis Tuchler picked up on this story over in our Micro blog (where we collect stories from around the web with interesting ethical and philosophical questions). He writes

"I don't
see this as a medical problem. Where does safety instruction by
physicians stop? Don't leave small children alone at a swimming pool?
Don't drive without your prescription glasses? etc.

The swimming pool example is one where paediatricians have taken a significant role in the development of public policy about swimming pool fences and gates. That seems (to me at least) unproblematic. Moreover doctors routinely enquire about a range of behaviours with potential health implications including smoking, alcohol or drug use, safe sex, diet, exercise. Why should driving behaviour be any different? Dennis notes

"My concern is not with the
physician's being a busybody. It is rather with the question of legal
liability for malpractice. If it is part of the physician's job to
lecture the patient on safety matters, failure to do so on a particular
safety matter might lead to claims of malpractice relative to the harm
caused by the patient to herself or another on the ground that the harm
could have been averted with proper warning and lecture. It's weird, I
know, but I am writing from the USA."

One concern about expanding the list of topics that a doctor might reasonably enquire about is that this risks becoming impractical. Fitting in questions about all of the above behaviours, even without adding in enquiries about phone use while driving just may not be possible in a busy outpatient clinic. It would seem problematic if doctors were found negligent for having failed to enquire about any conceivable risky behaviour in a patient's private life. But that concern seems to be more about the way 'malpractice' is managed in the US than about whether doctors, if they have the time, should take the lead in promoting safe driving.

One question is whether it makes a difference if doctors routinely or occasionally ask their patients about behaviours like phone use while driving. The evidence purists will surely ask for a trial before advocating a change in practice. In fact there is little evidence to support screening questions about drugs, diet, exercise etc either. But doctors (appropriately in my view) do persist in asking about them. So why not phones and driving? Dr Ship again:

"A question about driving and distraction is as central to the
preventive care we provide as the other questions we ask.
Not to ask — and not to educate our patients and reduce their
risk — is to place in harm's way those we hope to heal."

What do others think?

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1 Comment on this post

  1. How absurd. Why should any doctor be at risk from a malpractice suit as a result of not warning a patient about the dangers of using a cell phone while driving. A doctors role is to diagnose and cure illness not take responsibility for patients behavoir except perhaps where it might be caused by a side effect from a medical perscription.

    Where will all of this insane legal liability end. Doctors will end up unwilling to see or treat patients because of potential legal liability. This has already occurred on trains and planes.

    As a society we need to focus more on risk and reward and right and wrong rather than providing a global opportunity for lawyers to try and enrich themselves on the potential breach of absurd legal technicalities !

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