Niveau G, Kelley-Puskas M
Institute of Forensic Medicine, University of Geneva, Switzerland.
J Med Ethics. 2001 Feb;27(1):36-9. doi: 10.1136/jme.27.1.36.
In Switzerland, as in some other European countries, medical doctors may breach patient confidentiality and report to police authorities any patient who seems prone to automobile accidents or traffic violations. The aim of this study was to see if those patients reported to authorities actually represent a higher risk than drivers not reported to the police.
This study was designed following a case-control study comparing the characteristics of a group of psychiatric patients who were reported to authorities for preventive purposes, with the characteristics of another group of people who had disorders that were noticed at the time of an accident or traffic violation.
The results show that medical doctors tended to report male patients, patients with a low level of education, and patients with a severe psychiatric background. The subjects of the control group, who had often been involved in accidents or committed traffic violations in the past, did not possess these characteristics.
The breach of medical confidentiality by doctors in reporting to authorities patients who are allegedly at risk is ethically questionable as long as the evaluation of driving performance does not rely on objective bases.
在瑞士，和其他一些欧洲国家一样，医生可能会违反患者保密原则，向警方报告任何看似容易发生交通事故或交通违规的患者。本研究的目的是查看那些被报告给当局的患者实际上是否比未被报告给警方的司机具有更高的风险。
本研究采用病例对照研究设计，比较一组因预防目的被报告给当局的精神病患者的特征与另一组在事故或交通违规时被发现患有疾病的人群的特征。
结果表明，医生倾向于报告男性患者、低学历患者和有严重精神病史的患者。对照组的受试者过去经常发生事故或实施交通违规行为，但不具备这些特征。
只要对驾驶性能的评估不基于客观依据，医生向当局报告涉嫌有风险的患者而违反医疗保密原则在伦理上是有问题的。
