Mello Michael J, Nirenberg Ted D, Lindquist David, Cullen H Allethaire, Woolard Robert
Injury Prevention Center, Department of Emergency Medicine, Rhode Island Hospital and Miriam Hospital, Brown Medical School, Providence, Rhode Island 02903, USA.
Subst Abus. 2003 Dec;24(4):233-42. doi: 10.1023/a:1026012030492.
Our objective was to examine attitudes on reporting alcohol-impaired drivers by physicians of different specialties who are most likely to treat motor vehicle crash (MVC) patients. Specific objectives included examining 1) degree of comfort with reporting to police or Department of Motor Vehicles (DMV), 2) variability in attitudes across specialties surveyed, 3) perceived barriers to reporting, and 4) general attitudes on treating alcoholism. Physicians reported that they felt more comfortable with reporting to a medical review board of DMV than to police in all three of the case examples, which included treating a patient who is a clinically diagnosed alcohol-impaired MVC driver (66% DMV report, 36% police report), MVC driver at legal limit of blood alcohol concentration (63% DMV report, 32% police report), and an MVC driver with a very high blood alcohol concentration (81% DMV report, 53% police report). There was no difference between specialties in comfort with reporting, though emergency medicine physicians were less likely to screen and refer patients for counseling. The primary reasons given for not reporting an alcohol-impaired driver were physician-patient confidentiality and perceived threat of civil action by patients.
我们的目标是调查最有可能治疗机动车碰撞（MVC）患者的不同专业医生对举报酒驾司机的态度。具体目标包括：1）调查向警方或机动车管理部门（DMV）举报的意愿程度；2）调查不同专业医生态度的差异；3）找出举报的感知障碍；4）了解对治疗酗酒问题的总体态度。在所有三个案例中，医生表示向DMV的医疗审查委员会举报比向警方举报更自在，这三个案例分别是：治疗一名临床诊断为酒驾的MVC司机患者（66%向DMV举报，36%向警方举报）、血液酒精浓度达到法定上限的MVC司机（63%向DMV举报，32%向警方举报）以及血液酒精浓度非常高的MVC司机（81%向DMV举报，53%向警方举报）。不同专业在举报意愿上没有差异，不过急诊医学医生筛查并转介患者接受咨询的可能性较小。不举报酒驾司机的主要原因是医生对患者的保密义务以及担心患者提起民事诉讼。
