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Professional Reporting Obligations Part 2

A physiotherapist working in rehabilitation in a community hospital receives a telephone call from a patient who was referred to her by a neurologist working in a regional Acquired Brain Injury (ABI) program. The patient's brain injury resulted in the suspension of his driver's license.

During the course of her conversation with the patient, she discovers that despite his license being suspended, he continues to drive and on occasion, he takes passengers with him on his excursions. After finishing her conversation with the patient, the physiotherapist calls the referring neurologist to inform him that the patient is driving without a license. The physician informs the physiotherapist that he discharged the patient from his care four weeks ago because the patient had a history of non-compliance including sporadic attendance at scheduled office and ABI team appointments.

If the patient were under the care of a physician, the physiotherapist could have informed the physician involved and documented the conversation. However, being the sole health-care provider, the physiotherapist must make a decision between maintaining the confidence inherent in a patient-practitioner relationship and alerting authorities to the potential risk the patient poses to both himself and to registrants of the public while he continues to operate a motor vehicle.

What should the physiotherapist do?

Ethics

Unlike a situation where sexual abuse or the potential for sexual abuse is suspected, a physiotherapist is not legally obligated to report the fact that a patient is driving without a valid driving permit. Only physicians and optometrists are required by law to report their findings and make recommendations around a patient's ability to drive a vehicle.

However, from an ethical standpoint the College would almost certainly condone the reporting of information to the authorities where the life or safety of either the patient or others is at serious risk. Having said that, the physiotherapist also has a civil obligation to the patient upon which the College cannot advise. The physiotherapist may wish to speak to counsel representing the facility where he or she is employed or to an independent counsel.