Doctors who do not feel sober enough to drive should avoid helping in medical emergencies

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7166.1158a (Published 24 October 1998) Cite this as: BMJ 1998;317:1158
  1. J A D Stewart, Specialist registrar in general medicine and gastroenterology.
  1. Glenfield General Hospital NHS Trust, Leicester LE3 9QP

    EDITOR—The ethical debate entitled “Too drunk to care?” raises interesting moral problems but mixes ethical arguments with comments about legal responsibility.1 Ethics and the law are different subjects that occasionally overlap; it is dangerous, however, to confuse one with the other. The real question is how much alcohol Cressey had drunk before he found himself in the difficult situation of knowing whether to offer help to a spectator at a sports event who became unconscious after an incident. Once we know the degree of intoxication involved we can comment on the wisdom of his actions and formulate guidelines about the dangers of involvement. Clearly, from a legal perspective the safest course of action is not to get involved at all (however morally questionable that is). There is no duty to rescue in law. Once one becomes embroiled, however, a professional relationship is established and the spectre of negligence looms large.

    The answer may come by looking at comparative legal situations. If a person has had an alcoholic drink but believes that a Breathalyser test would show that he or she was sober enough to drive then it is reasonable to say that that person is probably competent to attend a medical emergency. I therefore suggest that if doctors find themselves in Cressey's position and feel compelled to act they should first ask themselves whether they are sober enough to drive. If the answer is yes then proceeding to assist a sick person is probably safe; if the answer is no or there is any uncertainty then it is probably fair to themselves and the patient that they resist, whatever the moral motivation. It is a sad reflection on our litigious society and the effect this has had on the medical profession that all medicine must now be practised defensively and the only truly legally safe course is not to get involved. I fear that society as a whole may now be paying the price for being so ready to sue the medical profession. For some unfortunate people this may be the ultimate price.


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