Should healthcare professionals breach confidentiality when a patient is unfit to drive?

Sokol uses pathos very effectively to highlight the very real dangers of driving when unfit to do so. As anaesthetists we routinely advise patients that they will be unfit to drive whilst their reactions are impaired by residual effects of their anaesthetic drugs - usually for 24-48 hours. We often emphasise this by stressing that their driving insurance will be invalid during this period. Unfortunately, in reality we simultaneously de-emphasise the message by bundling it with a myriad of other important 'do's and 'don't's. Unfortunately also, the newly updated DVLA guidance (Feb, 2017) on fitness to drive fails to highlight the risks (and responsibilities) associated with recent general anaesthesia. This, and that we have little evidence about the extent to which patients choose to follow our advice, or ignore it and are involved in 'accidents', is a matter of obvious concern. Perhaps we should regard 'same-day discharge general anaesthesia' as a notifiable condition and be required to inform the DVLA as a matter or course: then at least data could be collected and collated. Perhaps also, rather than relying on logos, we too should resort to pathos. The tragic story of little Poppy-Arabella and the dangerous driver is a very powerful one.