Intended for healthcare professionals

Education And Debate

Ethical debate : why are doctors ambivalent about patients who misuse alcohol?

BMJ 1997; 315 doi: (Published 15 November 1997) Cite this as: BMJ 1997;315:1297

The case history and survey of doctors' attitudes

  1. Ruth Dale, medical studenta,
  2. Roger Barton (, reader in medicinea
  1. a University of Newcastle upon Tyne, Academic Department, North Tyneside Hospital, North Shields, Tyne and Wear NE29 8NH
  1. Correspondence to: Dr Barton
  • Accepted 25 April 1997


Alcohol misuse is common, with 4% of adults being dependent.1 Doctors have a duty not only to those patients but also to the wider community. Such patients may bring harm to others while driving a vehicle or while employed in a variety of occupations. There are clear guidelines on the actions medical practitioners should take with respect to such patients who drive motor vehicles,1 2 3 but the advice with respect to patients in potentially dangerous occupations is less specific.4

Case report and survey

A 57 year old man with malaise was referred to the outpatient department. He was late for his appointment as he had crashed his car in the hospital car park. He had stigmata of chronic liver disease and was anaemic. He was admitted the following …

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