From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: chi.general,sci.med
Subject: Re: Do NOT trust American doctors - EVER AGAIN
Date: 5 Jan 2000 05:59:49 GMT

In <84u3pr0152k@enews3.newsguy.com> Tommy the Terrorist
<mayday@newsguy.com> writes:

>In article <83nfko$d08$1@nnrp1.deja.com> , wordsmithgrr@my-deja.com
>writes:
>>necessary to decide that their driving is safe or unsafe. One of my
>>traumatic brain injury patients (hurt his head in a fall) recovered well
>>enough to go home. During a 15-minute period when he was not being
>>supervised (his wife was taking a shower), he managed to get into his
>>garage, start his power saw, and ended up in our ER with an amputated
>>arm. He did not have the judgment to stay away from power tools (he had
>>been a carpenter). Nor did he have the ability to decide that he was
>>unsafe to drive.
>>
>>In the above situations the physician should have the right to notify
>>the DMV of unsafe situations.
>
>The example you quote tends to disprove, not prove, your point.
>(at least, I suppose, until the government gets around to requiring
>licenses and registrations for power saws, nail guns, drain cleaner
>and so on, but that should be at least five years).
>
>But the real question I have is how someone who is so out of it that
>he can cut his arm off with a saw despite having a lifetime of training
>in using it, is going to be deterred from driving because the DMV sent
>him a notice that he isn't supposed to drive his car...?
>
>The fact is simple:  the government is NOT your father, it is NOT
>your mother, it is NOT your spouse, and it will NOT be of any help
>baby-sitting you if you are nuts or senile.  Giving it more power to
>pry into medical records and stigmatize people according to the
>sporadic judgments of its medical officials will not be of any help
>to anyone at all.




   And, lastly, may we add that in Utah and California (where I hold
licences to practice), doctors not only have the *right* to notify the
DMV, they are *required* by law to report long term cognative
impairment and dementia to the department of motor vehicles, which then
sets about doing full driving skills tests on the named individual.
Just as doctors are required to report certain communicable diseases,
suspected child and elder abuse, and gunshot wounds of all
desecriptions.  I don't really mind the DMV law-- I'm not the one
making the decision that they can't drive-- that's up to the athorities
after proper testing.  And my family and I drive on the roads with
these people, too.  As for many of the others, I have mixed feelings
about them.  The gunshot wound law surely delays people coming in for
treatment, and perhaps so do the child-abuse reporting laws.  Parents
damage their children and then are afraid to get them treated, hoping
(often wishfully) that things will get better.  And so on.  We found a
great deal of improvement in people seeking help for drug problems when
they found they would not be turned in by the hospital.  You need some
place you can go for medical and psych help where you can trust people
not to rat on you (I am supposing that there is no prima fascie
evidence of a really heinous crime).

   On the other hand, the demented, rather as a matter of course, are
seldom knowledgable and crafty enough not to go to the doctor because
they know they will be reported to the DMV if they do.  And their
families have just as much reason to want them off the roads as anyone
else does.