J Med Ethics 27:36-39 doi:10.1136/jme.27.1.36

Psychiatric disorders and fitness to drive

  1. Gérard Niveau,
  2. Melissande Kelley-Puskas
  1. Institute of Forensic Medicine, University of Geneva, Switzerland


      Objective—In Switzerland, as in some other European countries, medical doctors may breach patient confidentiality and report to police authorities any patient who seems prone to automobile accidents or traffic violations. The aim of this study was to see if those patients reported to authorities actually represent a higher risk than drivers not reported to the police.

      Design—This study was designed following a case-control study comparing the characteristics of a group of psychiatric patients who were reported to authorities for preventive purposes, with the characteristics of another group of people who had disorders that were noticed at the time of an accident or traffic violation.

      Results—The results show that medical doctors tended to report male patients, patients with a low level of education, and patients with a severe psychiatric background. The subjects of the control group, who had often been involved in accidents or committed traffic violations in the past, did not possess these characteristics.

      Conclusions—The breach of medical confidentiality by doctors in reporting to authorities patients who are allegedly at risk is ethically questionable as long as the evaluation of driving performance does not rely on objective bases.


      • Gérard Niveau, MD, is Lecturer in Forensic Psychiatry at the Faculty of Medicine, University of Geneva, Switzerland. Melissande Kelley-Puskas, MD, is Assistant Psychiatrist at the Institute of Forensic Medicine, University of Geneva.