QuestionSBA
QuestionChoice
Those with a lorry, bus or coach driving liscence who suffer a stroke must report this to the DVLA regardless of their ongoing symptoms or neurological defecit. Therefore, a neurological examination would not change the outcome of the consultation.
62191
d
Conduct a full neurological examination to determine if he is safe to drive
QuestionChoice
As the patient is a bus driver, it is therefore in the public's best interest to report the issue to the DVLA without the patient's consent. However, it is important to inform the patient of your intention to disclose this to the DVLA and explain your legal responsibility to do so.
62188
a
Contact the DVLA and inform the patient
QuestionChoice
This would only be acceptable if the patient agrees to stop driving in the meantime whilst they consider reporting to the DVLA. If they do not agree to this then it is the doctor's responsibility to report it.
62192
e
Review the patient again in 2 weeks to see if he has changed his mind
QuestionChoice
This would be the case for a car or motorbike liscence, however, the patient is a bus driver and therefore there is a legal responsibility for the patient to inform the DVLA that they have had a stroke.
62190
c
The patient only needs to inform the DVLA if he is still having problems 1 month after the stroke
QuestionChoice
Whilst the patient may have capacity there is a legal responsibility for doctors to report to the DVLA in this situation if they have not been able to persuade the patient to stop driving.
62189
b
Nothing as  the patient has capacity
Concept
Chapter
# Legal Duties 

When considering ethical scenarios, various things can guide decisions that healthcare professionals make. One of these is the law. The law can not only provide details of what _cannot_ be done (i.e. what is illegal), it can also set out certain things that have to be done; these are called legal duties.

Examples of legal duties include:

**Confidentiality**

A legal duty to breach confidentiality, if: ordered to by a court or judge, a patient is diagnosed with a notifiable disease (notify the local authority), the police request information on a road traffic accident, or grounds are met under the Terrorism Act 2000.

**General Practitioners**

General Practitioners have a legal duty of care to all persons registered on their practice list or anyone who needs help in the practice area.

Any doctor who offers help to someone, where the **help is accepted**, then owes that person a legal duty of care.

# Legal Defences 

A doctor may have a professional duty (or moral duty) to do something that breaks the law. For example, breaching confidentiality where none of the above conditions are met. In some of these circumstances, a **legal defence** may exist, which allows the doctor to fulfil their professional/moral duty without facing criminal proceedings.

**Legal defences** are established defences for breaking the law, which negate the criminality of the offence. In these situations, the law _allows_ the action to the taken, but does not _oblige_ it.

For example, the _public interest defence_ is an established legal defence. This means doctors are able to breach confidentiality if they know there is a risk of harm to the public by not doing so, e.g. may have to break confidentiality if a patient with mental illness poses harm to others.

# Examples of Legal Defences 

Legal defence to breach confidentiality if: the public interest defence applies, it relates to serious crime or it relates to serious Sexually Transmitted Diseases

NB: Serious Crime - gunshot and knife wounds have special consideration. Doctors have a duty to inform the police when patients present with these injuries, but what information they choose to disclose is left up to professional decision. Doctors can choose and then justify what information they disclose as a public interest defence (i.e. by giving the patient's name and address, the police might be able to prevent further harm to others).
567
581
Legal duty vs legal defence
Topic
30
Ethics and Law
12499
A 53 year old male bus driver attends his GP practice, he has recently been discharged from hospital after having a stroke. He has attend to discuss his new medication. He mentions that he has not told the DVLA about the stroke as he is keen to return to work and does not want to lose his liscense. After discussing why he needs to inform the DVLA he continues to refuse.

Which of the following is the best next step in the management of this patient?
a