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Letters
August 18, 2010

Cognitively Impaired Older Drivers, Risk Assessment, and Physician Responsibility—Reply

JAMA. 2010;304(7):744-745. doi:10.1001/jama.2010.1150

In Reply: Dr Finucane raises several excellent points. We agree that the issue of confidentiality must be weighed in decisions to report at-risk cognitively impaired older drivers. Physicians have an obligation to protect health information, and that breech of confidentiality to a third party has to be carefully considered. In the case of dementia, physicians are often faced with patients who lack insight and decision-making capacity. In this instance, involving a surrogate decision maker or a third party like the state may not only be appropriate but also be justifiable from both a legal and ethical standpoint.1

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