Mandatory physician reporting of drivers with medical conditions: legal considerations.

BACKGROUND Physicians are facing ever-increasing legal obligations in all Canadian jurisdictions to report patients believed to be unfit to drive a motor vehicle or pilot an aircraft. In most Canadian jurisdictions these statutory obligations are mandatory; in others, they are discretionary. OBJECTIVES To provide a legal perspective on a physician's duty to report in the various jurisdictions in Canada. METHODS Reporting legislation and case law from each of the Canadian jurisdictions were compared with respect to reporting requirements, physician protection and the production of medical reports. Federal legislation was examined in respect of the duty to report pilots deemed unfit to fly. Lastly, provincial guidelines and medical standards were examined for their impact on standard of care issues. RESULTS While the obligations vary slightly from one jurisdiction to another, the majority of Canadian jurisdictions provide for mandatory reporting. Additionally, courts have been willing to apply and give considerable weight to medical guidelines, such as those formulated by the Canadian Medical Association and other provincial medical bodies, to determine the scope of a physician's obligation to report. CONCLUSIONS In all jurisdictions, a physician who fails to report in circumstances where the physician is of the opinion that a driver is unfit faces potential quasi-criminal liability, civil liability and/or College disciplinary proceedings. The current statutory provisions and professional guidelines leave little room for the exercise of discretion on the part of the physician.