Regulation Matters 2019 - Issue 3

Client with a Visual Impairment Seen Driving

Scenario: What should the dietitian do?

A client of a diabetes education centre has a visual impairment. The physician has documented in the client’s health record that the client was advised not to drive. After their follow-up appointment, the dietitian sees the client driving out of the parking lot.

How should the dietitian handle this situation?

No Mandatory Obligation for Dietitians to Report the Client

According to the Highway Traffic Act, 1990 , the Regulated Health Professions Act, 1991 and Dietetics Act, 1991, dietitians do not have a mandatory reporting obligation for a client who may be medically unfit to drive.

Some healthcare providers (e.g., physicians, optometrists, nurse practitioners and occupational therapists) have a mandatory obligation to report to the Ministry of Transportation of Ontario (MTO) any person 16 years and older, who, in their opinion, “has or appears to have a prescribed medical condition, functional impairment or visual impairment,” that would make it dangerous to drive.  Once the MTO has received a report, it determines whether restrictions will be imposed on a person’s driving privileges. 

Collaborate with the Healthcare Team

Although dietitians do not have a reporting obligation in this case, they  do have a professional obligation to work with the healthcare team to provide safe client care and ensure public safety. 

  1. A good first step would be for the dietitian to report what she has seen to the physician or the other members of the healthcare team. They may already be aware of the situation and have taken steps to address the driving issue with the client, or the matter may have been addressed with the appropriate authorities already. 

  2. ​If the other members of the healthcare team are not aware that the client was driving out of the parking lot, find out if the organization has a formal policy to ensure public safety in cases where clients are advised not to drive. 

  3. If there is no formal policy, work with the other members of the healthcare team to determine the risks to the client and the public, and the appropriate next steps. Next steps could include working with the client, a family member or a social worker to find alternate transportation for healthcare appointments and other daily activities, or contacting the MTO.

Interested in discussing an ethical dilemma in practice?

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