Doctors Affected by Drugs and Alcohol

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Intoxicated Doctors

Consider this scenario. A person consults a solicitor for medical negligence advice to find out whether complications she experienced during labour were the result of negligence. Whilst taking a statement from the client, the client informs the solicitor that “I think the doctor may have been drunk. I could smell alcohol on his breath, he was slurring his words and wouldn’t pay attention to what I was saying.” The solicitor asks if there were any other witnesses present, and the client states that her husband, mother, a midwife and a nurse were present during the childbirth.

Whether the doctor was affected by drugs and/or alcohol could be an important factor in a medical negligence action and also in any disciplinary action against the individual intoxicated doctor. However there may also be legal ramifications for nurses and doctors who witnessed the behaviour of the intoxicated doctor and failed to intervene.

Harm Prevention

What can be done to protect a patient from harm in the first place? If a patient finds themselves in a situation where they are concerned that their doctor is intoxicated, the patient should raise concerns immediately, and request that they be attended to by another doctor within the hospital. The patient should also raise their concerns with the nurse in charge or with another doctor.

Reporting the Doctor

The patient may subsequently choose to report the doctor to the Medical Board or Australian Health Practitioner Regulation Agency (AHPRA).

However, the nurse or any other health care practitioner (e.g another doctor) who is made aware of the conduct may infact be required by law to notify AHPRA.

If the nurse forms a “reasonable belief”that the doctor is intoxicated, the nurse has a legal obligation to report the intoxicated doctor (i.e make a “notification”) to AHPRA. AHPRA would then refer the notification to the Medical Board of Australia for assessment.

This legal obligation arises under the new Health Practitioner Regulation National Law Act  2009, which came into effect on 1 July 2010.

Notifiable Conduct includes conduct where the doctor has practiced his profession (e.g consulted with a patient) while intoxicated by drugs or alcohol. It doesn’t matter whether the patient came to harm or not; the mere fact that the doctor has consulted with the patient whilst intoxicated or under the influence of drugs OR has placed the public at risk of substantial harm because of an impairment, is grounds for other health practitioners to report the doctor to the authorities. An impairment includes mental impairment, disability, disorder (including substance abuse or dependence).

These new laws are aimed at protecting patients from harm that detrimentally affects or is likely to detrimentally affect the person’s capacity to practice the profession.

What Patients should consider

• You have the right to refuse treatment from a health care practitioner who appears to be intoxicated.
• You should report your concerns to a nurse or another doctor on your ward/unit. In the case of a medical practice, report your concerns to the practice manager.
• You have the right to ask for a second opinion.
• You have the right to report the intoxicated doctor to the Medical Board.
• Remember, being treated by a doctor who is intoxicated puts your life at risk. Your health and safety should be your first priority.

What Nurses and other Health Care Practitioners should consider

• You have a legal obligation to report notifiable conduct to AHPRA.
• This duty applies to medical practitioners, chiropractors, dentists, nurses, midwives, optometrists, osteopaths, pharmacists, physiotherapists, podiatrists, psychologists.
• The obligation to make a mandatory notification applies to the conduct or impairment of all registered practitioners, and not just those in the same health profession as the practitioner who is making the notification. It also applies to students who are undertaking clinical training.
• A reasonable belief must be formed before reporting the conduct to AHPRA. You don’t need conclusive proof, but if you have direct knowledge or have observed the behaviour, then you legally must report it.
• You cannot be sued in civil law, criminal law, or for defamation if you make a notification in good faith (i.e well intentioned and without malice).
• Failure to make a notification may result in disciplinary action against you.

Update: Please see revised mandatory reporting guidelines which are due to come into effect in March 2020.

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