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McKenzie v. Hawaii Permanente Medical Group

6/10/2002

34. The plaintiff was injured in an accident caused by the patient shortly after she left the clinic to drive to the hospital at the doctors' behest. Id. One of the reasons offered by the court for imposing a duty was that the doctors could easily have warned their patient not to drive in "her irrational and uncontrolled diabetic condition." Id. at 735. The court noted that such a warning would likely have been effective: " aving otherwise complied with her doctors' professional recommendations, [the patient] presumably would have continued to follow their advice had [the doctors] warned her not to drive." Id.


In many circumstances, however, the dangers associated with driving and a particular medication may already be commonly known or already known to the individual patient. In a related context, the court in Praesel, concluding that physicians do not owe a duty to non-patients to warn seizure patients against driving, reasoned:


Balancing both the need for and the effectiveness of a warning to a patient who already knows that he or she suffers from seizures against the burden of liability to third parties, we conclude that the benefit of warning an epileptic not to drive is incremental but that the consequences of imposing a duty are great. The responsibility for safe operation of a vehicle should remain primarily with the driver who is capable of ascertaining whether it is lawful to continue to drive once a disorder such as epilepsy has been diagnosed and seizures have occurred. Accordingly, we decline to impose on physicians a duty to third parties to warn an epileptic patient not to drive. Praesel, 967 S.W.2d at 398.


Thus, the scope of the physician's duty may be limited in situations where the danger is obvious, a warning would be futile, or the patient is already aware of the risk through other means.


To summarize, we balance the considerations in favor of imposing a duty to warn for the benefit of third parties against the considerations militating against imposition of a duty. The primary considerations favoring a duty are that: (1) it is evident that a patient who is unaware of the risk of driving while under the influence of a particular prescription medication will probably do so; (2) warning against such activity could prevent substantial harm; (3) imposing a duty would create little additional burden upon physicians because physicians already owe their own patients the same duty; and (4) the majority of jurisdictions appear to recognize a duty under some circumstances. The primary consideration militating against the imposition of a duty is that it may not be worth the marginal benefit, in some circumstances, where the effectiveness of the warning is minimal or where the reasonable patient should be aware of the risk. Such circumstances may include, e.g., situations where patients have previously taken a particular medication and where patients are prescribed medications commonly known to affect driving ability. " he relative knowledge of the risk as between a patient and a physician is factor to consider in deciding the threshold question of whether a physician owes a duty to third parties to warn a patient." Praesel, 967 S.W.2d at 398. Balancing these considerations, we believe that a logical reason exists to impose upon physicians, for the benefit of third parties, a duty to advise their patients that a medication may affect the patient's driving ability when such a duty would otherwise be owed to the patient.


As presented, the facts in this case do not suggest that the adverse effects of prazosin are commonly known by the lay public; nor do the facts suggest that Wilson was likely to know the adverse effects without a warning. Dr. Washec

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