By R Carter
In this era of opioid hysteria many doctors are rightly concerned about liability issues with regards to prescribed medications and it’s impact on patient behavior while operating an automobile or machinery.
It’s not unusual for a patient contract for chronic pain while taking opioids to include one or more clauses regarding this issue and those clauses can include a range of restrictions and or waivers. From something as simple as a warning about driving while taking medications up to an including a legal waiver absolving a prescriber of any liability. Some may even include a type of affidavit which requires a patient to agree not to drive an automobile while taking medications such as opiates.
I’m not aware of any patients being denied medical care for refusing to sign a waiver or affidavit, but when such restrictions are buried in the body of a patient contract, many patients fail to recognize such limitations because they fail to read the contract before signing.
While absolving a prescriber from liability for an accident is not unreasonable, conditions which forbid patients from operating an automobile or machinery while taking medication is not. Such conditions have the potential of preventing patients from holding down a job or performing duties while on the job, making employment all but impossible if and when enforced.
The real question becomes are such conditions enforceable? Can a prescriber refuse medical care if a patient refuses to sign a waiver or affidavit? The short answer is yes, particularly under a new ruling by HHS called the moral conscious clause, which allows a medical provider to refuse care for any reason they find objectionable to their moral values.
Many chronic pain patients are objecting to such interpretations due to the fact that it is now possible for medical providers to hide any number of personal biases behind this moral conscious clause and in doing so, use it as a means for any type of discrimination, even those which have been outlawed by federal regulations.
A recent ruling by an appeals court in New Jersey has added to case law an interpretation of this idea of doctors being held liable for the actions or behaviors of patients for whom they prescribe medications, especially medications which have the potential of altering behavior and consciousness.
Law360.com recently reported on an appeals decision, where a New Jersey doctor whose patient struck and killed a bicyclist with her car while taking medication he prescribed was fond not liable for the cyclist’s death because there was not enough evidence to prove the driver was impaired.
A three-judge panel affirmed a lower court’s decision in concluding that Dr. Stefan Lerner was not responsible for the 2014 death of Judith Schrope. Lerner’s patient, identified in the published opinion as B.M.D., was prescribed at least six psychiatric medications for depression, panic disorder and attention deficit disorder at the time of the crash as reported by Sarah Jarvis.
Such a decision has relevance for chronic pain patients taking opioids while operating an automobile or machinery. While many would assume patients taking opioids have their judgement and reaction times impaired, such assumptions do not take into consideration factors such as the development of tolerance which significantly dampens these effects. Furthermore, when taken as prescribed, hundreds of millions of patients have been driving and operating machinery for hundreds of years without a clear connection between their side effects and their actual potential for contributing to accidents. A fact that seems to have been recognized in this NJ case.