Case study: Lee. Putting others at risk.

Lee Lee is a 45 year old man, married to Jane. They live together with their teenage son. Lee was taken to hospital following a fall at home. He had suspected rib fractures. His wife telephoned for an ambulance. Lee is found to be very drunk. After x-rays and tests, Lee is discharged from accident and emergency after 4 hours. His wife comes to pick him up. Nursing staff witness Lee taking the car keys from his wife and insist that he is going to drive home. They point out to Lee and his wife that he is still too intoxicated to drive. Lee denies this and his wife shrugs and says to the staff, ‘what can I do?’

Lee (cont.) The staff members tell Lee that they cannot discharge him if he is going to drive home. He says they can’t stop him and walks out of the hospital. The staff members observe Lee walking to the car and getting in the driver’s seat. They notify the police, giving his details and number plate. Lee is stopped on leaving the hospital grounds, is breathalysed and arrested.

Questions What duty of care were the staff exercising when they contacted the police? Who were they protecting? How could the staff members justify breaking confidentiality in this case?

Suggested answers The staff – nurses, doctors or other health and social care professionals, have a duty of care to the patient and the public. They were protecting Lee, Jane and other road users. Staff members can justify breaking confidentiality in this case because of the duty of care to safeguarding – Lee was at that time vulnerable and Jane may also have been vulnerable. See the resource on Safeguarding for more on this.Safeguarding