Visually impaired drivers and public protection vs confidentiality

Patients consenting to health care are usually content for information to be disclosed to other team members if it will help to provide effective health care. They rarely state at the commencement of a conversation that information is 'secret', but assume that professionals will use the information solely to assist their care. Nurses working in the field of ophthalmology regularly test patients' visual acuity. Not all patients' eyesight reaches the minimum standard required by the Driver and Vehicle Licensing Agency. What should nurses do if test results reveal a patient who they know is a driver and whose eyesight does not meet the minimum standard for driving? Should the nurse breach confidentiality? There may be a public safety issue. This article discusses the legal, ethical, professional and employment duty of the nurse, giving examples from previous case law and highlighting the standards of confidentiality required of those employed as professionals in the health service.