Is a doctor or an optometrist ethically or morally obligated to report a patient with poor eyesight to the state department of motor vehicles?

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I assume we're imagining that the doctor knows that the patient hasn't herself reported her optical problems. I suppose the first thing to try would be asking the patient to do so. Now imagine that the patient refuses, or that the doctor has reason to suspect that the patient won't make a report. The first issue is whether the law requires the doctor to inform the authorities. If it does, then it seems to me pretty clear that she should do so. If the law doesn't require this, then the doctor may be subject to legal, or professional, obligations of confidentiality. If those are absent too, then I'm inclined to think she should go ahead and make the report. It might be said that it would damage the relationship of trust between her and her patient, and I guess that is more than likely if the patient's driving licence is revoked! But that seems a price worth paying. Nor do I think it would do much if any harm to the reputation of the doctor, or doctors in general, if it became known that the doctor had reported her patient's condition on the ground that the patient herself had not done so. Indeed it might be thought irresponsible to keep the information confidential. It might, of course, make it less likely that patients in a similar situation in future would consult their doctors. But I can't see that that is especially relevant here, since such patients would anyway be those inclined to drive without reporting their defective eyesight.

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