NATURAL DEATHS WHILE DRIVING - WOULD SCREENING FOR RISK BE ETHICALLY JUSTIFIED

Objectives - To determine the epidemiology and rite underlying patholo gical conditions of natural deaths among motor vehicle drivers. Sudden death while driving may cause damage to properties, other vehicles or rand users. Although the Medical Commission an Accident Prevention re commended restrictions to drivers at risk of sudden dentil die to thei r medical conditions, these restrictions are useless if they do nor re sult in greater safety to the public. Design -A retrospective study of natural deaths of motor vehicle drivers. Setting - Natural deaths of motor vehicle drivers reported to the coroner for Birmingham and Solih ull. Subjects - 86 consecutive,natural deaths of motor vehicle drivers in a five-year period between 1984 and 1988. Results - Of rite 86 fat alities reviewed, 80 (93%) sudden deaths were caused by ischaemic hear t disease. Fifty vehicles were involved in collision with 32 propertie s, 20 Other vehicles and six pedestrians. Fifty-one out of 80 cardiac deaths had past cardiac history aid three had repaired chest pain prio r to the sudden death. Conclusion - An applied normative ethical asses sment based on the basic moral principles of autonomy, justice, benefi cence and non-maleficence are discussed. We conclude that medical scre ening of drivers has little benefit for the drivers or other persons.