COMMENTARY

Doctors and Nurses Should Be Drug-Tested -- Get Used to It

Arthur L. Caplan, PhD

Disclosures

August 01, 2013

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Routine Drug Screening of Healthcare Professionals

Hi. I'm Art Caplan from the New York University (NYU) Langone Medical Center, Division of Medical Ethics. Today I want to talk about a very controversial subject. Should physicians and nurses be subjected to routine drug screening? Should they have to void in a cup to get a job? Should they have to do that to keep their jobs?

This is a regular aspect of work in many walks of life; airline pilots and train conductors must be tested all the time. They are subject to random testing. Should doctors and nurses have to follow suit? Some people say that the whole idea is degrading. It invades privacy and it's disrespectful of the professionalism of the doctors and nurses.

Doctors and nurses who suspect a colleague of being impaired by drugs, alcohol, or abuse of sedatives will blow the whistle, and that is what is needed -- an alert, peer-review staff who will draw the attention of the appropriate people when there is a suspected drug problem. Unfortunately, the data don't support peers being willing to do that. When you ask doctors, residents, and even medical students hypothetically if they would report someone that they thought was impaired, they tend to say "no." It's something of an embarrassment.

To have to pass a drug screening to get a job should be a requirement. After all, any employer can say, "We don't want to have an impaired physician or nurse on the staff. That's just part of our giving you admitting privileges or allowing you to practice in our hospital, healthcare system, hospice (or wherever)." More controversial is the notion of random drug testing. I would support it because when you have physicians and nurses in circumstances where drugs are easily obtained and easy to abuse, you probably do need to do a certain amount of spot checking. It may be that in certain areas of the hospital, such as anesthesiology, the occasional random test makes sense.

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