I guess this may be influenced by the laws in your community. In BC, failure to report suspected child neglect is cause for professional disciplinary action, not to mention legal action. I think it would be very reasonable to report this, and would have difficulty believing that there would be any repercussions to you. Jon Slater Pediatrician Kamloops,BC -----Original Message----- From: [mailto:]On Behalf Of Decker, Catharine Sent: February 20, 2001 1:25 PM To: '' Subject: medicolegal question A woman presents to the urgent care dept at 1:00 in the afternoon with sinusitis. You and your nurse both note that she smells strongly of alcohol and seems intoxicated, though on direct questioning, she denies drinking ("none today, once in awhile on weekends"). You treat her for sinusitis but are concerned b/c, in passing, she mentions that she is a home daycare provider for eight children, aged 6 mos to 4 years. She tells you her husband is home from work today and taking care of the children today. Still, you are concerned that an individual who shows up intoxicated to a doctors appt on a midweek afternoon is likely to be drinking on a chronic basis and therefore might not be a safe daycare provider. What do you do? Is this reportable? Is it mandatory to report this? Are you legally protected from recourse if you report this? How to handle this? Keeping in mind, we really have no proof that the woman was truly intoxicated, no idea who the involved kids are and supposedly the woman is not 'on the job' this day. But still, I have to wonder. Most people just don't get drunk on a midweek afternoon when they are sick and headed for a doctor appointment... I am highly suspicious that she's chronically intoxicated on a daily basis. If it were *my* kids in that daycare, I'd want that investigated. Thoughts? -Catharine (waiting for a 'call-back' from our legal advisors...)