Consent and liability: Special problems with anxiolytics

The use of benzodiazepine anxiolytic therapy has sometimes been associated with certain adverse reactions. The authors discuss the extent to which the clinician is responsible for warning patients that benzodiazepine therapy may result in addiction, withdrawal problems, and/or impaired cognitive and motor skills. The development of new anxiolytics such as buspirone, which seem to exert less effect on cognitive and motor skills and lack addiction potential (and thus withdrawal problems), presents the clinician with a treatment alternative. The authors review two legal cases involving benzodiazepine-induced driving impairment and discuss whether the clinician is obligated to prescribe the agent that generally demonstrates the least interference with such common activities as driving. Primary issues that arise in the discussion of physician responsibility are informed consent (both verbal and written) and the documentation of all treatment decisions. The authors recommend quality care and individualized treatment to avoid liability.