Yesterday in the ED, on Cinco de Mayo, had an interesting medico-legal dilema. We had a girl who came in insensate after a single vehicle motor vehicle collision. In brief, stone drunk, in the middle of the night, she drove her car into four parked cars. She came in to us essentially unresponsive and damn near bought herself a tube. blood alcohol was 218 and she had a UTox positive for THC. After the work up was negative I checked with the cops to see what the next step was and....she was free to go. The reporting officer hadn't suspected alcohol (in a single vehicle Cinco de Mayo accident?!) so there was no criminal report filed! I called the PD, spoke with the officer, and (I think) guilted him into ammending the report and indicating she was DUI. I don't know what will come of it all, but the meat of the issue for me is the ethics of my actions--reporting a patient to the police. I feel right about it. But I have the sense that the armchair ethicists might differ.