Estonia criticized over plan to have ER departments determine intoxication

Estonia's Ministry of the Interior is working on amendments to the Law Enforcement Act concerning the determination of a person's state of intoxication — for example, in cases of suspected drug-impaired driving. The stated goal is to speed up proceedings and reduce the burden on doctors, but the proposed solution would place this task on emergency medical departments (EMO), which are already operating under heavy strain.

Critics point out that determining intoxication is not treatment and is not considered a medical service — a fact acknowledged even in the bill's own explanatory memorandum. If the task is unrelated to treatment, it raises the question of why it should be handled in a hospital at all.

The purpose of emergency departments is to save the lives of those whose health is at risk, and to do so quickly. If the state adds a task unrelated to treatment — assessing a person's sobriety and drawing up a report on it — the additional staff needed for this work will not simply appear. That time will be taken from other patients, such as someone waiting for help with chest pain or a child struggling to breathe.

According to the bill's explanatory memorandum, since the University of Tartu Clinic's psychiatric hospital stopped offering expedited service for this purpose, police have already been forced to turn to emergency departments instead, increasing wait times. An emergency care reform set to take effect in coming years will bring even more patients to EMO departments.

Questions of training and liability

Treatment and preparing evidence for criminal proceedings are two fundamentally different tasks that should not be mixed — when treating a patient, a medical worker is on the patient's side, but when issuing a report for police, they become an instrument of the state. The bill leaves unclear who would train nurses for this new responsibility, who would be liable for an erroneous assessment, and what insurance coverage would apply in case of complications — such as bleeding or injury — from urine sample collection via catheter, which the bill permits when necessary.

Critics argue the state should instead organize this work in more logical settings — police stations, sobering-up facilities, or expert institutions — rather than placing it on already overburdened hospitals. Hospitals and medical worker organizations have already submitted these objections once before, but they were largely ignored.