Driver Licensing Authorities should take responsibility for deciding medical fitness to drive
Australian driver licensing authorities must take responsibility for determining whether a person’s medical condition makes them unfit to drive. This can be difficult, especially for conditions like epilepsy, where the impairment is intermittent and unpredictable. An expert review mechanism is needed to deal with uncertain or exceptional cases, according to an article published in the Medical Journal of Australia.
Driver licensing authorities in Australia have shifted most of the responsibility for determining fitness to drive to the treating doctor, write A/Prof Ernest Somerville, Director of the Comprehensive Epilepsy Service at Prince of Wales Hospital, Sydney, and his co-authors.
This creates a conflict of interest and may lead to unsafe decisions, damage to the doctor-patient relationship, interference with medical management and legal vulnerability for the doctor.
“Licensing authorities suggest that the problem of conflict of interest can be solved by referring the patient for a driving assessment or to a specialist. However, a driving assessment is not helpful in conditions such as epilepsy, where the impairment is intermittent, and referral to a specialist passes the responsibility from one doctor to another,” Prof Somerville said.
“Licensing authorities offer no advice on how a specialist should proceed when fitness is uncertain.”
Prof Somerville said Australian neurologists had called for a system in which licensing authorities used objective information provided by the treating doctor about the patient’s condition to determine fitness. He proposed that such a system should be supported by an expert review process.
“Ideally, this should be an expert panel of neurologists, indemnified by the driver licensing authority. Such a panel only exists in Victoria,” he said.
Prof Somerville said that although drivers were legally obliged to notify the licensing authority when they became unfit, most people were unaware of this law and passing this responsibility to doctors in the form of mandatory reporting was counterproductive to road safety.
“Mandatory reporting of all potentially unfit patients encourages concealment of symptoms, thereby impeding optimal treatment and ultimately reducing road safety,” he said.
The Medical Journal of Australia is a publication of the Australian Medical Association.
The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.
CONTACT:
A/Prof Ernest Somerville 0403 079 679 / 02 9555 9029Poppy Diamantis 0411 730 842 / 02 9382 8398
Media Officer POW Hospital