Assessing Fitness to Drive - BiOptic Driving Network

PATIENT ASSESSMENT5 THE ASSESSMENT OF PATIENTS WHO ARE DRIVERS5.1 REVIEW OF POTENTIAL RISK5.1.1 The majority of adults drive; patients with a potentially disabling condition may drive,although sometimes in restricted circumstances, sometimes with conditions placedupon their licences (see below) or in modified vehicles.5.1.2 Health professionals should advise patients about the ways in which theircondition may impair their ability to drive safely. As part of this process, thepatient becomes better informed about the nature of his or her condition, the extentto which he or she can maintain control over it, the importance of periodic medicalreview and the need for regular medication where appropriate.5.1.3 At such a medical review, the health professional may form the view that the patientis fit to drive. On the other hand, the view may be formed that the patient is unlikelyto be safe to hold an unconditional driver licence. The professional’s role is then toobtain confirmatory evidence and, where appropriate, to advise the patient to ceasedriving (or to drive only in specific circumstances that are considered safe).Confirmatory evidence is often obtained from family members or friends and manydifficult situations can be resolved with goodwill from all relevant parties, though notalways immediately.5.1.4 Where the health professional believes that continued driving would be likely to bedangerous, the patient should be reminded of the risk to him or herself, and to others,of continuing to drive. The driver should also be reminded of the legal obligationto report the condition to the driver licensing authority (currently in all States andTerritories, except Western Australia).5.1.5 The guidelines in this book should be consulted when dealing with any suchsituation since they carry an authority that is not imposed on the driver by the healthprofessional but by the national consensus of the driver licensing authorities.5.1.6 If such an impaired driver continues to drive against medical advice, the ethicaland legal dilemma outlined on page 5 et seq. is faced by the health professional.Without the patient’s consent, the professional may be reluctant to discloseinformation to the driver licensing authority unless certain of indemnity fromlitigation for breach of confidentiality (see page 6). Whether indemnified or not, ajudgement needs to be made, weighing up the obligation to the patient and theprotection of the public.5.1.7 When the health professional is aware that the driving is continuing and that it islikely to endanger the public, despite counselling and despite the driver’s ownobligation to report, reasonable measures to minimise that danger will include9