An overhaul of fitness to drive guidelines means patients whose illness is well controlled or only moderate will not be barred from the road.
The new national standards, Assessing Fitness to Drive, released last week, urge doctors to focus on a patient’s functional capacity rather than their diagnosis.
They make specific driving recommendations for different kinds of seizures — including sleep-only and seizure with aura — in a major revision from the previous guidelines issued in 2003. For patients with conditions such as diabetes and schizophrenia, the new guidelines make different recommendations depending on the disease’s severity and whether it is well controlled.
The standards have been endorsed by the specialist colleges and are published by Austroads and the National Transport Commission.
Associate Professor Ernest Somerville, a neurologist at the University of NSW and contributor to the standards, said the advice for patients with seizures was highly prescriptive and “removes much of the discretion from the doctor”.
“Although some doctors may think this is a bad thing, in some ways it takes the pressure off the doctor, because now they can say to the patient ‘that’s what the guidelines say’,” he said.
In a recent Monash University survey, half of GPs said patients had subjected them to undue pressure after being told they were medically unfit to drive.
But Professor Somerville said he felt driver licensing authorities needed to take responsibility for decisions to ban patients from driving, “rather than passing the buck to doctors”.
He called for independent review panels to be set up in each of the states to assess difficult cases, as is already the case in Victoria.
International Journal of Family Medicine 2012; online.