American Academy of Neurology position statement on physician reporting of medical conditions that may affect driving competence

Abstract

The American Academy of Neurology (AAN) represents over 20,000 neurologists and neuroscience professionals, many of whom have patients for whom driving is an uncertain privilege due to the progression of diseases that affect cognition, consciousness, vision, or motor skills. Physicians are expected to report a patient’s driving-related condition to driving authorities when it appears that the condition might pose a safety risk to the patient or others, especially when a patient is noncompliant with requests to be tested or stop driving. Making reporting a mandatory requirement, however, may have a strongly negative impact upon the patient–physician relationship, and may ultimately provide no greater safety benefits to the public or the patient, who may feel compelled to withhold important medical information. Poorly designed reporting laws may also expose physicians to undeserved liability for a patient’s driving outcomes, even when a physician has followed all applicable laws honestly and capably. For these reasons and more, the AAN has developed a new position statement to promote better policies for all parties involved in the discussion: patients, private citizens, and physicians alike. Driving laws for individuals with relevant medical conditions vary greatly from state to state. Current or would-be drivers with medical conditions of interest are expected to disclose their condition to the state Department of Motor Vehicles (DMV) and to obtain a physician’s note to confirm their fitness to drive. Many of these conditions (but not all) are neurologic in nature, such as dementia, epilepsy, and Parkinson disease. On a discretionary or mandatory basis, a physician may be obligated to report a patient to the DMV when that patient’s medical condition makes driving a hazardous proposition. According to the Epilepsy Foundation, six states currently have some form of mandatory-reporting law in place (California, Delaware, Nevada, New Jersey, Oregon, and Pennsylvania) for various medical …