PCL Week 7 - Doctors and Drivers

When a patient’s health affects their ability to drive, a doctor must consider their duty to their patient’s privacy, but also to the public’s safety. For many aging citizens, particularly in rural or remote areas, their ability to drive is more than just an issue of convenience, but also represents a level of independence. Many people may have had their licence for up to fifty years and so are naturally reluctant to give up what they have managed to obtain and maintain for such significant proportion of their lives. It is for this reason that they often require support and encouragement to make lifestyle changes in anticipation of not being able to drive.

Visual standards:
• Visual acuity - The person’s visual acuity in the better eye or with both eyes together must not be worse than 6/12. However, a conditional licence may be granted taking into account the opinion of the treating doctor, and the nature of the driving task, and is subject to periodic review. Cataracts often cause a loss of contrast sensitivity and greater sensitivity to glare, so patients may have more difficulty seeing when driving than is indicated by their visual acuity.
• Visual fields - The criteria for an unconditional licence are that binocular visual field has a horizontal extent of at least 120 degrees, within 10 degrees above and below the horizontal midline and that the person is free from any significant visual field loss that is likely to impede driving performance.
• Diabetes - A person with diabetes controlled by diet alone may drive without licence restriction and without notification to the Driver Licensing Authority. They should be reviewed periodically.

Reporting process:
The laws require drivers to report VicRoads if they have any permanent or long-term illness that is likely to affect their ability to drive safely. As the relationship between patient and health professional is confidential, the doctor will not normally communicate directly with VicRoads. They will however provide the patient with advice about their ability to drive safely as well as a letter, or report, to take with them (except in South Australia and the Northern Territory, where reports are directly made to the relevant licensing authorities).

Penalties may be imposed on a driver that fails to report an impairment, and may be liable at common law if they continue to drive knowing that they have a condition that is likely to adversely affect safe driving.

Doctors also have an obligation to public safety, so if they believe a patient is not heeding advice to cease driving, they may report directly to VicRoads. The Victorian Road Safety Act (1986) provides statutory immunity to doctors who, in good faith, report that a patient has a medical condition which renders them unfit to hold a driver’s licence.