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Abstract
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Highlights
• Literature on the efficacy of mandatory medical reporting (MMR) by medical and other health practitioners was reviewed.
• Some evidence that MMR improves knowledge regarding how to report patients to licensing authorities.
• Inconclusive evidence regarding whether MMR: 1) increases reporting of drivers, or 2) reduces crash risk of these drivers.
• Emerging evidence that MMR laws adversely affects the physician-patient relationship.
• Population-based controlled research study in multiple jurisdictions is warranted to investigate the efficacy of MMR.
One approach aimed at reducing road trauma is the mandated reporting of medically unfit/unsafe drivers by medical and other health practitioners to licensing authorities (Jones et al., 2012, Redelmeier et al., 2008, Sims et al., 2012). A number of jurisdictions have implemented legislation requiring mandatory medical reporting – impacting both medical and other health practitioners (Langford et al., 2010, White and O’Neill, 2000).
Mandatory medical reporting targets drivers with a chronic, long-term medical condition(s) or disability(ies), as opposed to a temporary condition(s) (Austroads, 2016), which would likely result in functional impairments (either due to the medical/disability condition itself or its treatment) and increases their risk of being involved in a motor vehicle crash. However, the specific requirements for reporting by medical and other health practitioners are variable across different licensing authorities. In Australia, the Assessing Fitness to Drive Guidelines (Austroads, 2016) are utilised by medical and other health practitioners to determine whether or not a patient is fit to drive dependent upon their functional status. However, South Australia and the Northern Territory, physicians are mandated to report the patient to the relevant driver licensing authority if they are suffering from a physical or mental illness, disability or deficiency such that, if they patient drove a motor vehicle, they would be likely to endanger the public. Similarly, mandatory medical reporting of unfit drivers is required by Canadian physicians in all provinces except Alberta, Nova Scotia and Quebec, and is determined by a physician's diagnosis of a person's ability to drive a vehicle safely with regard to the safety of the public. However, differences exist regarding the reporting requirements between Canadian provinces. For example, physicians in the provinces of British Columbia and Manitoba are only required to report patients if they have been warned and still continue to drive (Canadian Medical Association, 2018).
Advocates of mandatory medical reporting argue that the law takes the onus away from the individual driver to report their medical condition(s) and/or functional impairments to licensing authorities and places the responsibility onto medical and other health practitioners who are best placed to objectively assess a patient's medical fitness to drive (Langford et al., 2010). However, critics of mandatory medical reporting argue that medical and other health practitioners are often reluctant to report their patients to licensing authorities due to: uncertainty over what constitutes an ‘unfit’/‘unsafe’ driver or ‘significant’ functional impairment; worries about patient dissatisfaction; limited time; a lack of training or appropriate screening or assessment tools, and the view that road safety/road trauma is not a medical/health problem that merits preventive efforts by medical or other health practitioners (Jones et al., 2012, Langford et al., 2010, Redelmeier et al., 2008, Sims et al., 2012). In addition, critics of mandatory medical reporting also argue that the current evidence for causal relationships between specific medical conditions and increased motor vehicle crash risk is limited (Charlton et al., 2010, Dobbs, 2001, Marshall, 2008, Vaa, 2003). Indeed, not all medical conditions affect motor vehicle crash risk to the same extent, and not all individuals/drivers with the same medical condition will be affected in the same way ...
Language: en |