Intended for healthcare professionals


My patient’s condition could affect their fitness to drive. What should I do?

BMJ 2019; 365 doi: (Published 09 April 2019) Cite this as: BMJ 2019;365:l1622

Observations column

Should healthcare professionals breach confidentiality when a patient is unfit to drive?

  1. Abi Rimmer
  1. The BMJ

It is often difficult to know what to do when a patient continues to drive despite medical advice but guidance is available, three experts tell Abi Rimmer

Consider how to support safe driving

Desmond O’Neill, consultant physician and director of the National Office for Traffic Medicine, Dublin, says, “The UK and Ireland have helpful and regularly updated guidelines on medical fitness to drive. These are supportive of continued safe driving and over recent decades have reduced restrictions on driving. This is recognition of better evidence and of how many medical interventions, from cataract surgery to therapy for obstructive sleep apnoea, can improve driving safety.

“The first step is to check the online guidelines on medical fitness to drive on the Driver and Vehicle Licensing Agency (DVLA) website (or, in Ireland, the National Driver Licence Service).12 It’s worth remembering that certain conditions may involve several elements of the guidelines, such as vision and neuropathy problems for drivers with diabetes. Equally, it’s important to factor in multimorbidity, and the guidelines will usually clarify which element has the most significant impact on medical fitness to drive.

“The resulting discussion with the patient will be …

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