Driving and Seizures

These are general resources relating to fitness to drive and epilepsy.

Background

Assessing Fitness To DriveThe ability of a person with epilepsy to hold a driver licence depends on the likelihood of them having a seizure while driving and the impact of a seizure on their ability to drive. Thus, the assessment of fitness to drive in a person with epilepsy is a probability estimate.

The ESA Driving Committee has for many years been active in the development of national guidelines for driving with seizures, in consultation with Austroads and the National Transport Commission (NTC). The aim has been to develop guidelines that rely on objective clinical data rather than opinion, while preserving flexibility in exceptional cases. These "Assessing Fitness to Drive" guidelines can be accessed via the Austroads website or via the link below. 

Problems related to the process of driver licensing and legal liability faced by doctors remain a major concerns for the Committee and ESA members. The ESA and ANZAN have persistently argued that the certification of fitness to drive should be removed from the hands of the treating doctor, and that the treating doctor’s role be only to provide relevant medical information for the DLA to make a determination. The process of driver licence certification is potentially harmful to the clinical relationship between the doctor and patient as it creates a potential conflict of interest with the doctor acting on behalf of the patient and the DLA at the same time. Thus, the treating doctor cannot be expected to provide an objective and accurate assessment of fitness to drive, diminishing the quality of the assessment and therefore road safety. Furthermore, certifying doctors are legally vulnerable. Legal proceedings have been commenced or recommended against neurologists whose patients have been involved in motor vehicle accidents.

The ESA Driving Committee, previously chaired by Andrew Black and currently chaired by Ernie Somerville, have corresponded at length with the state and national transport agencies. In 2007, committee members made two formal representations to the NTC and the state DLAs, stressing that certification is the duty of the DLAs, doctors should provide only relevant medical information, expert medical panels need to be established to review complex cases, and indemnification needs to be provided to doctors completing FTD forms. In 2007, ANZAN and the ESA advised their members to continue to certify fitness only in those cases where fitness or otherwise was beyond any doubt. In November 2008, DLAs in NSW and Victoria performed a trial of a decision tree developed by the ESA and ANZAN to determine fitness in straightforward cases, based on information provided by the treating doctor. DLAs in NSW and SA have agreed to accept a form developed by the ESA and ANZAN to capture relevant clinical information WITHOUT a fitness recommendation. The form may be downloaded by clicking on the links below. A brochure for patients explaining neurologists’ stance on certification of fitness is also downloadable below.

"Driving to distraction-certification of fitness to drive with epilepsy" authored by Ernie Somerville, Andrew Black and John Dunne and published in the Medical Journal of Australia in 2010 discusses the Epilepsy Society of Australia viewpoint in detail.

The rationale for and results of the trial of the NSW and Victorian trial of the decision tree have been published in Epilepsia.

Information specifically relating to the ESA Driving Standing Committee can be found under About Us - Committees - Driving.

Fitness to Drive Information

Contact details for state and territory driver licensing authorities are included in Assessing Fitness to Drive.

 

 

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