Fitness to Drive after Accidents

Some patients with traumatic brain injury secondary to a motor vehicle accident will recover to the point where they wish to drive again. It is the job of doctors and other health practitioners to make challenging decisions as to whether or not the individual should be able to drive again. In order to do this, doctors need to perform reliable psychometric testing batteries so that unreliable and unsafe drivers can be detected.
Some researchers have looked into five different driving-associated personality traits that predict whether or not a driver can resume driving after a traumatic brain injury. It also helps when evaluating the post-stroke patient who wants to drive again. About 178 patients who suffered from traumatic brain injury or stroke were evaluated for their ability to drive after their medical incident. Each participant took a standardized psychometric test battery and also took a specific standardized driving test. The two tests were combined to see how the individual fared in being able to drive again.

The results of the testing showed that the patients required certain personality traits and a certain level of cognition in ability to drive with cognition felt to be slightly more predictive of whether or not a person is able to drive. The personality factors were less important when it came to driving. There were slight differences in the driving abilities and test taking of stroke patients and TBI patients; they were able to make some calculations so that they could tell the driver’s ability to drive fairly accurately.
The individual’s ability to drive safely depended on their success in therapy and medications that together helped them function better. Those that didn’t succeed in post-injury therapy run the risk of having another serious motor vehicle accident due to loss of vision, cognitive deficit or seizure in the patient.

Testing of drivers depends on what kind of license they desire. If a person is a professional driver, driving a big rig, they have to prove to a greater degree that they are capable of driving such big vehicles and handling them on the road. The doctor must weigh the effects of medication the patient is taking as some of these medications can adversely affect a person’s cognition and ability to drive.

If the patient has had a pattern of crashes that might be associated with their health conditions, the doctor may elect to wait for a while or refuse to authorize the patient’s ability to drive. If the patient ever suffers from a medically associated motor vehicle accident, it is the responsibility of the doctor to contact the DMV so the license can be temporarily suspended. In addition, if the patient has multiple medical problems, these together can impair a patient’s ability to drive.

Doctors need to recognize that they have an important role in doing this type of examination. They need to remember that driving is not a right and the doctor has the ethical and legal obligation to make sure that other road users are as safe as the individual driver. It is tempting for the doctor to want to be an advocate for their patient but this is a bad idea. If it can’t be helped, the doctor should take himself or herself off the case and have a neutral third party perform the fitness to drive evaluation.

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