I write as a caregiver who has hands-on experience with the issue of family physicians assessing their patients’ fitness to drive.1 My husband, who suffered from Huntington disease, had a few near–misses in the car. His declining driving skills came to my attention when my children (8 and 11 years of age at the time) started making comments to me about his behaviour behind the wheel while they were riding in the car with him. It had never occurred to me that at that stage of the disease there would be a problem with his driving skills. If I had broached the subject with him of no longer driving, it would have caused problems at home, so I chose instead to speak to our FP and asked that he have a conversation with my husband. Our FP was great and was a very supportive resource for me. After speaking with my husband, our FP reported the concern to the Ministry of Transportation, and they set in motion the necessary upgrading and assessments. After several weeks it was determined that my husband could possibly “learn” to improve his driving skills and the correct way to drive. A long list of comments from the driving instructor was given to me; one comment was that my husband had run a red light. I was very upset with these findings because I was worried about his safety, as well as the safety of others, if he continued to drive. I wrote a letter to the Ministry and copied both the hospital where he had completed the testing and our FP, as they were also involved in his case. I pointed out in my letter that individuals with Huntington disease could not learn anything new and that his current level of functioning with his medical condition was the best he would ever be. People with Huntington disease deteriorate as time goes on—both physically and mentally. Only after I threatened to sue the hospital, the government, and our FP (which I regretted saying but who I had to name) if my husband or someone else were to get hurt while he was behind the wheel did they agree to suspend his licence.
I tell you these details because I disagree with the closing arguments of Dr Laycock’s article1; although I do agree that FPs should not be held responsible for taking driver’s licences away, they should be responsible for informing the testing agency about the specifics of the illnesses or problems affecting drivers. The decision to revoke driving privileges should be influenced by the FP’s insights into the person and the disease. The FP should not be able to opt out of the decision-making process. I believe that the No side of the debate has missed a very important piece of the driving–loss puzzle.
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