Medical-psychological assessment of fitness to drive in Germany

Abstract

Within the German road traffic safety system, the Medical-Psychological Assessment (MPA) has a more than six-decade-old history and tradition. According to the German traffic law system a driver has to make sure to drive only in a good physical and mental condition and to obey the traffic regulations. If drivers are sanctioned for driving under the influence (alcohol), driving while intoxicated (illegal drugs) or received offences for reverse or repeated violations to traffic rules etc. they have to pass the MPA before getting their driving license back or to avoid a withdrawal of their driving license. The MPA is an integrated medical and psychological examination usually containing the elements •Questionnaire (biography, driving history, knowledge of driving rules) •Medical examination (medical history, physical examination, laboratory analysis) •Psychological interview ((alcohol or drug consumption style, change of behaviors and attitudes, perception of problems in future) •Psychophysical computer-based test of cognitive functions (reaction capacity, visual perception, concentration, vigilance) The examination can be complemented by a driving test in real traffic under defined conditions. The integration of the data from different sources is outlined in a basic manual, the MPA-Expert-Manual, which is published. Inspection principles and rating criteria to identify the quality and intensity of the drivers personal problems (e.g. alcohol addiction, abuse of alcohol, habituation of high consume levels, risky attitudes to drive under the influence), the process of change and the stability of the behavior in future funds the interdisciplinary decision-making procedure, and lead to a MPA-report that is transparent and traceable for public servants or court members. Due to the importance of this measure for the applicants and for traffic safety the MPA has repeatedly been evaluated in terms of its effectiveness (recidivism rates after a probation period of 3 years, data from the Central Index for Traffic Offenders of the Federal Motor Transport Agency). The results show over the years a decrease of the percentage DUI- and DWI-offenders with a relapse (current state A 8 %) and therefore indicate the predictive reliability of the MPA. There are still problems with drivers with multiple traffic offences (e.g., speeding, tail gaiting), who have a relapse rate of more than 40 %. Altogether the MPA-system in Germany can be regarded as an effective measure in the German licensing procedure in preventing recidivism and an important approach for improving traffic safety.