Abstract
Epilepsy is a condition that comprises a group of neurological disorders characterized by seizures. Forms of epilepsy that produce abrupt bouts that cause lapses in consciousness may pose a major road safety problem for drivers who, while going through a seizure, could seriously harm themselves as well as others. A fundamental strategy for the purpose of reducing the risk of car accidents caused by epileptic drivers is constituted by prevention, in addition to adequate pharmacological therapies. In that respect, forensic medicine plays a pivotal role, since it deals with the set of requirements that must be met by those who have been diagnosed with epilepsy in order to get a driver's license, and with the obligation to signal such individuals to the national Driver and Vehicle Licensing Agency (in Italian: Motorizzazione Civile). In that regard, the Italian legislative framework is partly hazy in some respects, which the authors have set out to analyze herein, taking into account recently issued European norms. The aim of this paper was to better understand the current Italian legislation in the matter of epilepsy and driver's license requirements, especially regarding the medical criteria that must be met in order to obtain the driving license. The importance of those criteria is underlined by the fact that they directly influence (and are influenced by) the safety for the drivers and for the persons involved in car accidents. Thus, we can consider the issue not only strictly of medico-legal relevance but also from the standpoint of primary prevention. The analysis was conducted by reviewing the most recent documents of medico-legal relevance, in the light of European Union legislation. The authors have ultimately stressed the need for clearer and straightforward regulations, given that professional liability may arise whenever a driver's license is issued, in disregard of legal norms, to an individual who then causes a road accident.
Highlights
The epidemiology of epilepsy reflects how it represents one of the most common neurological causes of disability, with an estimated 1% prevalence [1] and an incidence ranging between 40 and 200/100,000 [2] globally, despite the clear difficulty to refer to large-scale sets of data, because of the various and heterogeneous groups of disorders that make up the condition itself, the degree of regional variability, and a dearth of relevant studies on the issue
One of the most controversial traits of the Italian legislation has surfaced from a Ministry of Transportation Decree, issued on 30th November 2010 [27], in turn spawned by the adoption of European directive 2009/112/CE. Such a decree clearly states in Annex III, Subsection 2 that “An obligation exists for any hospital, medical, welfare, or insurance institutions, administrations and bodies to report those suffering from epilepsy to the National Bureau of Civil Transportation once such a condition has been detected and verified, so that proper restrictions may be put in place when issuing or renewing the licenses for such patients.”
A further potentially harmful aspect, which may stem from the broader interpretation of the law, pertains to the fact that only doctors who do not practice in public health care facilities, or in private clinics not affiliated with it, would be exempted from the duty to report, which would give rise to unequal treatment: those who can afford private clinics and doctors could avoid coming into contact with facilities and physicians bound to report, whereas low-income people would be in no condition to do that [31]
Summary
Recent Medico-Legal Developments on the Issue of Epilepsy and Driver’s License Requirements in the Italian and European Legislation. The aim of this paper was to better understand the current Italian legislation in the matter of epilepsy and driver’s license requirements, especially regarding the medical criteria that must be met in order to obtain the driving license. The importance of those criteria is underlined by the fact that they directly influence (and are influenced by) the safety for the drivers and for the persons involved in car accidents. The authors have stressed the need for clearer and straightforward regulations, given that professional liability may arise whenever a driver’s license is issued, in disregard of legal norms, to an individual who causes a road accident
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