Breaking patient confidentiality
Epilepsy Society's medical director Professor Ley Sander stresses the importance of GPs and neurologists breaking patient confidentiality when necessary, if they know a patient is driving with uncontrolled seizures.
Last month a motorist was jailed for three and a half years for killing a pedestrian after having an epileptic seizure while driving. It was a tragic case in which an innocent man lost his life because someone with uncontrolled seizures had failed to be honest and surrender his driving licence.
The motorist had been warned by medical staff on more than one occasion but had chosen to ignore the warnings.
The case underlines the importance of people with epilepsy informing the DVLA and stopping driving if they have uncontrolled seizures. It also underlines our duty of care as healthcare professionals, to break patient confidentiality, where necessary, so as to inform the DVLA if a patient is refusing to do so themselves.
This is because not only are patients putting themselves at risk, but they are also endangering members of the public. As doctors we should always inform the patient that we will be notifying the DVLA of their refusal to stop driving.
If the DVLA becomes aware that someone with uncontrolled seizures is continuing to drive, their licence may be revoked and they may be fined.
Other health conditions
New draft guidelines have been drawn up by the General Medical Council saying GPs should advise patients to stop driving if they have certain illnesses such as dementia, epilepsy, sight or hearing problems and heart conditions. They should also stop driving if they are taking anti-depressants or sleeping tablets.
The General Medical Council is now seeking expert advice on the guidance and will publish a final version next year. But we are ahead of the game with epilepsy.
As doctors we should always inform the patient that we will be notifying the DVLA of their refusal to stop driving.
One of the hardest parts of a diagnosis of epilepsy can be telling someone that, until they have been seizure free for a year, they can no longer drive. Losing a driving licence is tough.
Our lives revolve around the car and if you can't drive you lose a degree of independence and freedom. Suddenly you are relying on other people for lifts. This can impact on your employment, social life, family life and even fundamental things like doing the shopping at the out-of-town shopping centre.
Stigma around not driving
Many people tell me that there is also a stigma to losing their licence - people automatically assume that they have lost it through drink/driving or speeding. Not everyone wants to tell their neighbours they have epilepsy, but if their car stays parked on the drive, it often forces the issue.
When I am giving a patient a diagnosis of epilepsy, I know that as soon as I mention that they cannot drive they don't hear anything else that I am saying. It's like pulling the rug from under their feet. Driving is a very big issue. But so is an innocent person losing their life. We must be sensitive but we must be clear.