The ability to travel hither and yon whenever and without dependence on others has become synonymous with independence, autonomy, dignity, self-esteem and the automobile. Losing the ability to drive in today's modern societies may have serious psychosocial ramifications with potential subsequent adverse biomedical consequences for individuals already facing many losses on the one hand, while sustained driving by the driving impaired increases the likelihood of injuries, hospitalizations and death, on the other. The number of older drivers has and will increase dramatically as populations world-wide continue to age. Family physicians are often approached by family regarding concerns of hazards posed by continued and often insistent driving of older loved ones who are felt to be too functionally impaired to drive. We have been ill equipped and trained to offer counsel, and frequently wonder as to whether this is indeed a problem that is ours to solve. While most governmental agencies deem driving licensure as a privilege and not a right, they have done little to clarify such privilege, nor have they offered guidance one might deem of use in the context of the physician–patient dyad. The purpose of this article is to review the current literature as it pertains to the pressing problem of clinician involvement. It is an attempt to facilitate the practitioner's balance as advocate for patient, family and society in the context of biomedical, psychological and sociological variables. (Author/publisher)
Abstract