Medische rijgeschiktheid: synthese en aanbevelingen van het symposium van de Koninklijke Academie voor Geneeskunde van België op 29 april 2023

Abstract

Medical fitness to drive: summary and recommendations of the symposium by the Royal Academy of Medicine of Belgium on April 29, 2023 Mobility is considered a fundamental right, with most people aspiring to exercise this right by driving themselves. To do so safely, the European Commission has established standards for drivers, which the Belgian legislator has translated into national laws and regulations. This article introduces 3 crucial concepts: knowledge, skill and medical fitness, which determine whether someone can safely participate in traffic. Problems can arise due to insufficient knowledge of traffic rules, inadequate control of the vehicle or insufficient health. A driver’s condition is often the result of interactions between these factors. Health is a significant condition for license holders, assessed through medical criteria. In Belgium, physicians can make decisions regarding the fitness to drive and they are required to inform the patient if this person no longer meets the medical criteria. This decision can also be delegated to CARA, a specialized entity that evaluates the fitness to drive in a multidisciplinary manner. Making fitness to drive decisions and the associated discussions between the physician and the patient are often sensitive due to the complexity of the topic and the impact on the physician-patient relationship. Integrating the evaluation of the fitness to drive into regular medical practice and providing concrete and validated guidelines can improve the perception of this process. The text then discusses topics related to fitness to drive, including aging (both pathological and non-pathological), Alzheimer’s disease and the use of psychotropic substances such as alcohol and medication.