General Question

tyrantxseries's avatar

Should people with schizophrenia be allowed to drive?

Asked by tyrantxseries (4719 points ) December 7th, 2008

When I was diagnosed my licance was suspended indefinitely, even though I have never had any (new) hallucinations wile driving… I have four driver training courses “under my belt” that I passed with flying colors.

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29 Answers

jholler's avatar

There are lots of people I don’t think should be allowed to operate heavy machinery including automobiles, people who hallucinate are on that list. I’m probably on some other people’s lists, but they gave me a fire engine to drive anyway…or maybe because of.

Judi's avatar

Maybe it’s not the illness, but the medication that you need to take.

jholler's avatar

Are you willing to bet the safety of those around you on the hope that you won’t hallucinate while driving? I think (obviously I don’t know what you’re going through) I would be sufficiently scared to run over someone while avoiding something that wasn’t there that I would voluntarily forego driving, but like I said, I don’t know what you’re going through.

galileogirl's avatar

Anybody with medical challenges that are controlled have a right to drive. Only people who are impaired while driving should have their licenses pulled until they can prove they have not been impaired for a specific period, say a year. That would include drunk drivers, drug users and most teenagers.

Judi's avatar

fluve gailileogirl, Except that some psych meds that may control the disease might also effect a persons ability to drive.
by the way, am I spelling your name right? i’m getting old and I can’t see the difference between an i and an l in that small text

galileogirl's avatar

jholler, are you willing to bet the safety of those around you on the hope you won’t be distracted by a phone call, spilling coffee in your lap, or telling the kids in the back seat to stop fighting while you are driving?

galileogirl's avatar

Judi, when people use the tiny font, I have to go nose to screen

tyrantxseries's avatar

galileogirl :FIRST OF ALL DON’T PUT ME IN THE SAME LIGHT AS DRUNK DRIVERS, TEENAGERS, as for drug users you better mean LEGAL DRUGS.
My licance was taken before they knew what drugs they were going to give, and made it very clear I will never drive again.

Judi's avatar

tyrant;
I don’t think she was doing that at all. I think she was saying that they SHOULD NOT take your drivers license away, that you deserve to be allowed to drive until you do something that makes them believe you would be a danger to yourself or others. Who made the decision anyway? The Doctor? The Department of Motor Vehicles? How did they find out about your illness? Aren’t there strict confidentiality laws regarding mental illness?

Judi's avatar

What state do you live in tyrant?

tyrantxseries's avatar

Drunk driving/teenagers are not medical issues,
I agree with everything until that,
The Doctor made the recommendation to the Department of Motor Vehicles then I get a letter in the mail and poof no drivers license. no review, no test, no chance of appeal.
I live in canada

Judi's avatar

I’m not sure about the laws in Canada, if you can appeal or not, but be thankful you can get medical coverage! My son didn’t have medical insurance where he worked, lost his job, and got caught in the catch 22. Can’t work if he can’t get medicine, can’t get medicine unless he has insurance, can’t get insurance without a job…..

galileogirl's avatar

Thanks Judi, that’s exactly what I meant. In California there are certain reporting requirements for medical conditions. I was quite surprised to find that anyone who has a stroke or certain brain injuries is automatically reported to the DMV. It took me 9 months to get certified by my MD, my physical therapist, go through a series of tests in a driving simulator, be tested in a 2 hour session and get my car modified (none of it paid by insurance) in order to be able to drive,

Tyrant: What I said (and meant) is that somebody with a controlled medical issue is likely a safer driver than some classes of people who are not. And if we have to prove our fitness to drive then they should too.

scamp's avatar

I can understand that you must be upset about losing your driving privileges, but there is still a chance you might have another episode, and I think this rule is for the safety of all. Since there is no absolute way to predict if and when this may happen, it’s best to err on the side of caution.

Even the best medications can fail at one time or another, and I don’t think you would be willing to be proven wrong by having an accident, maybe even dead wrong. People with epilepsy face the same challenges with being able to drive, and My Mother was no longer able to drive after a stroke. It’s sad and probably frustrating, if not downright inconvenient, but it’s really for the best.

Jeruba's avatar

@galileogirl and @judi, the easiest way to handle names in tiny type is to copy and paste them.

artificialard's avatar

@scamp I think there is the legal argument of precedence being presented (which I think I agree with) is that schizophenia presents risks similar to other drivers and situations that are allowed.

For example, people talking on cell phones, eating, those with an advanced risk of a heart condition all arguably present comparable risks to that of a schizophrenic that has managed their condition successfully for a long-term period. So if people with similar risk factors can drive, than there’s no reason in terms of fairness that schizophrenics can’t drive.

I wouldn’t make a like comparison with epilepsy because one of the hallmarks of epilepsy is unprovoked seizures. The unpredictability of the affliction presents a higher risk factor than a schizophrenic that has managed their condition such that the doctor and patient are both reasonably confident that there won’t be new symptoms, hallucinations, etc.

Upon first reading the question I assumed that anyone with schizophrenia is rubber-stamped a denial for a driver’s license but that’s not true. It’s the treating physician’s responsibility to report this to the Transportation Ministry only if the physician believes there is a danger for the patient to drive. Even then the Ministry employs a Medical Advisory Committee that makes a qualified assessment about whether the person in question should drive.

In Canada transportation, driver’s licenses are under provincial (for Americans ‘state’) jurisdiction. In Ontario

Section 203 of the Highway Traffic Act requires that all legally qualified medical practitioners must report to the Registrar of Motor Vehicles the… clinical condition of any patient… who, “is suffering from a medical condition that may make it dangerous for the person to operate a motor vehicle”.

This process seems like a reasonable way to assess the safety of a person with a potentially compromising medical condition behind the wheel by employing the discretion of the treating physician as well as an objective and qualified provincial committee.

@tyrantxseries The link above (in Ontario) has information at the bottom that will allow you to request a copy of the assessment and let you consider next steps.

scamp's avatar

@artificialard Thanks for your well written response. The laws concerning this matter vary from state to state.

This site is where I found the information which made me feel that schizophrenia and epilepsy are put into a similar category. It says the following:

“Section 502 of the Vehicle and Traffic Law is concerned with Loss of Consciousness, which is defined as “not being aware of one’s surroundings, or of one’s existence and the inability to receive, interpret or react to sensory impressions as the result of seizure, epilepsy or any disorder affecting consciousness or control.”

It goes on to say:
If I have had a Loss of Consciousness, can I regain my driver’s license?

Yes, but your doctor’s statement must confirm one of three different circumstances: 1) You have not had a Loss of Consciousness within the previous 12 months. 2) You have had a Loss of Consciousness in the last 12 months, BUT it was solely due to a change in medication ordered by your doctor. This includes a hospital admission for video-EEG Long Term Monitoring. 3) You have had a Loss of Consciousness but your physician states that, in his opinion, your loss of consciousness will not interfere with your safe operation of a vehicle.In addition, the Commissioner of Motor Vehicles, in consultation with his medical consultant, must state that he has no grounds to disagree with your physician.

Can I appeal the Commissioner’s decision to revoke my driver’s license?

If the Commissioner denies or revokes your license, he will send you a letter stating you have 30 days to reply to his letter. If you do not reply in 30 days, your license will be revoked. If the Commissioner decides that you are an immediate hazard, he will deny or revoke your license immediately. You will have 30 days to request a departmental hearing.

If I regain my driver’s license, how long can I keep it?

You must submit evidence of your fitness to drive each year. Your doctor must examine you within 120 days of your application, and he or she must state that your medication keeps your seizures under control.

So, it looks like tyrantxseries may have a chance at regaining his driving privileges if the laws there are similar, but it would be up to his doctor.

I also want to add that you mentioned cell phoning while driving as allowable. It has been outlawed in many states because of the dangers involved, and I wholeheartedly agree with those laws.

artificialard's avatar

@scamp It’s always interesting to compare things like this between the US and Canada (or here I guess it’s between New York state and Ontario).

It seems to be that NY is a little more explicit about what conditions would prompt the Commissioner to revoke a license but also seems to weigh the Doctor’s opinion more.

I completely agree that cell phone driving shouldn’t be allowed while driving (I hangup on friends that tell me they’re on the road) but I’m undecided about whether we should just be legislating in such explicitly narrow terms. I included it because I wanted to show that if something as clearly distracting as cell phone use while driving is allowed (or at least tolerated in many places) than that can in some cases have an equal risk factor to a controlled case of schizophrenia, validating the legal/accepted precedence argyment.

Anyways in the end I think we’re on the same page as it seems like both approaches heavily rely on the discretion of the treating physician which again I find wholly appropriate and non-discriminatory…

loser's avatar

They took your license away? That sucks!

Response moderated
EmpressPixie's avatar

Honestly, and without getting into the discussion above, I think the right to drive should be suspended upon diagnosis. While not all people with schizophrenia deserve to lose that right, not all of them deserve to keep it either. Better safe than sorry. Once the person involved is being appropriately treated (be it medication or other therapies) and their doctor is pleased with their progress and abilities, that doctor should be able to sign the person up for a psych eval by the state. The state psych would then give the license back or not.

I would say it should be at the discretion of the person’s primary doctor, but there would be concerns about psych doctors who are too easy. This way, it depends on the state, but your doctor has to sign off. Thus, your doctor could say, “Okay, we’ve got you medicated, your medications are under control and going well, we know that you’ve never hallucinated while driving, let’s try and get your license back.”

scamp's avatar

@artificialard Another great post! I agree completely!

artificialard's avatar

@EmpressPixie I don’t know if you read my earlier argument but I disagree and think it should be as it is now: the treating physician uses his/her discretion in reporting the person as a dangerous driver. I disagree with your approach for several reasons:

State authorities would probably offer less oversight and use less careful methodologies than individual doctors. Imagine the caseload and limited resources they’re dealing with. The treating physician has a significantly clearer picture of the patient’s history and insight into their condition. Also you’re assuming that a diagnosis from a state advisor is more legitimate than one from an individual doctor which I don’t think is true (because of the above reasons).

The other problem with such an approach is that if we start taking away the liberties of schizophrenics that could make people more reluctant to seek treatment, making their driving and themselves even more dangerous without managing their condition.

We can always ‘err’ on the side of caution. Schizophrenics are allowed to drive and are allowed to have children and be parents unless proven unfit. In the issue of risk management for individuals that have a condition posing an elevated risk to society, there’s a strong established precedent of allowing these people such as schizophrenics to have the same liberties as ‘normal’ people unless they demonstrate a risk factor above that of the accepted public tolerance.

This is consistent with the legal philosophy of ‘innocent until proven guilty’.

Also I don’t know if you’ve had any personal experience with schizophrenics but popular culture as usual projects a very inaccurate picture of them. There are those that shouldn’t drive, those that should be institutionalised but many that lead successful, productive lives and who’s behaviour and daily activities are indistinguishable from you and me.

EmpressPixie's avatar

@Artificialard: I agree that the treating doctor has better insight, which is why I set my system up thus that they had to be the ones to recommend reinstating the license. It was also meant to lessen the load on the state advisor. It in no way diminishes the findings of the original doctor to have a second, state opinion. The primary treating doctor would be more concerned with the patient’s overall health, while frankly the state advisor would only be looking at one thing: is this person safe on the road? If yes, they can drive. If no, they cannot.

I’m actually significantly less concerned about the schizophrenia than I am the side effects of the various, often dangerous, medications that people have to take to treat the schizophrenia. Until you find a good dose/medications/etc, the effects of the drugs can be pretty weird—sometimes worse than the disorder itself. In general, people on awareness changing drugs shouldn’t drive. With the right medications, obviously they are fine to drive because their awareness changes in a positive way. And they might be fine to drive before the medication game. But if they are going to try a drug therapy, I’d rather not have them on the road until it is smoothed out.

Frankly, I don’t think driving is anywhere near having children and being a parent.

Also, my method clearly doesn’t inhibit behavior of those indistinguishable from you and me. It just makes them jump through a few hoops and—as previously mentioned—those hoops have more to do with medication than mental disorders.

Though reading over my previous post, this wasn’t clear. That post was originally much longer, but I generally edit them quite heavily before posting. In this case, I wanted to skirt discussion of medication therapies.

And I have had personal experience with people with schizophrenia. Those I’ve spoken with preferred “people with schizophrenia” to “schizophrenics” because they weren’t their disorder. I’m aware that popular culture projects an inaccurate picture.

But I still think my basic system is a good one. Get diagnosed. Lose license. Get doctor’s approval to get it back. Get state’s approval. Get license. I mean, steps one and two could happen on the same day really. Of course, I would hope that the state would kick it back if they were planning to start a drug therapy.

I don’t want people on new drug therapies driving. It’s just a thing with me. Call it quirky, but since a lot of our treatment of schizophrenia still resembles throwing drugs at the brain and seeing what sticks, I would rather not have someone with a potentially bad drug mix on the road.

artificialard's avatar

@EmpressPixie I do apologise if my first response was in a condescending tone, I realise it seems that way now and you’re arguments are well-reasoned. My comparison of driving to raising children is in retrospect straw man.

I just don’t see such a system practically re-licensing those that are fit to drive as easy as you’re making it out to be. Ideally it would be efficient and a mere formality but in practicality the overhead would be (in my opinion) tantamount to making it significantly more difficult for qualified people with schizophrenia to garner a license. A system like that defaults to denial and would violate the standards commonly accepted of social justice and other precedents as in my last response.

EmpressPixie's avatar

@aritificalard: Eh, when I went back and read my answer, I did a double take too. My reaction was basically, “But wait, I had this all worked out, where did my answer go?” Thus is sometimes the power of the mighty edit.

I think in smaller communities, it would amount to nothing more than a meeting at the DMV and in larger communities getting a license back would go smoother because cities would be set up better. Plus, if you don’t have a license in a city, it’s not as big of a deal—there is usually some form of public transit available. And while I agree that it is certainly not a perfect solution, it is the best I can think of.

While I’m not a huge fan of defaulting to denial, I don’t care for leaving it all to the primary doctor either. Plus, in my system everything starts with the official diagnosis. Making an official diagnosis, or even one of schizophrenia, could be put off if in the best interest of the patient—either to keep them on the road until alternate accommodations could be made or saying they had a “less severe” disorder to keep them in therapy (like, say, schizotypal personality disorder), but not giving them the big S until, say, starting drug therapies. Because it is such a new science, there are a hundred ways for psychiatrists and psychologists to work the system when it comes to diagnosing.

scamp's avatar

After reading this question I think the doctor made the right decision. I don’t mean to insult you, but it just doesn’t seem like a good idea for you to be on the road.

Hardtolookback's avatar

This summer our family was driving home from on a clear beautiful evening when a car crossed the median at excessive speeds and struck our vehicle killing my 11 year son. The driver of the other car was “a person with schizophrenia”. She had been institutionalized 7 times. Each time she was released, she was given “drugs” to control her disorder. Who checks on these people to make sure they are taking those drugs? ANSWER: Nobody. She did make sure though to continue using recreational drugs and alcohol. Perhaps rountine mandatory check-ins are needed. I came to this blog because I was searching the internet for information of driving laws as it pertains to people who are mentally ill. I am looking for a way to keep our communities safer and a way to give rights back to the majority of law abiding citizens instead of worrying about offending those who are unable to make resonable decision. Driving is a privilege and should be treated as such. Unfortunately, we have many people on the road that should not be driving and I applaud the Doctor who may have realized that and took responsibility to keep you and others safe. Imagine what this women must live with her entire life – she stole a part of me that can never be replaced. I don’t know if she even yet realizes the magnitude of what she has done or ever will. She stated in court “this was not my fault”. I am compassionate to a point when it comes to disorders, but first and foremost we must look for ways to keep ALL people safe and allow ALL people to enjoy LIFE and liberty. When someone has a known disorder such as hallucinations and the iniablity to make sound choices because of the disorder then responible indivuals must act on the behalf of an entire community. This means that you should not drive and we need more doctors like yours to realize that. And if they decide to give you that privilage, you should have to prove by some means that you are taking your prescribed meds and that you have your disorder under control. I am truly sorry that you must live with this disorder, but let those who are there to help you do that to keep you and others SAFE!!!

schizo1988's avatar

The scary part was the whole movement behind the reporting of a Diagnosis of a serious mental illness, such as Schizophrenia, Bi-Polar Disorder (this was when it was still Manic-Depressive) was that they could be used as a weapon. You also have to remember just how common these disorders are, Schizophrenia 1 in a 100, same for Bi-Polar 1 in a 100, not all have the symptoms, it’s always the doc’s call, but the dangerous one’s are often not under a doctor’s care.

In most cases it’s the medications that cause an individual to be a danger behind the wheel, and I don’t in any way mean to restrict it to Psychiatric Medications, all medications, narcotics in particular, and everybody seems to be on something but often it’s the combo.

I actually lost my Ontario Driver’s License in the late 90’s, I was involved in a car accident the Officer commented my eyes looked a little glazed was I on any meds I said yes and provided a full listing of everything. This happened in mid-sept. and I received a letter from the ministry the following May asking for a note from my Shrink or they would pull my license in 30 days, my meds had changed and he wouldn’t write it.

Now there is another serious issue in the News in Canada driving while impaired from the use of Cannabis, or in combination with other Drugs or Alcohol, but the Medical Marijuana program is coming apart at the seams, it was so poorly designed it’s impossible to even fix. I know having been legal for a little over 2 years and it is impairing, how much is the question. Cannabis may be one of the most benign Drugs for a great many illnesses but not totally Benign, although when it’s used responsibly for a Legitimate Medical condition you think of it as Medication and it got me off of 80mg Oxycontin 3 times/day. Can’t find a shrink but that’s another battle.

Again We in Canada must remember our neighbours to the South for whom quality Health Care is often unavailable or prohibitively expensive and Mental Health Services in particular, just build a new prison seems to be the solution and one we are sadly following.

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