RETURN TO DRIVING AFTER TRAUMATIC BRAIN INJURY - Part II Guest Editors: Bruno Gradenigo, Anna Mazzucchi Free access

Europa Medicophysica 2002 March;38(1):19-24

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

Final certifications for car driving licence. Present and future of European regulation

Costanzo A.

From the Orthopaedics and Traumatology “La Sapienza” University, Rome Inter-Ministerial Technical Committee on Transportation-Health Medical Consultant of the Automobile Club of Italy

European reg­u­la­tions con­cern­ing ­the ­issue of driv­ing licenc­es fol­low 2 con­nect­ed prin­ci­ples: to guar­an­tee ­the ­free cir­cu­la­tion of cit­i­zens and to guar­an­tee traf­fic safe­ty. The ­first ­goal ­has ­been pur­sued, in ­the ­sphere of ­the “European Community driv­ing ­licence”, ­through ­full rec­og­ni­tion of ­the valid­ity of driv­ing licenc­es includ­ing ­those ­issued by dif­fer­ent mem­ber ­states, ­thus elim­i­nat­ing ­the ­need to con­vert ­the ­licence ­itself on trans­fer­ring res­i­dence to a dif­fer­ent EU ­state. The strin­gent ­need to in ­any ­case ­ensure traf­fic safe­ty ­has ­made it nec­es­sary—in ­order ­for recip­ro­cal rec­og­ni­tion to be accept­ed—to ­fix a min­i­mum ­basis of com­mon ­rules gov­ern­ing ­the ­issue ­and reten­tion of driv­ing licenc­es. The com­mon ­rules con­sid­er ­some ­basic ele­ments: ­age lim­its ­for ­each ­type of ­licence, phys­i­cal fit­ness to ­drive, theo­ret­i­cal ­and prac­ti­cal knowl­edge ­required to ­drive ­and capa­bil­ity of manoeu­vring ­the vehi­cle, in rela­tion to ­the ­type of ­licence ­applied ­for, ­these ­being sub­di­vid­ed ­into a pre­de­ter­mined ­and uni­form ­series of “class­es”. The com­mon ­basis of reg­u­la­tions con­sists of EC Directive 91/439 dat­ed 29th July 1991, ­which estab­lished ­the min­i­mum require­ments ­for ­the ­issue ­and reten­tion of a driv­ing ­licence. The con­tent of ­this Directive ­was fur­ther devel­oped by EC Directive 2000/56 dat­ed September 14th 2000, ­which ­must be imple­ment­ed by mem­ber ­states by ­the ­end of 2003. It ­should be not­ed ­that obtain­ing a driv­ing ­licence is sub­ject to ­the pos­ses­sion of min­i­mum require­ments in ­terms of psy­cho­phys­i­cal capa­bil­ity. Driving licenc­es ­may ­not be ­issued to per­sons affect­ed by phys­i­cal or men­tal dis­eas­es or organ­ic def­i­cit or men­tal, ana­tom­i­cal or func­tion­al hand­i­caps ­that pre­clude ­their capa­bil­ity to ­drive a vehi­cle in safe­ty. The Italian Highway Code ­and ­the Regulations ­that com­ple­ment it ­fix 2 lev­els ­for ascer­tain­ing psy­cho­phys­i­cal fit­ness to ­drive. This eval­u­a­tion ­may be car­ried ­out (Art. 119, Comma 2 of ­the Highway Code) by an indi­vid­u­al doc­tor. However, ­when ­this doc­tor ­must eval­u­ate par­tic­u­lar con­di­tions, list­ed in ­the reg­u­la­tions, or in ­the ­case of sub­jects ­above a spe­cif­ic ­age, or ­when spe­cif­ic labor­a­to­ry ­tests ­must be eval­u­at­ed, ­such eval­u­a­tion ­must be per­formed by a Medical Commission. With ­regard to psy­cho­phys­i­cal require­ments, ­the European reg­u­la­tions dis­tin­guish 2 “class­es” of driv­ing licenc­es, ­one of ­which ­has ­more strin­gent require­ments ­than ­the oth­er: Group 1, includ­ing licenc­es A, B, B+E ­and ­their sub­class­es; Group 2, includ­ing licenc­es C, C+E, D, D+E. These reg­u­la­tions do ­not ­take ­into ­account ­the spe­cif­ic modal­ities ­for eval­u­a­tion, ­but ­define ­the min­i­mum require­ments ­for ­the rel­e­vant param­e­ters: ­sight, hear­ing, loco­mo­tor ­system. They ­also ­define ­the admis­sibil­ity of dis­eas­es of ­the car­di­o­vas­cu­lar ­system, ­use of ­drugs or med­i­cines, alco­hol­ism, as ­well as ­the impor­tance of neu­ro-psy­chic dis­ease, kid­ney dis­eas­es ­and dia­betes. Medical exam­ina­tion is nei­ther implic­it ­nor oblig­a­to­ry, ­since eval­u­a­tion meth­ods ­may be deter­mined by indi­vid­u­al ­states; nev­er­the­less, eval­u­a­tion by a med­i­cal doc­tor is ­the cho­sen Italian meth­od, ­both ­for ­the ­initial ­issue of ­the ­licence ­and—­since driv­ing licenc­es ­are ­not val­id ­for an unlim­it­ed peri­od ­but ­have a dura­tion var­y­ing ­between 3 ­and 10 ­years—on ­the occa­sion of sub­se­quent renew­als. The require­ments in ­terms of tech­ni­cal capa­bil­ity to ­drive ­and ­the pro­ce­dures to eval­u­ate ­this ­were clear­ly ­defined in Directive 91/439. On ­the con­trary, eval­u­a­tion of psy­cho­phys­i­cal capa­bil­ity—­apart ­from require­ments in ­terms of ­sight—­are ­only ­defined in gen­er­al ­terms, del­e­gat­ing to ­the indi­vid­u­al ­states ­the meth­ods to be ­used, except­ing ­that a pre­ven­tive med­i­cal exam­ina­tion is ­required ­for driv­ing licenc­es in Group 2. Only ­with ­the sub­se­quent Directive 2000/56 ­was great­er pre­ci­sion ­reached ­with ­regard to cer­tain ­types of dis­abil­ity, at ­least estab­lish­ing uni­form “codes” ­with ­which to indi­cate ­the fit­ting ­required ­and ­the lim­its pre­scribed, ­even ­with ­regard to ­the ­times at ­which driv­ing is per­mit­ted (­night/­day) or to ­the ­area with­in ­which ­the sub­ject ­may ­drive or ­the max­i­mum ­speed. In ­any ­case, ­the modal­ities ­through ­which ­the spe­cif­ic lim­its ­and fit­tings ­are to be indi­cat­ed ­are ­the pre­rog­a­tive of indi­vid­u­al ­states, to be spec­i­fied at ­the ­time of “imple­men­ta­tion” ­the Directive.