The following is a report done by the Social Concerns
Committee of the Retired Teachers Association. In BC when a person reaches 80,
they are required to take a test to determine their ability to drive. This test
is done every two years and there is no standard fee for the test. As a result,
some seniors have paid over $300 for the test by the Doctor and some have paid
$50.00.
The Province's DriveABLE program tests drivers with a computer touch screen and has resulted in people having their drivers' licence cancelled. We believe recent efforts to improve the DriveABLE program's image and accessibility are simply wrongheaded.
The program
is not "misunderstood" – it is simply wrong: poorly conceived,
unsupported by current science, a violation of our charter rights and tainted
by conflict of interest. Improved access will only bring more harm.
BC Motor Vehicles Fitness to Drive
A member’s bitter experience led us to look into the
DriveABLE program. His wife's driving licence was revoked after failing a
computer-based test. We did some digging and "put out the word". Our
members and others are really angry. Rather than a scientific breakthrough in
public safety, we have a program based on out of date research. We have
privatized public policy developed by consultants, delegated to clerks and
computers and outsourced to independent contractors.
Recent Developments
On March 19, 2016 Shirley Bond, Minister of Justice and Attorney
General, announced changes to the DriveABLE program: "… a decision
regarding a person’s ability to continue driving will not be made solely from
an in-office computer assessment. People who fail the computer assessment will
be offered a DriveABLE road assessment. The results of the in-office assessment
combined with the on-road evaluation and medical information will ensure
licence decisions are made in the fairest manner possible. The Province will
pay for the cost of both assessments."
Our efforts, and those of others advocating for seniors
have had some impact. Drivers' licences will no longer be suspended "on
the spot" as a result of a screening test.
Are we there, yet? No.
We believe that efforts to improve the program's PR and
accessibility are simply wrongheaded. The program is not
"misunderstood" – it is wrong. It should be cancelled. Improving
access will only result in more people's lives being damaged.
Background
There are two programs under the Office of the
Superintendent of Motor Vehicles (OSMV) that affect seniors' driving: the 80+
medical assessment and DriveABLE.
•
After the age of 80, accident free or not,
drivers are required to get a doctor’s assessment of their medical fitness to
drive. While most receive a positive report, others may be referred for further
assessment. (DriveABLE)
•
Under the DriveABLE program, a report from the
police, health care provider or "concerned citizen" may result in
having to take a DriveABLE test. The purpose of the test is to assess cognitive
fitness.
The DriveABLE program is based on an out-of-date view of
the world. Twenty years ago, there was what amounts to a moral panic about
aging and driving; an apocalyptic vision of a "grey wave" of demented
"wrinklies" careening down the roads. It was not hard to convince
funding agencies and academic journals of the risks inherent in the rising tide
of demented drivers. Clever entrepreneurs have used fear, uncertainty and doubt
to promote their agenda and their products.
The real world, thank goodness, has not cooperated.
Seniors' accident and death rates have gone down, not up. Cooler heads have
prevailed in the academic world. Where mass screening of drivers for cognitive
fitness was sliced bread in the '90's, a respected voice in health care now
says:
…the
available literature fails to demonstrate the benefit of driver assessment for
either preserving transport mobility or reducing motor vehicle accidents."
adding their reasons:
the cognitive
test that most strongly predicted future crashes would … prevent six crashes
per 1000 people over 65 screened, but at the price of stopping the driving of
121 people who would not have had a crash.
Attitudes about senior drivers are changing but we still
have work to do. Too many conversations about aging drivers include words like
these:
"No
one wants unsafe drivers on the road"
thus justifying almost any level of heavy-handed
intervention into seniors' lives.
This is unhelpful. We will always need to strike a balance
between mobility and safety. The only way to have no unsafe drivers on the road
is to have no drivers or close the roads. Drawing neat little lines in the sand
isn't possible.
Our Continuing Concerns
•
The harm caused by the DriveABLE program far
outweighs the benefits. The program casts too wide a net, damaging people's
lives. We have seen little acknowledgement of the impact of driving cessation.
We need a balanced, thoughtful review of this program with community input. The
review must exclude those who have an institutional bias or business interest
in the outcome. • The driving record should be the "gold standard"
not the DriveABLE road test.
•
The over 80 medical exam should be discontinued.
In reviewing European experience, the UK Transport Research Laboratory stated: "There
is no evidence that any licence renewal procedure or requirement for a medical
examination has an effect on the overall road safety of drivers aged 65+"
•
Since the fatal crash rate for 70-74 year olds,
75 - 79 year olds and 80+ year olds is now less than that of 35-54 year olds
there is no justification for discriminating against seniors.
•
Retraining and remediation are absent from the
OSMV's program. The belief seems to be that cognitive impairment is incurable,
decline inevitable and remediation impossible. This doesn't square with modern
science. One cognitive factor which modern research has found to be strongly
predictive of crashes is the Useful Field of View - UFOV. Training is readily
available which remedies UFOV problems and would undoubtedly reduce risks and
promote independence. There are likely other remedial approaches. OSMV relies
solely on driving cessation.
•
Our doctors have been misled into believing
that they are liable for damages under case law if they don't report on those
they believe unfit to drive. A professional development document for BC doctors
cites a 1973 precedent that was overruled in 2003. A minor quibble, you say? Ask
your doctor how she feels about being misled and bullied into reporting. We
believe this program damages the doctor-patient relationship; patients becoming
guarded about disclosing information to doctors; doctors reluctant to bring up
the subject of driving. Medicine doesn't work on a "don't ask, don't
tell" basis. We support the Neurologists position; physicians should be
free to report or not report based on their assessment of the needs of the
individual, the family and the community.
•
If seniors must be screened and assessed, then
individual and community needs must be taken into consideration. We believe
that physicians - people we trust - should be the major players in the complex
decisions about driving restriction, retraining, remediation or cessation. We
need the "meaningful and trusted consultation" that only our doctors
can provide, not a heavy-handed approach with all of the decisions being made
by clerks, computers and contractors.
If you or anyone you know has lost a drivers' licence
through taking a DriveABLE test, you should write to:
Office of the Superintendent of Motor Vehicles
Attn: Driver Fitness Unit
PO Box 9254 STN PROV GOVT Victoria, BC V8W 9J2
and request a road test.
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