Perceptions and attitudes toward risk and personal responsibility in the context of medical fitness to drive

Objective: Although there is a considerable body of literature probing the knowledge and awareness of doctors of guidelines on medical fitness to drive, little is known of knowledge and awareness of such guidelines among the general public. We investigated awareness, perceptions and attitudes among a range of adults toward risk and personal responsibility in the context of medical fitness to drive. Methods: This quasi-experimental between groups study assessed response differences between healthcare (33%) and non-healthcare professionals. Five hundred and fourteen adults (f = 342) completed a 15-item online survey, which assessed their license status, direct and secondhand experience with key medical conditions, perceptions of risk, driving intentions if advised to stop driving by a doctor and beliefs about responsibility for ensuring driver fitness. Results: Most of the participants had a driver license. Although the majority (87%) had no first-hand experience with key medical conditions contained in the Irish medical fitness to drive guidelines, two-thirds knew someone with at least one of these conditions. No participant admitted to an alcohol or drug misuse/dependence problem. Alcohol misuse/dependence and fatigue/chronic sleep loss were perceived as the greatest crash risk for drivers and for vulnerable road users. Risk perceptions in general public and the medical professionals were similar for most conditions but where they differed, the medical professionals perceived lower risk. Most respondents indicated that they would cease driving immediately if advised by their doctor for temporary and long-term conditions. No effects of age, gender, experience with medical conditions or professional status were noted on perceived intentions to cease driving. Perceptions about who is responsible for ensuring people are fit to drive fell into two categories. Drivers were perceived as chiefly responsible where alcohol, non-prescription drugs, fatigue and age were factors and doctors were identified as responsible in cases of diabetes, epilepsy, stroke, heart conditions and physical disabilities. Conclusions: These results suggest that more needs to be done to raise awareness of the risks posed by medical and other factors that reduce driver capability and also about drivers' responsibility to ensure that they are fit to drive and thus improve road safety.