“Can I drive, doctor?” LEAN thinking may help us answer the question

Abstract

The loss of a driving licence can have a devastating effect on an individual's domestic life and work. Driving is a complex composite function comprising a number of other complex composite functions, and it is difficult to predict driving ability just from the traditional neurological examination. We propose the acronym LEAN as an aide-memoire to help structure a suggested driving section in the routine neurological clerking, and to help unpack the concept of "fitness" to drive: Licence status, Eligibility (to drive), Ability (to drive) and Notification requirements (to the licensing authorities), now and in the future; cover most of the important issues and may help ensure that people get the best advice. If there are concerns about someone's driving ability, with or without vehicle adaptations, an assessment in a Disabled Drivers Assessment Unit is recommended.

Denying a Patient’s Final Will: Public Safety vs. Medical Confidentiality and Patient Autonomy

“…4,5 To support physicians confronted with this issue, an aide-m emoire with the acronym LEAN was proposed by Thomas and Hughes. 6 It relates to License status, Eligibility (to drive), Ability (to drive), and Notification (to the licensing authorities).…”

“…The most difficult part of this is the judgment of ''A,'' because driving ability is a complex function and difficult to predict from the traditional clinical examination. 6 Specifically, the clinical findings have to be judged in view of the underlying disease(s). For this, the UK Driving and Vehicle Licensing Agency provides thoroughly developed, disease-specific information concerning the assessment of driving ability, which is readily available online.…”

¿Puedo conducir un automóvil, doctor?: Evaluación para el manejo de automóviles en personas con discapacidad y su importancia en la rehabilitación

“…En Estados Unidos de Norteamérica y algunos países de Europa, como Inglaterra, se ha avanzado mucho en el último tiempo y se han creado entidades encargadas de clarificar las leyes para poder clasificar en forma eficiente a los pacientes y dejar menos cabida a la interpretación personal 8,[25][26][27] . En la realidad chilena hay que conocer la definición de discapacidad que se incluye en el Artículo N°3 de la Ley de Integración Social para Personas con Discapacidad 28 para tener claro cuáles pacientes se encuadran en ella.…”

Awake seizures after pure sleep-related epilepsy: a systematic review and implications for driving law

“…They are also charged with deciding if a patient is legally able to drive. In many cases, the answer may be apparent to their clinician after consulting the DVLA guide to medical rules, named ‘At a Glance.’11 Although on-road testing can assess fixed disabilities, paroxysmal disorders, such as seizures, are less well suited; the proscriptive DVLA regulations are therefore of greater importance for epilepsy 12. Medical advisory panels meet at intervals to discuss these regulations, and it is in support of this process that we have undertaken a systematic review of the literature.…”