Is your driving licence about to expire? Have you just gone through the form-filling to renew it? For most of us, the medical aspects of this will be confined to getting our eyes tested. For some, however, a fuller medical examination is required. So how do doctors decide if you are fit to drive?
The Department of the Environment and Local Government issues doctors and the public with guidelines as to how fitness is addressed, highlighting the illnesses that call for a full medical opinion before a licence is issued.
In general, there is a much higher standard for people who require a Group II licence, which encompasses heavier vehicles, such as trucks and buses.
People who obtained their first licence some years ago will have been entitled to drive vehicles in the CI category; they now have to meet more stringent standards to retain it.
The medical standards for Group II licences are much higher than those for Group I because of the size and weight of the vehicles and also because the drivers are likely to spend much longer periods driving.
For most of us who require a motorcycle or car licence, the more lenient Group I standards will apply.
Whatever category of licence you are applying for, medical conditions such as epilepsy, diabetes and heart disease are important.
Although absolute bans on driving are rare, they apply to certain people with epilepsy. At present, you must be seizure-free for a year in order to drive.
The guidelines used to be stricter, but they were relaxed in response to ongoing medical research.
If you have a history of epilepsy, however, and even if it is not currently a problem, you are not eligible for a Group II licence.
Diabetes guidelines have also been relaxed. If you wish to drive a family car, then a medical certificate from your GP will let you keep your licence. If you are taking insulin, however, and want a Group II licence, the assessment must be done by a specialist,
If you recently have had a heart attack, the general rule is that you should not drive for four to six weeks. The assessment is very much an individual one, however. If, on the other hand, you have unstable angina - chest pain at rest - then you are not fit to drive any vehicle.
According to Dr Annette Jennings, a Galway GP and tutor in continuing medical education at the Irish College of General Practitioners, patients sometimes expect that all they have to do is drop in a medical form for the doctor to sign. But doctors must be able to stand over their decisions, made after individual examinations and assessments of every patient.
"Patients are generally very understanding when doctors explain the difficulties which surround the issue of medical fitness to drive. However, your doctor has to adhere to guidelines set down by the Department of the Environment," she says.
Desmond O'Neill, who is professor of medical gerontology at Trinity College, Dublin, has a particular interest in the mobility of people in later life.
He is one of the authors of a recent OECD report on ageing and mobility, which makes a strong case for the assessment and rehabilitation of people with age-related disabilities that may interfere with their mobility.
"Older people are the safest group of drivers on the roads," he says. "Sometimes, they are too good at taking themselves off the roads when, in fact, they are still fit to drive."
International research confirms that older drivers have fewer crashes per capita. In addition, the mandatory age-based testing of older drivers appears ineffective, and it is probably time we moved towards an individually tailored assessment, regardless of age.
Drivers in the Republic can obtain a licence for a maximum of three years if they are over 70; those who are 80 or over can be licensed for only one year at a time.
The effect of drugs on driving is also an important issue. A doctor will take into account the type and dosage of psychoactive medication when assessing fitness to drive. Long-acting benzodiazepines could be a problem, as might older forms of antidepressants, especially in the elderly.
Judging someone's fitness to drive is a highly individual exercise. It probably helps to work with your doctor on this, and to see him as an advocate of your ability to drive rather than an agent of the Big Brother of central government.
E-mail Dr Muiris Houston, Medical Correspondent, at mhouston@irish-times.ie or leave a message at 01-6707711 ext 8511. He regrets he cannot reply to individual medical problems