Abu Dhabi: Doctors confirmed that a diagnosis of illness alone is not enough to determine lack of fitness to drive, explaining that the medical assessment should be based on the stability of the health condition and the efficiency of the driver's cognitive and motor functions, and the extent of his ability to drive safely, and not on the name of the disease or advanced age.
They stressed that having chronic diseases does not necessarily mean an absolute or permanent ban from driving, but rather requires an individual assessment that balances the patient's right to mobility and the safety of road users.
They explained that conditions such as epilepsy, strokes, dementia, severe sleep disorders, and the effects of certain medications may necessitate permitting driving under certain conditions and restrictions, or imposing a temporary or permanent ban, depending on the individual's condition and the established medical criteria. They emphasised that the physician's role is to assess and recommend, while the licensing authority makes the final decision, ensuring medical confidentiality, non-discrimination, and consideration of the impact on the livelihoods of professional drivers.
Disclosure of illness
Doctors warned that linking the disclosure of the disease to the automatic withdrawal of the licence may push patients to hide symptoms and avoid treatment, stressing that the success of the system is measured by the prevention of risks and the enhancement of trust, not by the number of licences withdrawn.
The new executive regulations of the Federal Traffic Law set controls for granting and renewing driving licences, and coordination procedures for monitoring health conditions affecting driving, with special provisions for people with disabilities.
Article 56 stipulates that proof of health fitness must be provided by a medical report approved by the competent health authorities in the country, and accepted by the licensing authority, proving the soundness of the body, eyesight, and mind, and the absence of diseases or disabilities that directly affect the ability to drive the vehicle safely, or impede this ability.
Fitness requirement
The article exempted persons with disabilities from the aforementioned fitness requirement, stipulating that the relevant provisions would apply to them. It also mandated that health authorities coordinate with the licensing authority to provide information on individuals suffering from illnesses that affect their ability to drive.
Furthermore, it authorised the licensing authority, after consulting with medical authorities, to propose additional examination criteria, subject to approval by the Federal Traffic Council. According to statistics from the Ministry of Interior, the country's roads have witnessed accidents in recent years related to drivers losing control of their vehicles due to chronic illnesses, extreme fatigue, or drowsiness.
Proactive prevention
Public health and community medicine specialist, Dr. Saif Darwish. Picture credit: SuppliedPublic health and community medicine specialist, Dr. Saif Darwish, confirmed that the new approach represents a shift from dealing with accidents after they occur to proactive prevention of health risks, including epilepsy, heart disorders, severe hypoglycaemia, and sleep disorders, which may cause loss of consciousness or impaired vehicle control.
He explained that having the disease does not necessarily mean being unfit to drive, as a patient who is committed to treatment and is in stable health is different from someone who is exposed to sudden attacks. The fitness requirements also differ between private vehicles, buses and trucks. He pointed out that this approach is applied in Britain, Australia and Canada, and that there are medical standards for assessing the eligibility of drivers in Dubai.
He pointed to questions that deserve clarification to ensure the success of the application, including identifying the diseases that warrant prohibition, adopting unified and updated standards, determining the authority of the unfitness report between the treating physician and the specialised committee, the limits of sharing medical information, and the mechanisms for objection, re-evaluation, and restoring the licence after improvement.
Medical confidentiality
He emphasised the importance of ensuring individual assessments and medical confidentiality, non-discrimination against those with chronic illnesses, the elderly, and people with disabilities, and consideration for the living conditions of professional drivers. He warned that the fear of automatic licence revocation might lead patients to conceal their symptoms and avoid doctors, thus increasing the risk to themselves and the community.
He affirmed that the goal is to guarantee the driver's health fitness, and that success is measured by the risks and accidents prevented, while simultaneously protecting patients' rights and enhancing their trust in the healthcare system.
Absolute prohibition
For his part, Dr. Suhail Abdullah Al-Rukn, a consultant neurologist and president of the Emirates Neurology Society, confirmed that there is no single list that constitutes an absolute prohibition on driving for all patients. The decision depends on the nature of the disease, its severity, stability, and its impact on the functions necessary for safe driving.
He explained that driving requires awareness, perception, attention, quick decision-making, eye-hand-foot coordination, and responsiveness to surprises, noting that the most prominent conditions affecting it include epilepsy, loss of consciousness, strokes, dementia, sleep disorders, neuromuscular diseases, some heart diseases, and metabolic disorders, such as severe hypoglycaemia.
Regarding epilepsy, he explained that it requires careful evaluation, especially if the seizures cause loss of consciousness, impaired perception, or involuntary movements, as the driver may lose control within seconds, threatening his safety, the passengers, and other road users.
Restoring eligibility
Dr. Suhail Abdullah Al-Rukn, consultant neurologist and president of the Emirates Neurology Society. Picture credit: SuppliedDr. Al-Rukn emphasised that a diagnosis does not necessarily mean permanent disqualification, as legal capacity can be restored after seizures are controlled for a suitable period, depending on their type, history, response to treatment, and the duration of seizure-free periods as defined by medical regulations. However, seizures occurring only during sleep, or focal seizures that do not affect consciousness, require a specialised evaluation that differs from seizures accompanied by loss of consciousness.
He stressed the importance of adhering to the treatment regimen and not stopping epilepsy medications or modifying their dosages without consulting a doctor, in order to avoid a recurrence of seizures and an increased risk of accidents.
Regarding strokes, he explained that they can affect movement, vision, balance, and cognition, causing weakness in the limbs, slowed reflexes, difficulty judging distances, blurred visual field, or neglect of one side of the body. While the motor effects may be minor, the ability to concentrate, make decisions, and process information may be impaired.
Neurological assessment
Dr. Al-Rukn emphasised that the ability to walk and move limbs is insufficient to establish driving fitness; a comprehensive neurological evaluation is necessary, and cognitive tests or a practical driving experience may be required.
He added that transient ischemic attacks (TIAs) necessitate immediate evaluation before resuming driving, especially if there is impaired consciousness, vision, or motor control.
Regarding dementia and Alzheimer's disease, he noted that concentration, remembering traffic rules, estimating distances and speeds, and decision-making are affected even before obvious motor problems appear. Some patients may be able to drive in the early stages, provided their memory, executive functions, attention, and judgment are assessed. However, in the middle and advanced stages, impaired perception, spatial orientation, and decision-making often render driving unsafe and may necessitate stopping the vehicle. He stressed the importance of relying on a comprehensive medical and functional assessment, not solely on age or diagnosis.
Sleep disorders
Dr. Al-Rukn explained that sleep disorders, especially obstructive sleep apnea, narcolepsy, and excessive daytime sleepiness, can cause short, involuntary sleep episodes during which the driver is unaware of losing attention for a few seconds. Sleep apnea can lead to fatigue, poor concentration, and slow response, despite the belief that one has gotten enough sleep.
The risk is higher for drivers of heavy vehicles and public transport due to their long driving hours and responsibilities. Diagnosis and treatment, such as the use of continuous positive airway pressure (CPAP) in appropriate cases, can improve alertness and reduce risks. He emphasised the importance of not continuing to drive when extremely drowsy or feeling the possibility of falling asleep.
Regarding Parkinson's and multiple sclerosis, he explained that the impact varies among patients. Parkinson's may cause slowness of movement, muscle stiffness, poor balance, and difficulty with rapid movements, and may affect perception and vision, while multiple sclerosis may cause weakness of the limbs, vision disturbances, extreme fatigue, and problems with motor coordination.
However, some patients may be able to drive safely if their symptoms have stabilised and do not affect basic functions, and in certain cases the vehicle can be adapted with special controls, after expert assessment and approval by the competent authorities.
He pointed out that some sedatives, sleeping pills, anti-anxiety medications, strong painkillers, and drugs that cause dizziness and drowsiness may impair alertness, concentration, and responsiveness, even without severe neurological diseases, and combining medications may increase these effects, especially in the elderly.
He stressed the need for the doctor to explain the effects of the medications and to adhere to his instructions, and not to drive while drowsy, dizzy, or with poor concentration. He also warned of the danger of alcohol, drugs, and psychoactive substances on vehicle control, and their subjection to clear legal provisions in the country.
Ageing
He stressed that ageing is not an illness or an automatic reason for prohibition. Older people with good abilities may drive safely, while younger people suffer from more impactful diseases. However, the chances of vision, hearing, memory, response, and motor control disorders increase with age, which necessitates focusing on actual functions and periodic checkups to detect changes early.
He explained that the doctor’s responsibility includes the medical history, assessment of consciousness, perception and movement, review of medications and necessary examinations, and may recommend temporary prohibition, reassessment after treatment, driving with restrictions, or referral to a specialised centre, while the licensing authority makes the final decision to issue, renew, or suspend the licence in accordance with the law.
He emphasised that medical assessment is a means of protecting lives, and that the driver's health is no less important than vehicle safety and adherence to traffic laws. He urged those experiencing loss of consciousness, excessive drowsiness, impaired perception, or reduced motor control to consult a specialist before continuing to drive, without automatically barring those with chronic illnesses from driving if they are able to drive safely.
He stressed the need to reach a system that takes into account medical development, is based on an objective scientific assessment, balances the patient’s independence and right to mobility with the responsibility of protecting lives, and grants the right to drive when health and functional eligibility are available, while putting the safety of society first.
Critical cases
Dr. Majed Sharab, family medicine specialist at Al Tadawi Specialty Hospital. Picture credit: SuppliedFor his part, Dr. Majed Sharab, a family medicine specialist at Al Tadawi Specialty Hospital, said that some cases require immediate stopping of driving, the most dangerous of which is a severe drop in blood sugar, due to its effect on thinking and causing confusion and loss of control. He advised measuring blood sugar before driving and keeping soft sweets inside the vehicle for quick intervention.
He added that sleep and breathing disorders during sleep cause daytime drowsiness that may lead to falling asleep while driving or while waiting at traffic lights, stressing the need to stop and refrain from driving when feeling an impending epileptic seizure or experiencing sudden vision problems.
Neurological and mental diseases
Dr. Sharab explained that sudden blurred vision, whether related to low blood sugar, epilepsy, a stroke, or a blood clot, necessitates immediate stopping. He also noted that neurological and mental illnesses, including Parkinson's disease, can affect hand stability on the steering wheel and vehicle control.
He emphasised that the fundamental rule is to stop the vehicle immediately if one experiences a decline in mental abilities below their usual level, or if they feel confused, distracted, or lose control.
Loss of health eligibility
Article 75 of the new executive regulations authorizes the licensing authority to suspend, cancel, or refuse to renew a driver's licence or driving permit if it is proven that the person lacks the necessary eligibility or health fitness to drive.
The relevant health authorities were obligated to coordinate with the licensing authority to provide it with data on people suffering from diseases or health conditions that affect their ability to drive a vehicle safely.
